A Case of False-Positive HIV Test in a Patient With Newly Diagnosed Hodgkin Lymphoma and Literature Review

Abstract

Hodgkin lymphoma (HL) is one of the non-acquired immunodeficiency syndrome (AIDS)-defining cancers (NADCs). HIV testing has become a part of routine testing in HL because of commonly anticipated association. Here we report an unusual case where the need for HIV screening in a newly diagnosed case of HL raised an ethical dilemma and a medical challenge due to false-positive HIV test results. In literature, pregnancy, autoimmune disorders, some viral infections, and the presence of hypergammopathy of hematologic malignancy have all been linked with false-positive HIV screening. The reactive results require additional testing with an HIV-1/HIV-2 antibody differentiation assay. The specimens show reactivity on the initial screening immunoassay, but negative or indeterminate antibody differentiation assay should undergo nucleic acid testing. Nevertheless, several instances of discordance between screening and confirmatory techniques have been described. It is speculated that this might be due to coincidental cross-reaction of subtypes of polyclonal gamma globulin with the HIV p24 antigen. In conclusion, this case signifies the understanding of the HIV testing algorithm and the use of reflex testing in the context of a positive HIV test before disclosing such preliminary results to patients and/or physicians.