Nigerian HIV Positive Mother Tested Negative after Fifty-Four Months on HAART

Abstract

Background: There is currently no cure for HIV/AIDS infection. Antiretroviral treatment can suppress and delay AIDS-related illness for many years but cannot clear the virus completely. This case review includes an attempt to find explanation for the conversion of an HIV positive grand-multiparous woman to a negative status. Findings: The source of data was the patient's case file and review of relevant literature. A 38 year old HIV positive grand-multiparous female trader was diagnosed on 12/08/2010. She was placed on HAART for four years but was found to have tested HIV negative when the routine retroviral test was performed on 08/04/2014. Her last delivery was on 12/04/12 and she was placed on PMTCT regimen for that pregnancy. The baby's status was not documented. From 16/08/2010 to 06/03/2014, the patient's weight ranged between 52 kg to 66 kg. She was not screened for tuberculosis and viral load was not done. Initial CD4 count on 30/08/2014 was 357 cells/micro-liter while the value was 887 cells/micro-liter on the 24/02/2014. Other test results were essentially normal. Conclusions: Though a functional cure is a possibility here yet in resource limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie breaker algorithms can leave a false-positive result undetected for a long time. Beyond HIV screening, mandatory confirmatory tests are imperative before reporting HIV positive results. Weak positive results should not be recognized as valid except in the screening of blood donors.