A “false-positive” HIV test?

HIV ◽  
2020 ◽  
pp. 37-44
Author(s):  
Michael J. Peluso ◽  
Timothy J. Henrich
Keyword(s):  
Hiv Infection ◽  
Clinical Outcomes ◽  
Clinical Setting ◽  
False Positive ◽  
Clinical Spectrum ◽  
Hiv Test ◽  
Management Challenge

Individuals capable of naturally controlling HIV infection in the absence of ART represent both a diagnostic and a management challenge for the treating clinician. In this chapter, we review what is known about the epidemiology, biology, and clinical outcomes of individuals across the clinical spectrum of natural HIV control and provide suggestions for the management of such individuals in a clinical setting.

scholarly journals False-positive fourth-generation HIV test associated with autoimmune hemolytic anemia. Case report

Case reports ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. 132-138
Author(s):  
Santiago Sánchez-Pardo ◽  
Jaime Andrés Osorio-Ramírez ◽  
Isabela Choi-Park ◽  
Daniel Felipe Rojas-Holguín ◽  
Adrián Bolívar-Mejía
Keyword(s):  
Hiv Infection ◽  
Hemolytic Anemia ◽  
Lupus Erythematosus ◽  
Autoimmune Hemolytic Anemia ◽  
False Positive ◽  
Screening Tests ◽  
Fourth Generation ◽  
Hiv Screening ◽  
Hiv Test ◽  
Positive Results

Introduction: The fourth-generation ELISA human immunodeficiency virus (HIV) screening test has a high sensitivity and specificity >99% to detect both antigens and antibodies. Estimates are that only 0.5% yield false positive results.Case description: 61-year-old female patient with a clinical picture consisting of malaise, unquantified fever, asthenia and adynamia. Laboratory tests revealed anemia, so a Coombs test was performed, obtaining a positive result along with other findings of mixed autoimmune hemolytic anemia. Two fourth-generation ELISA HIV screening tests were performed obtaining positive results. Given the national recommendations on the diagnosis of HIV infection, a viral load was performed, which turned out to be negative, so the result was considered a false positive.Discussion: Clinical and biological factors are related to false positive results. There are descriptions about autoimmunity phenomena, such as systemic lupus erythematosus or autoimmune hemolytic anemia, with few cases in older adults.Conclusions: Rapid tests have changed the diagnosis of HIV infection worldwide; however, like any other diagnostic test, they may yield false positive results with differential diagnoses, including autoimmune hemolytic anemia.

Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records

2017 ◽  
Vol 94 (3) ◽  
pp. 194-199 ◽  
Author(s):  
James Blain Johnston ◽  
Joss N Reimer ◽  
John L Wylie ◽  
Jared Bullard
Keyword(s):  
Viral Load ◽  
Hiv Testing ◽  
Clinical Outcomes ◽  
Point Of Care ◽  
Age Groups ◽  
Linkage To Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Viral Load Suppression ◽  
Hiv Test

ObjectivesHIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.MethodsA retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.Results3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.ConclusionsPOCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.MeSH termsHIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.

scholarly journals Do I Have HIV or Not? Lack of RNA Detection and the Case for Sensitive DNA Testing

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Sandra A Springer ◽  
Silvina Masciotra ◽  
Jeffrey A Johnson ◽  
Sheldon Campbell
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Viral Rna ◽  
Infection Status ◽  
Test Results ◽  
Dna Testing ◽  
Rna Detection ◽  
Hiv Test

Abstract We present a case of a 20-year-old male who had ambiguous HIV test results after entering new provider care and whose status was later complicated by undetectable viral RNA off antiretroviral therapy (ART). Verifying HIV infection status may occasionally require sensitive DNA testing that might need to be considered in diagnostic guidelines to resolve diagnosis and ensure appropriate ART management.

