False-positive reactivity of fourth-generation HIV enzyme immunoassay caused by COVID-19 and other infections.

Publication date: Jul 01, 2025

Diagnosis of acute human immunodeficiency virus (HIV) infection and rapid initiation of antiretroviral therapy (ART) are the cornerstones in HIV elimination. Fourth- and fifth-generation HIV enzyme immunoassays (EIAs) can detect patients with acute infection. However, HIV false-positive results can occur, requiring confirmatory nucleic acid amplification testing, which is expensive and may not be available. This review highlights reports on various infections and vaccines causing false-positive reactivity in fourth-generation HIV immunoassays. Despite the improvements in tests of HIV immunoassays, false-positive results may occur, which require continuous updates in testing algorithms to be used appropriately with newer assays. Many factors can result in false-positive HIV serological assays, such as COVID-19, several viral, bacterial or parasitic infections, and vaccines. Physicians should be aware of the causes of false-positive HIV reactions and include them in the clinical assessment of suspected cases and consider confirmatory testing.

Concepts Keywords
Bacterial COVID‐19
Covid ELISA
Fifth false‐positive
Hiv fourth‐generation
Therapy HIV

Semantics

Type Source Name
disease MESH COVID-19
disease MESH infections
disease IDO immunodeficiency
disease IDO infection
disease IDO acute infection
disease IDO nucleic acid
disease MESH parasitic infections
disease MESH causes

Original Article

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