At first glance, this case describes a relatively common finding in the clinical laboratory, namely a positive HIV screen followed by a negative HIV antibody differentiation immunoassay. As the authors describe, this pattern of results most often indicates either a false positive screen or early infection, in which the p24 antigen is detectable but anti-HIV antibodies are not. This case serves as a welcome reminder of a third possible explanation—seronegative HIV in patients with advanced disease. To distinguish between these 3 scenarios, the CDC recommends nucleic acid testing to conclusively establish the presence or absence of HIV RNA.

中文翻译：

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对最初解释不正确的真阴性 HIV 抗体结果的评论——HIV 筛查中的一个诊断难题

乍一看，这个案例描述了临床实验室中一个相对常见的发现，即 HIV 筛查呈阳性，随后 HIV 抗体分化免疫测定呈阴性。正如作者所描述的，这种结果模式通常表明筛查是假阳性或早期感染，其中 p24 抗原可检测到，但抗 HIV 抗体不可检测。这个案例很好地提醒了第三种可能的解释——晚期疾病患者的血清阴性 HIV。为了区分这 3 种情况，CDC 建议进行核酸检测以最终确定 HIV RNA 的存在与否。