False Positive HIV Report

I participated in a discussion on News 24 channel about a case with a false-positive HIV report on Tuesday night.

A so-called safai karamchari-turned-technician alleged that a Delhi-based medical laboratory had tested him ‘reactive’ for HIV and when he went for re-testing to another laboratory, the test was negative. The technician alleged that after seeing the report as HIV-reactive, his wife left him along with their child. He also alleged that he had undergone a lot of mental agony in his job as a result.

The response of the pathologist was that the said sample had been received from outside for HIV test and no lab technician had withdrawn the sample directly.  The sample, which was brought to them from outside, tested ‘reactive’ for HIV by a rapid test and two different ELISA tests. The pathologist lab ordered for a direct sample test from the patient that was then found to be negative.

The alleging technician got the test repeated at Dr. Lal’s Lab and again at Stars Diagnostics. Dr. Lal’s Lab did combo test (with antigen) and reported the result as non reactive. Stars diagnostics also reported a negative result. He had shown the reactive report in both labs.

The situation is clear. It’s a case of false-positive HIV report. As one can have a false-reactive HIV test, one should go for proper pre test counseling. As per NACO policy, no HIV test can be done without pre and post test counseling.

In this case, the gynecologist ordered the test for the couple as a routine protocol and never pre counseled the couple. The pathologist did the test and gave the report without pre and/or post counseling.  Also, the pathologist never wrote in the report that “HIV-reactive has to be interpreted clinically and may require further confirmatory test.”

1.              In ELISA test, three different company kits should be reactive before labeling them as reactive test.

2.              Even if you confirm Elisa by three tests, the report should always be written as ‘reactive’ and never as ‘positive’.  In a ‘reactive’ report, one should always write ‘post test counseling given and refer to the referring physician for further confirmatory tests and follow up tests as required.”

3.              Every HIV ‘reactive’ case in a low risk behavior should be taken with a pinch of salt. In this case the wife tested negative and the husband had no history of high risk behavior. One should have interpreted the ‘reactive’ test as “requires further confirmation by either antigen test or Weston Blot or HIV RNA Load test.”

4.              One should also not give a report as HIV ‘reactive’ without doing pre-confirmatory tests with three ELISAs. Even if one test is negative, one cannot label them as HIV ‘reactive’.

If not handled properly, such disputes may continue to occur and will further damage the already damaged image of the medical profession.