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Commentary on a True Negative HIV Antibody Result with an Initially Incorrect Interpretation—A Diagnostic Conundrum in HIV Screening
Clinical Chemistry  (IF8.327),  Pub Date : 2021-10-01, DOI: 10.1093/clinchem/hvab118
Nerenz R.

At first glance, this case describes a relatively common finding in the clinical laboratory, namely a positive HIV screen followed by a negative HIV antibody differentiation immunoassay. As the authors describe, this pattern of results most often indicates either a false positive screen or early infection, in which the p24 antigen is detectable but anti-HIV antibodies are not. This case serves as a welcome reminder of a third possible explanation—seronegative HIV in patients with advanced disease. To distinguish between these 3 scenarios, the CDC recommends nucleic acid testing to conclusively establish the presence or absence of HIV RNA.