High positive HIV serology results can still be false positive

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dc.contributor.authorReid, Joannaen_ZA
dc.contributor.authorVan Zyl, Gerten_ZA
dc.contributor.authorLinstrom, Michaelen_ZA
dc.contributor.authorKorsman, Stephenen_ZA
dc.contributor.authorMarais, Gerten_ZA
dc.contributor.authorPreiser, Wolfgangen_ZA
dc.date.accessioned2021-11-09T12:49:35Z
dc.date.available2021-11-09T12:49:35Z
dc.date.issued2019
dc.descriptionCITATION: Reid, J., et al. 2020. High positive HIV serology results can still be false positive. ID Cases, 21:e00849, doi:10.1016/j.idcr.2020.e00849.
dc.descriptionThe original publication is available at https://www.sciencedirect.com
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund
dc.description.abstractENGLISH ABSTRACT: The consequences of falsely reactive HIV test results can be significant, for patients and healthcare providers. This case describes a diagnostic investigation of a patient with pronounced discordant HIV serological results, to determine HIV status. The fourth generation serological screening assay (Roche COBAS Elecsys HIV combiPT) had high positive results but confirmatory testing was negative (Abbott HIV Ag/Ab Combo). Five separate samples over 13 days were tested using multiple fourth generation HIV immunoassays and molecular tests for HIV-1 and HIV-2. Potential causes of falsely reactive serological results were investigated. Samples were sent to the manufacturer for analysis. The screening assay was positive on all samples with a very high signal to cut-off ratio (S/CO) of greater than 400. However, multiple serological and molecular assays did not detect HIV-1 or HIV-2 specific antibodies, antigen or nucleic acid. A recombinant immunochromatographic assay had faint reactivity to gp41 peptide and the manufacturer investigation reported cross-reactivity to one of the screening assay’s synthetic peptides. Possible causes of the false positive result include cross reactivity to other antigens, including prior schistosomiasis infection, or the patient’s previously excised ameloblastoma (a rare germ cell tumor of the jaw). This is a rare case of false high positive results on fourth-generation HIV serology testing due to high level non-specific reactivity to an isolated synthetic peptide component of the assay. It highlights the need for confirmatory testing even in settings with HIV high prevalence and awareness that false-positive serological results may have a high S/CO.en_ZA
dc.description.urihttps://www.sciencedirect.com/science/article/pii/S2214250920301578?via%3Dihub
dc.description.versionPublisher's version
dc.format.extent4 pagesen_ZA
dc.identifier.citationReid, J., et al. 2020. High positive HIV serology results can still be false positive. ID Cases, 21:e00849, doi:10.1016/j.idcr.2020.e00849
dc.identifier.issn2214-2509 (online)
dc.identifier.otherdoi:10.1016/j.idcr.2020.e00849
dc.identifier.urihttp://hdl.handle.net/10019.1/123409
dc.language.isoen_ZAen_ZA
dc.publisherElsevieren_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectHuman immunodeficiency virusen_ZA
dc.subjectSero-positive persons, HIV-en_ZA
dc.subjectHuman immunodeficiency virusesen_ZA
dc.subjectHIV -- Test resultsen_ZA
dc.subjectTest validityen_ZA
dc.titleHigh positive HIV serology results can still be false positiveen_ZA
dc.typeArticleen_ZA
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