A 42-year-old man with a history of rheumatoid arthritis has a routine HIV screening test performed as part of a yearly primary care visit. The initial HIV-1/2 antigen-antibody immunoassay is positive, but a follow-up HIV-1/HIV-2 differentiation assay is negative for HIV-1 and HIV-2. In addition, an HIV-1 RNA assay is negative. He has no symptoms and has not had sex with anyone for at least 3 months. He recently had COVID-19 infection and was sick for about 5 days. Repeat HIV testing is repeated 2 weeks later, yielding exactly the same results.
What is the most likely explanation for these test results?
Figure 1. CDC and APHL Recommended Laboratory Testing Algorithm for the Diagnosis of HIV Infection
Source: 1) Centers for Disease Control and Prevention and Association of Public Health Laboratories. Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations. Published June 27, 2014.
(2) Centers for Disease Control and Prevention and Association of Public Health Laboratories. 2018 Quick reference guide: Recommended laboratory HIV testing algorithm for serum or plasma specimens. Published January 27, 2018.
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Question Last Updated
February 1st, 2025
February 1st, 2025
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