Clinical outcomes of a false positive antenatal diagnosis of placenta accreta spectrum

2021 ◽  
Author(s):  
Bahram Salmanian ◽  
Amir A. Shamshirsaz ◽  
Karin Fox ◽  
nazlisadat meshinchi asl ◽  
Hadi Erfani ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Resource Utilization ◽  
False Positive ◽  
Maternal Morbidity ◽  
Placenta Accreta ◽  
Antenatal Diagnosis ◽  
Estimated Blood Loss ◽  
Management Protocol ◽  
Significant Difference ◽  
Placenta Accreta Spectrum

Objective: Antenatal diagnosis of placenta accreta spectrum (PAS) is critical to reduce maternal morbidity. While clinical outcomes of women with PAS have been extensively described, little information is available regarding the women who undergo cesarean delivery with a presumptive PAS diagnosis which is not confirmed by histopathologic examination. We sought to examine resource utilization and clinical outcomes of this group of women with a false-positive diagnosis of PAS. Study design: Retrospective analysis of patients with prenatally diagnosed PAS cared for between 2015 and 2020 by our multidisciplinary PAS team. Maternal outcomes were examined. Univariate analysis was performed and a multivariate model was employed to compare outcomes between women with and without histopathologically confirmed PAS. Results: A total of 162 patients delivered with the pre-operative diagnosis of PAS. Of these, 146 (90%) underwent hysterectomy and had histopathologic confirmation of PAS. Thirteen women did not undergo the planned hysterectomy. Three women underwent hysterectomy but pathologic examination did not confirm PAS. In comparing women with and without pathologic confirmation of PAS, the false positive PAS group delivered later in pregnancy (34 vs. 33 weeks of gestation, P=0.015) and had more planned surgery (88% vs. 47%, P = 0.002). There was no difference in skin incision type or hysterotomy placement for delivery. No significant difference in either the estimated blood loss or blood components transfused was noted between groups. Conclusion: Careful intraoperative evaluation of women with pre-operatively presumed PAS resulted in a 3/149 (2%) retrospectively unnecessary hysterectomy. Management of women with PAS in experienced centers benefits patients both in terms of resource utilization and avoidance of unnecessary maternal morbidity, understanding that our results are produced in a center of excellence for PAS. We also propose a management protocol to assist in the avoidance of unnecessary hysterectomy in women with the pre-operative diagnosis of PAS.

scholarly journals Potential for false positive HIV test results with the serial rapid HIV testing algorithm

2012 ◽  
Vol 5 (1) ◽  
Author(s):  
Steven Baveewo ◽  
Moses R Kamya ◽  
Harriet Mayanja-Kizza ◽  
Robin Fatch ◽  
David R Bangsberg ◽  
...  
Keyword(s):  
Hiv Testing ◽  
False Positive ◽  
Test Results ◽  
Rapid Hiv Testing ◽  
Hiv Test ◽  
Testing Algorithm

scholarly journals Predictors Of Provider-Initiated Hiv Testing In Heterosexuals At Increased Risk Of Hiv (Het) In Puerto Rico: Data From Nhbs-Het Cycle 2016

2020 ◽  
Author(s):  
Maureen Marie Canario de la Torre ◽  
Ivony Yireth Agudelo Salas ◽  
Sandra Miranda de León ◽  
Yadira Rolón Colón ◽  
María Pabón Martínez ◽  
...  
Keyword(s):  
Sexual Behavior ◽  
Puerto Rico ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Perceived Risk ◽  
Healthcare Providers ◽  
World Health ◽  
Healthcare Settings ◽  
Hiv Test ◽  
Increased Risk

Abstract The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have established guidelines for HIV testing in healthcare settings. The aim of this study was to identify the sociodemographic, healthcare, and sexual-behavior predictors of provider-initiated HIV testing (PIHT) using data from the Puerto Rico National HIV Behavioral Surveillance (PR-NHBS) 2016 cycle directed towards heterosexuals at increased risk of HIV infection (HET). A total sample of 531 eligible participants were recruited through respondent-driven sampling (RDS). Logistic regression models assessed the associations between sociodemographic, healthcare, and sexual-behavior predictors, whilst adjusting for sex and age. The majority of the participants were women (66.1%), with 72.7% reporting having received healthcare services in the past year. Of them, 18.7% had received an HIV-test offer from their healthcare providers. More than half of the participants (65.2%) reported a low perceived risk of getting infected with HIV in the next 12 months. Results suggest an overall low prevalence of PIHT among HET in PR who exhibited a relatively high prevalence of low perceived risk of HIV infection. Furthermore, the assessed predictors show that individuals who engaged in high-risk sexual behaviors (AOR = 0.52; 95% CI: 0.30–0.90) were less likely to receive HIV-test offers from their providers. This study further emphasizes the need for healthcare providers to follow recommended guidelines for HIV testing in healthcare settings as a means of establishing preventive measures to further counteract the HIV epidemic in Puerto Rico, specifically among HET.

