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Eleftherios Mylonakis, MD; Maria Paliou, MD; Thomas C. Greenbough, MD; Timothy P. Flaningan, MD; Norman L. Letvin, MD; Josiah D. Rich, MD, MPH

Arch Intern Med. 2000;160:2386-2388.

Considering the lifelong implications of a positive human immunodeficiency virus (HIV) test result, physicians should be aware of the limitations of tests for HIV. A 43-year-old man had a reactive enzyme-linked immunosorbent assay and an indeterminate result on Western blot analysis. The results of subsequent enzyme-linked immunosorbent assay and Western blot tests were interpreted as positive, and the patient was informed that he had HIV infection. Persistently undetectable plasma HIV-1 RNA, combined with normal physical examination findings, CD4⁺ cell count, and CD4/CD8 ratio, prompted further testing, which revealed that the patient was not infected with HIV. False-positive HIV test results are uncommon, but they can occur. In the appropriate clinical setting, follow-up and the use of other laboratory tests, such as determination of plasma viral load, may help identify such cases.

From the Infectious Disease Division, Massachusetts General and Brigham and Women's Hospitals (Dr Mylonakis), and the Department of Medicine, Beth Israel Deaconess Medical Center (Dr Letvin), Harvard Medical School, Boston; the Department of Medicine, Division of Clinical Immunology, The Miriam Hospital, Brown University School of Medicine, Providence, RI (Drs Mylonakis, Paliou, Flaningan, and Rich); and the Program in Molecular Medicine, Department of Pediatrics, University of Massachusetts Medical School, Worcester (Dr Greenbough).

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