Justin Temple, MD; Rob Striker, MD, PhD; Amy Pease, APNP
WMJ. 2025;124(2):176-179
ABSTRACT
Introduction: More availability of HIV pre-exposure prophylaxis (PrEP) is needed to end the HIV epidemic, but this means more clinicians will encounter false positive HIV test results. These cases highlight such occurrences and the steps a clinician may take to determine the significance of such results.
Case Presentations: We present the case of a 68-year-old male who presented for routine follow-up for HIV PrEP and a 41-year-old transgender male who presented to establish care with a primary care clinician. On labs, both had repeatedly positive HIV antigen/antibody tests with undetectable viral loads.
Discussion: With increasing prescription of HIV PrEP comes a need for accurate interpretation of HIV serologies. HIV PrEP users may have altered stages of seroconversion. Additionally, heterophile antibody interference can lead to false positive or negative results.
Conclusions: The reader should gain an understanding of HIV testing, potential pitfalls, and next steps amidst unclear results.