HIV and pregnancy: screening and management update

A case of false-positive test results in a pregnant woman of unknown HIV status at delivery

We report a case of a false-positive HIV result in an apparently healthy pregnant woman. Since no prenatal HIV testing had been performed, we screened for HIV reactivity utilizing the Architect HIV-Ag/Ab Combo assay. Results obtained were inconsistent in that they were repeatedly HIV reactive on a single serum sample while nonreactive on a plasma sample. However, both sample types were nonreactive on the Advia Centaur HIV-1/O/2 and Oraquick assays. For further confirmation, an HIV-1 Western blot and viral load were performed; blot results were indeterminate while the viral load was undetectable. We concluded that the repeatedly reactive serum serology results were false-positive. While the cause of this false reactivity is not clear, most likely fibrin microclots in the serum sample interfered with the assay and thus accounted for the false positivity. Plasma may thus provide a more appropriate sample type when using the Architect assay, especially when testing pregnant women.