Can a reactive HIV screening be false?

Question

Hello doctor,

I received a preliminary reactive HIV test result, followed by two confirmatory tests that were negative more than 30 days after my last sexual encounter. For reference, I am 34 years old, 5'3", and weigh 181 lbs.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

I know that getting a preliminary reactive human immunodeficiency virus (HIV) test result can be scary. But it is vital to remember that first screening tests can give false results. It is very reassuring that you had two negative confirmatory tests more than 30 days after your last sexual contact. This is especially true if those tests were a 4th-generation HIV Ag/Ab combo test or an HIV RNA (viral load) test, which are both very accurate by that time.

There may be certain metabolic aspects that alter your immune response a little bit because of your height and weight (5'3", 181 lbs, BMI - 32), but these do not usually change the accuracy of HIV tests. At this time, more testing is usually not needed unless there is continued high-risk exposure or symptoms that imply acute HIV infection.

A repeat 4th-generation test at six weeks or three months can be done if you want to be really sure. According to CDC recommendations, this test is definitive. In general, your results strongly suggest that you do not have HIV, which is good news.

I hope this answers your questions.

We appreciate your comments and use them to make patient care better.

Thanks.