BACKGROUND False-positive and false-negative results in human immunodeficiency virus (HIV) testing are expected at some frequency. False-positive results have been reported in association with various conditions, including pregnancy, autoimmune disease, and infection. We present an atypical case of a pregnant patient receiving false-positive HIV results for both screening and antibody confirmatory tests after a recent routine vaccination. CASE A 34-year-old woman, G4P1021, with a negative first-trimester HIV test result received a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) booster at 35 2/7 weeks of gestation. Test results at 36 2/7 weeks of gestation were positive in both HIV-1/2 antigen-antibody screening and a confirmatory HIV-1 antibody differentiation immunoassay, but follow-up test results at 36 5/7 weeks and later were negative. Repeat testing and erythrocyte typing confirmed that this was not a result of laboratory error or specimen mishandling. HIV antiretroviral therapy was started and was later discontinued. A scheduled primary cesarean delivery performed at 39 1/7 weeks of gestation due to breech presentation was uncomplicated. CONCLUSIONS False-positive results in HIV screen and confirmation testing were associated with receipt of a Tdap vaccine booster 7 days prior. This test result pattern is similar to that seen very rarely in previous cases, and the rapid seroreversion to negative suggests an acute immunologic trigger leading to a falsely reactive antibody. Clinicians should be aware of the potential for false-positive HIV test results in patients who recently received vaccination or with other immune triggers and retest at a short interval if suspected.

中文翻译：

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妊娠晚期 Tdap 加强疫苗接种后，人类免疫缺陷病毒 1 假阳性检测结果可快速血清逆转。


背景技术人类免疫缺陷病毒（HIV）检测中预计会出现一定频率的假阳性和假阴性结果。据报道，假阳性结果与多种疾病有关，包括怀孕、自身免疫性疾病和感染。我们介绍了一个非典型病例，一名怀孕患者在最近进行常规疫苗接种后，在筛查和抗体确认测试中均出现了假阳性艾滋病毒结果。病例 一名 34 岁女性 G4P1021，妊娠早期 HIV 检测结果呈阴性，在妊娠 35 2/7 周时接受了破伤风类毒素、减量白喉类毒素和无细胞百日咳 (Tdap) 加强针。妊娠 36 2/7 周时的 HIV-1/2 抗原抗体筛查和确认性 HIV-1 抗体分化免疫测定的检测结果均为阳性，但 36 5/7 周及以后的后续检测结果为阴性。重复检测和红细胞分型证实这不是实验室错误或标本处理不当的结果。开始了艾滋病毒抗逆转录病毒治疗，后来停止了。由于臀位，在妊娠 39 1/7 周时进行的初次剖腹产并不复杂。结论 HIV 筛查和确认检测中的假阳性结果与 7 天前接受 Tdap 疫苗加强剂有关。这种检测结果模式与之前病例中很少见的情况类似，血清快速恢复为阴性表明急性免疫触发导致抗体出现错误反应。临床医生应意识到最近接受疫苗接种或有其他免疫触发因素的患者可能出现艾滋病毒检测假阳性结果，如果怀疑，应在短时间内重新检测。