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University of Nebraska Medical Center

Acute COVID-19 Might Cause False-Positive HIV Screens

NEJM

In Michigan, COVID-19 brought a wave of erroneous HIV test results.

Serologic screening tests are fast and inexpensive, but their accuracy can be compromised by a range of unpredictable circumstances. Several years ago, Michigan physicians noted a surge in false-positive HIV screening tests, just as the COVID-19 epidemic also was surging. A retrospective chart review confirms their suspicion that the two trends were related.

Between March 2020 and January 2022, ≈32,000 patients at a single Detroit hospital were screened for HIV with state-of-the-art, fourth-generation antigen/antibody tests within 2 weeks of being tested for COVID-19. All told, 335 of these people screened positive for HIV. Among those with PCR-confirmed COVID-19, almost half of positive HIV screens (47%) proved to be false positives, with negative follow-up diagnostics. In contrast, 23% of positive screens among those without COVID-19 were false positives. No demographic variables accounted for the disparity nor did pregnancy or COVID-19 vaccination status.

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