Academy Exchange

Hello all!

We have a patient, 20 year old Black cis-male who is MSM, who has come to us for routine STI/HIV screening. For the past year, his HIV-1 antibody test only has returned positive. Upon confirmatory results, it is negative and considered a false positive result.

He has no significant past medical history and does not take PrEP.

Any ideas about why this keeps happening?

Thank you!

Evan Cottrill, PA-C

Hi Evan, 

That's so frustrating. I've had a few patients like this, but interestingly it seems like they fluctuate between a negative HIV screen and then a false-positive for a few tests and then back to negative. Are these tests rapid tests and if so, are you using a specific test each time (e.g., Alere Determine, or Insti, or other)? I'm curious if it's a specific product and maybe it's one with lower sensitivity? Any other things going on with this patient medically? Does he have an autoimmune disorder, have a history of a blood transfusion or gamma globulin, or anything else? These can cause false positives. He's fairly young so I suspect he's probably overall healthy with no medical complications, but I'm wondering if maybe one of those things are causing the false positive. Additionally, I've seen false positives after flu vaccination, but they don't stay positive over the course of a year...

Hello all!

We have a patient, 20 year old Black cis-male who is MSM, who has come to us for routine STI/HIV screening. For the past year, his HIV-1 antibody test only has returned positive. Upon confirmatory results, it is negative and considered a false positive result.

He has no significant past medical history and does not take PrEP.

Any ideas about why this keeps happening?

Thank you!

Evan Cottrill, PA-C

Thanks for your reply Dr. Floyd.

Our site uses the Bio-Plex 2000 array for our HIV testing. To my knowledge, he has no significant PMHx.

Hi Evan, 

That's so frustrating. I've had a few patients like this, but interestingly it seems like they fluctuate between a negative HIV screen and then a false-positive for a few tests and then back to negative. Are these tests rapid tests and if so, are you using a specific test each time (e.g., Alere Determine, or Insti, or other)? I'm curious if it's a specific product and maybe it's one with lower sensitivity? Any other things going on with this patient medically? Does he have an autoimmune disorder, have a history of a blood transfusion or gamma globulin, or anything else? These can cause false positives. He's fairly young so I suspect he's probably overall healthy with no medical complications, but I'm wondering if maybe one of those things are causing the false positive. Additionally, I've seen false positives after flu vaccination, but they don't stay positive over the course of a year...

Hello all!

We have a patient, 20 year old Black cis-male who is MSM, who has come to us for routine STI/HIV screening. For the past year, his HIV-1 antibody test only has returned positive. Upon confirmatory results, it is negative and considered a false positive result.

He has no significant past medical history and does not take PrEP.

Any ideas about why this keeps happening?

Thank you!

Evan Cottrill, PA-C

Thanks for your reply Dr. Floyd.

Our site uses the Bio-Plex 2000 array for our HIV testing. To my knowledge, he has no significant PMHx.

Hi Evan, 

That's so frustrating. I've had a few patients like this, but interestingly it seems like they fluctuate between a negative HIV screen and then a false-positive for a few tests and then back to negative. Are these tests rapid tests and if so, are you using a specific test each time (e.g., Alere Determine, or Insti, or other)? I'm curious if it's a specific product and maybe it's one with lower sensitivity? Any other things going on with this patient medically? Does he have an autoimmune disorder, have a history of a blood transfusion or gamma globulin, or anything else? These can cause false positives. He's fairly young so I suspect he's probably overall healthy with no medical complications, but I'm wondering if maybe one of those things are causing the false positive. Additionally, I've seen false positives after flu vaccination, but they don't stay positive over the course of a year...

Hello all!

We have a patient, 20 year old Black cis-male who is MSM, who has come to us for routine STI/HIV screening. For the past year, his HIV-1 antibody test only has returned positive. Upon confirmatory results, it is negative and considered a false positive result.

He has no significant past medical history and does not take PrEP.

Any ideas about why this keeps happening?

Thank you!

Evan Cottrill, PA-C

Hello all!

We have a patient, 20 year old Black cis-male who is MSM, who has come to us for routine STI/HIV screening. For the past year, his HIV-1 antibody test only has returned positive. Upon confirmatory results, it is negative and considered a false positive result.

He has no significant past medical history and does not take PrEP.

Any ideas about why this keeps happening?

Thank you!

Evan Cottrill, PA-C

Hello all!

We have a patient, 20 year old Black cis-male who is MSM, who has come to us for routine STI/HIV screening. For the past year, his HIV-1 antibody test only has returned positive. Upon confirmatory results, it is negative and considered a false positive result.

He has no significant past medical history and does not take PrEP.

Any ideas about why this keeps happening?

Thank you!

Evan Cottrill, PA-C