A serology conundrum – HIV infection in acute babesiosis infection could merely be a false positive result

Hindosh, Rand; Ernst, Emily; Kamau, James; Cardio, Steven

doi:10.47723/kcmj.v18i1.280

Cited by 1 publication

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“…However, there have been case studies that have reported that diseases such as schistosomiasis [ 8 ], chronic granulomatous disease [ 9 ], and even COVID-19 [ 10 ] have been associated with false-positive HIV test results. Few case reports have described false-positive HIV tests associated with acute babesiosis [ 2 , 11 ]. Previous authors have speculated that false positivity in HIV could be due to Babesia serology interacting with HIV serology testing.…”

Section: Discussionmentioning

confidence: 99%

Acute Babesiosis Causing a False-Positive HIV Result: An Unexpected Association

He,

Rezwan,

Arif

et al. 2023

Case Reports in Infectious Diseases

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Babesiosis is a tick-borne condition that causes hemolytic anemia and manifests with flu-like symptoms such as fevers, chills, fatigue, and anorexia. Very few case reports have documented babesiosis infection associated with a false-positive HIV test. In this case report, we add to the current literature by describing a patient admitted for treatment of babesiosis who had a preliminary positive HIV test on admission and a negative repeat HIV test after one week of treatment for babesiosis. A 60-year-old male with a past medical history of high cholesterol presented to the Emergency Department after having abnormal laboratory tests with his primary care doctor. He reported fever, fatigue, anorexia, and worsening jaundice for three weeks. He was hypotensive and febrile on admission. A blood smear showed Babesia species with 1-2% infected red blood cells. He was admitted to the intensive care unit and received treatment with plasmapheresis, atovaquone, and antibiotics. The fourth-generation HIV 1/2 antigen/antibody test was initially positive but after treatment, HIV testing was negative. A misdiagnosis of HIV can greatly impact a patient’s quality of life as antiretroviral therapy has multiple deleterious side effects. Clinicians must consider further evaluation of patients with acute babesiosis who also test positive for HIV.

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