False Reactive HIV Tests In AAS Use

[Michael Scally MD]

[OA] Repeated False Reactive ADVIA centaur® and bio-rad Geenius™ HIV Tests In A Patient Self-Administering Anabolic Steroids

Background: An individual is considered HIV positive when a confirmatory HIV-1/HIV-2 differentiation test returns positive following an initial reactive antigen/antibody combination screen.

Falsely reactive HIV screens have been reported in patients with various concomitant infectious and autoimmune conditions. Falsely positive confirmatory HIV differentiation assays are seen less frequently, but have been observed in cases of pregnancy, pulmonary embolism, and malaria.

Case presentation: A healthy 27 year-old man was referred after a reactive ADVIA Centaur® HIV Ag/Ab screen and positive Bio-Rad Geenius™ HIV 1/2 Confirmatory assay, suggesting HIV-1 infection. The patient's HIV viral load was undetectable prior to initiation of antiretroviral therapy, and remained undetectable on subsequent testing after initiation of antiretroviral therapy.

Both Centaur® and Geenius™ tests were repeated and returned reactive. As this patient was believed to be at low risk of acquiring HIV infection, samples were additionally run on Genscreen™ HIV-1 Ag assay and Fujirebio Inno-LIA™ HIV-1/2 score, with both returning non-reactive. For confirmation, the patient's proviral HIV DNA testing was negative, confirming the initial results as being falsely positive. The patient disclosed that he had been using a variety of anabolic steroids before and during the time of HIV testing.

Discussion and conclusions: The erroneous diagnosis of HIV can result in decreased quality of life and adverse effects of antiretroviral therapy if initiated, hence the importance of interpreting the results of HIV testing in the context of an individual patient. This reports suggests a potential association between the use of anabolic steroids and falsely-reactive HIV testing.

Tsybina P, Hennink M, Diener T, et al. Repeated false reactive ADVIA centaur® and bio-rad Geenius™ HIV tests in a patient self-administering anabolic steroids. BMC Infect Dis. 2020;20(1):9. Published 2020 Jan 6. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4722-8

 

[genixcon]

So I dont have AIDS?

 

[LeoTC]

Think I've actually had that issue in the past. Was in kind of a bad way and buried myself in alcohol and a lot of rando sex for almost a year.

Tested for everything on a monthly basis and the last one came back Pos. False positive, but scared the living shit out of me.

Always wondered what might've caused the initial test to produce a positive result.

 

[JMpMasterSteve]

So if it does show a false positive, especially for the military folk who get hiv tested regularly, there would more than likely be a further investigation of the cause. I assume. I didn’t see it say they identified the compounds the subject was using

 

[Old]

I didn’t see it say they identified the compounds the subject was using

"The patient revealed that he had been using a variety of oral and injectable supplements for bodybuilding beginning in July of 2017 under the supervision of his trainer, including testosterone, exemestane, and trenbolone enanthate"

 

[JMpMasterSteve]

"The patient revealed that he had been using a variety of oral and injectable supplements for bodybuilding beginning in July of 2017 under the supervision of his trainer, including testosterone, exemestane, and trenbolone enanthate"

Ah thanks brother I overlooked it

 

[JMpMasterSteve]

Still, according to that he spilled the beans rather than them identify the compound

 

[m314]

Could this happen with HTLV? I got a false positive result a few years ago when donating blood. The Red Cross told me at the time it was probably a false positive, and repeated tests afterwards showed I was negative.

 

[Old]

Still, according to that he spilled the beans rather than them identify the compound

He took HIV meds for over 4 months not knowing that AAS caused the false positive. He had gonorrhea so probably figured he had HIV.

When the doc interviewed him about other possibilities then he revealed AAS. Perhaps he didn't remember other than the 3 since half the guys "under the supervision of his trainer" don't know what they are taking.

Generally when one goes to a doctor and the doc says it is so and so, one doesn't start confessing the last 10 years of misbehaviour.

 

[Millard]

He took HIV meds for over 4 months not knowing that AAS caused the false positive.

The researchers have no idea if AAS caused the false positive:

"It is impossible to determine whether his use of anabolic steroids was of significance, although the timeline of events is at least suggestive of a plausible association."