False reactive HIV-1 diagnostic test results in an individual from Kenya on multiple testing platforms-A case report
Jew Ochola,
Michelle Imbach,
Leigh Anne Eller,
Mark de Souza,
Chiaka Nwoga,
June Doryne Otieno,
Lucas Otieno,
Eric Rono,
Edwin Kamau,
Trevor A. Crowell,
John Kevin Owuoth,
Christina S. Polyak,
Valentine Sing’oei
Affiliations
Jew Ochola
HJF Medical Research International, Kisumu, Kenya; U.S. Army Medical Research Directorate – Africa, Kisumu, Kenya
Michelle Imbach
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
Leigh Anne Eller
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
Mark de Souza
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
Chiaka Nwoga
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
June Doryne Otieno
U.S. Army Medical Research Directorate – Africa, Kisumu, Kenya; Kenya Medical Research Institute, Kisumu, Kenya
Lucas Otieno
U.S. Army Medical Research Directorate – Africa, Kisumu, Kenya; Kenya Medical Research Institute, Kisumu, Kenya
Eric Rono
U.S. Army Medical Research Directorate – Africa, Kisumu, Kenya; Kenya Medical Research Institute, Kisumu, Kenya
Edwin Kamau
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
Trevor A. Crowell
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
John Kevin Owuoth
HJF Medical Research International, Kisumu, Kenya; U.S. Army Medical Research Directorate – Africa, Kisumu, Kenya
Christina S. Polyak
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
Valentine Sing’oei
HJF Medical Research International, Kisumu, Kenya; U.S. Army Medical Research Directorate – Africa, Kisumu, Kenya; Corresponding author at: HJF Medical Research International, Kisumu, Kenya.
Background: Rapid diagnostic tests (RDT) are routinely used in screening for HIV infection. More complex diagnostic algorithms incorporating fourth-generation screening and confirmatory HIV-1/HIV-2 differentiation immunoassays (IA) may be used to confirm HIV infection. Co-infections and autoimmune diseases may lead to falsely reactive HIV diagnostic test results. Case presentation: A Kenyan man with asymptomatic schistosomiasis and low risk factors for HIV infection demonstrated an inconsistent and discordant pattern of reactivity on HIV RDT, repeated reactivity on fourth-generation IA and positive at a single time-point for HIV-1 on the Geenius HIV1/HIV2 confirmatory assay during the course of a prospective cohort study with HIV repeat testing. The individual initiated antiretroviral therapy following HIV diagnosis. However, his bi-annual behavioral questionnaire suggested low-risk factors for infection. Supplementary confirmatory serologic and nucleic acid tests were performed and gave discordant results. The participant was determined to be HIV uninfected using cell-associated HIV-1 DNA/RNA testing and antiretroviral therapy was discontinued. Discussion and conclusions: Sole reliance on diagnostic test results may result in misdiagnosis of HIV infection, social harm and potential antiretroviral induced drug toxicity. Interpretation of HIV test results should incorporate multiple parameters.