Low Rate of False-Positive Results with Use of A Rapid HIV Test

2002 ◽  
Vol 23 (6) ◽  
pp. 335-337 ◽  
Author(s):  
Cassandra D. Salgado ◽  
Heidi L. Flanagan ◽  
Doris M. Haverstick ◽  
Barry M. Farr
Keyword(s):  
Enzyme Immunoassay ◽  
False Positive ◽  
Diagnostic System ◽  
Rapid Test ◽  
Occupational Exposures ◽  
High Rate ◽  
Negative Results ◽  
Hiv Test ◽  
Rapid Hiv Test ◽  
Positive Results

Background:Occupational exposure to human immunodeficiency virus (HIV) is an important threat to healthcare workers. Centers for Disease Control and Prevention guidelines recommend prompt institution of prophylaxis. This requires (1) immediate prophylaxis after exposure, pending test results that may take more than 24 hours in many hospitals; or (2) performance of a rapid test. The Single Use Diagnostic System (SUDS)® HIV-1 Test is used to screen rapidly for antibodies to HIV type 1 in plasma or serum, with a reported sensitivity of more than 99.9%. We used this test from January 1999 until September 2000, when it was withdrawn from the market following reports claiming a high rate of false-positive results.Methods:We reviewed the results of postexposure HIV testing during 21 months.Results:A total of 884 SUDS tests were performed on source patients after occupational exposures (883 negative results, 1 reactive result). The results of repeat SUDS testing on the reactive specimen were also reactive, but the results of enzyme immunoassay and Western blot testing were negative. A new specimen from the same patient showed a negative result on SUDS testing. This suggested a specificity of 99.9%. In the 4 months after SUDS testing was suspended, there was 1 false-positive result on enzyme immunoassay for 1 of 132 source patients (presumed specificity, 99.2%).Conclusion:Use of the SUDS test facilitated rapid and accurate evaluation of source specimens, obviating unnecessary prophylaxis.

The Continuous Surveillance of InSTI resistance could be an important Public Health Tool in the Fight against HIV Infection

2021 ◽  
Vol 19 ◽  
Author(s):  
Giuseppa Visalli ◽  
Alessio Facciolà ◽  
Maria Giovanna Costanzo ◽  
Angela Di Pietro
Keyword(s):  
Drug Resistance ◽  
Hiv Infection ◽  
Hiv Treatment ◽  
Large Cohort ◽  
University Hospital ◽  
Hiv Positive ◽  
Percentage Increase ◽  
Resistance Mutations ◽  
Hiv Test ◽  
Resistance Tests

Aims: To evaluate the frequency of the InSTIs mutations in a large cohort of HIV-infected people. Background: The Highly Active Anti-Retroviral Therapy (HAART) allow turning HIV infection from a fatal disease to a chronic infection and Integrase Strand Transfer Inhibitors (InSTIs) represent the cornerstone of this treatment. However, the spread of HIV-1 drug resistance mutations represents an emerging threat to the long-term success of HIV treatment programs. Objectives: To evaluate the trend of the HIV drug resistance to InSTIs in a large cohort of HIV-positive people in order to assess the risk represented by these subjects in the spread of the HIV infection to the community. Methods: A cross-sectional study was conducted analysing all the InSTIs resistance tests performed in HIV positive subjects in the period 2017-2019 by the HIV Laboratory of the University Hospital "Gaetano Martino" of Messina, Italy. Results: In 2017-2019, 252 InSTIs resistance tests were performed of which 59 (23.4%), 88 (34.9%) and 105 (41.7%) respectively in the three considered years. Overall, 28 (11.1%) samples showed resistance to at least one of the four InSTIs. We observed a significant percentage increase of 95% about the resistance to all the four drugs. Conclusion: Because the InSTI resistance is not rare, a continuous surveillance can represent nowadays, together with an incessant health education and a wide offer of the HIV test, the most important tool in the fight against HIV infection.

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