Journal article
Navigating false positive HIV test results: a case report
ASM Case Reports, Vol.1(3), e00097-24
05/06/2025
DOI: 10.1128/asmcr.00097-24
PMCID: PMC12530234
PMID: 41246379
Abstract
Background
All Food and Drug Administration-approved laboratory-based human immunodeficiency virus (HIV) screening tests have high sensitivity and specificity. There is an HIV diagnostic test algorithm recommended by the Centers for Disease Control and Prevention (CDC) and Association of Public Health Laboratories (APHL) in the United States. Still, diagnostic challenges can occur in real-world practice. We describe an unusual case that exhibited false positive results for HIV screening and confirmation testing.
Case Summary
A 27-year-old cisgender female had HIV testing as part of antenatal care. Her local HIV-1/2 antigen/antibody (Ag/Ab) screening test was reactive, and the HIV Ab differentiation assay was positive for HIV-1. Using CDC and APHL algorithm guidelines, she was diagnosed with HIV-1 infection. However, her HIV-1 ribonucleic acid (RNA) quantitative polymerase chain reaction was undetected. Although she immigrated from an HIV-1 high prevalence region, she was otherwise at low risk for HIV transmission. Qualitative HIV-1 deoxyribonucleic acid/RNA was undetected, and HIV-1 Western blot analysis was only positive for HIV-1 gp160 reactivity, confirming that her initial testing represented a false positive and that she did not have HIV infection. The rest of her pregnancy and delivery course was uneventful.
Conclusion
Our case highlights the limitations of current HIV diagnostic tests and challenges in interpretation. Clinicians should be aware that false-positive tests are rare and be reminded to consider the pre-test probability when interpreting results.
Details
- Title: Subtitle
- Navigating false positive HIV test results: a case report
- Creators
- Q. Kaewpoowat - University of IowaL. Stulken - University of IowaM. D. Krasowski - University of Iowa, PathologyB. Ford - University of Iowa, PathologyJ. T. Stapleton - University of Iowa
- Resource Type
- Journal article
- Publication Details
- ASM Case Reports, Vol.1(3), e00097-24
- DOI
- 10.1128/asmcr.00097-24
- PMID
- 41246379
- PMCID
- PMC12530234
- NLM abbreviation
- ASM Case Rep
- ISSN
- 2996-2684
- eISSN
- 2996-2684
- Language
- English
- Electronic publication date
- 03/25/2025
- Date published
- 05/06/2025
- Academic Unit
- Microbiology and Immunology; Infectious Diseases; Pathology; Internal Medicine
- Record Identifier
- 9984802408102771
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