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Clinical Observation |

Two "HIV-Infected" Persons Not Really Infected

Robert W. Wood, MD; Carol Dunphy, ARNP, MN; Keith Okita, BA; Paul Swenson, PhD
Arch Intern Med. 2003;163(15):1857-1859. doi:10.1001/archinte.163.15.1857.
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The Centers for Disease Control and Prevention's1 5-year strategic plan for human immunodeficiency virus (HIV) prevention seeks to reduce the proportion of persons who are unaware of their HIV infection from the currently estimated level of 25% to 5%. Achieving this goal will require testing of increased numbers of persons, and the Centers for Disease Control and Prevention states that "providers in all settings . . . should ideally recommend [HIV counseling, testing, and referral (CTR)] to all clients on a routine basis to ensure that all clients who could benefit from CTR receive these services."2(p7) Even with tests as accurate (>99% sensitive and >99% specific)3 as the current third-generation HIV enzyme-linked immunosorbent assay (ELISA) coupled with Western blot or other confirmatory tests, an increasing number of false-positive results may be anticipated when large numbers of persons at low risk are tested. Cases of false-positive HIV test results have been reported.4 Public Health–Seattle & King County recently encountered 2 patients with false-positive HIV serologic test results, each of whom experienced serious psychological consequences. We describe 2 recent false-positive cases.

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