Q and A

Question

Can COVID cause false-positive HIV test results?

31 December 2022. Related: All topics, Complications and coinfections, COVID-19, HIV testing.

I read online in the British Medical Journal that HIV has been misdiagnosed on people who have presented at A&E with fever and flu like symptoms. They tested positive for both Covid and HIV.

When their Covid PCR result eventually came back negative so did their HIV. How common is this and what is put in place to ensure those who take a HIV test whilst in an active Covid infection receive the correct diagnosis?

Answer

Answer: Simon Collins

Hi there

Thanks for highlighting this.

You are right that a few cases have been reported of people with COVID who have tested false positive for HIV. I have included links to the BMJ papers below.

The false positive HIV results were only on the initial antibody tests, becasue of the limitations of these tests.

Any positive result on these tests always needs to be confirmed by laboratory testing, either using ELIZA or PCR tests. In all these published cases, the confirmatory tests were negative. In practice, this would apply to the small percentage of people who can test false positive to HIV antigen tests.

It is still really important though for anyone hospitalised with COVID to know their HIV status, and to have an HIV test if they don’t know their recent HIV status.

This is because the overlapping symptoms of COVID and some advanced HIV complications can be misdiagnosed as one rather than the other. Different treatment and management is needed for each situation.

Unfortunately, there were cases of HIV symptoms being misdiagnosed as COVID which had very serious outcomes.

References
Tsang J et al. P22 Transitioning from PEP to PrEP- a case of false positive abbott determine early detect HIV rapid test after recent Covid infection. Sexually Transmitted Infections 2022;98:A35.
Cipitelli MDC et al. Letter to the editor: additional evidence to support a cross-reactivity of SARS-CoV-2 with HIV chemiluminescent assay. Journal of Clinical Pathology 2022;75:503-504.
Tan SS, Chew KL, Saw S, et al. J Clin Pathol Epub ahead of print: [please include Day Month Year]. doi:10.1136/jclinpath-2020-206942

2 comments

  1. Josh Peasegood •

    Hi Kelvin, when did you start PEP and when did these symptoms start? Have you noticed any other symptoms e.g., fever, sweats or diarrhoea?

  2. Kelvin •

    Why do I feel a lot of stomach upset and vomit blood after taking PEP