WMJ : official publication of the State Medical Society of Wisconsin · 2025
Interpretation of HIV Serologies in the Era of PrEP: Two Cases of False Positives.
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Temple Justin, Striker Rob, Pease Amy
Аннотация
INTRODUCTION: More availability of HIV pre-exposure prophylaxis (PrEP) is needed to end the HIV epidemic, but this means more clinicians will encounter false positive HIV test results. These cases highlight such occurrences and the steps a clinician may take to determine the significance of such results.
CASE PRESENTATION: We present the case of a 68-year-old male who presented for routine follow-up for HIV PrEP and a 41-year-old transgender male who presented to establish care with a primary care clinician. On labs, both had repeatedly positive HIV antigen/antibody tests with undetectable viral loads.
DISCUSSION: With increasing prescription of HIV PrEP comes a need for accurate interpretation of HIV serologies. HIV PrEP users may have altered stages of seroconversion. Additionally, heterophile antibody interference can lead to false positive or negative results.
CONCLUSIONS: The reader should gain an understanding of HIV testing, potential pitfalls, and next steps amidst unclear results.
CASE PRESENTATION: We present the case of a 68-year-old male who presented for routine follow-up for HIV PrEP and a 41-year-old transgender male who presented to establish care with a primary care clinician. On labs, both had repeatedly positive HIV antigen/antibody tests with undetectable viral loads.
DISCUSSION: With increasing prescription of HIV PrEP comes a need for accurate interpretation of HIV serologies. HIV PrEP users may have altered stages of seroconversion. Additionally, heterophile antibody interference can lead to false positive or negative results.
CONCLUSIONS: The reader should gain an understanding of HIV testing, potential pitfalls, and next steps amidst unclear results.