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Autoimmune disorders delaying seroconversion (AUTOIMMUNE DISORDERS AND DELAYED SEROCONVERSION)

Feb 20, 2009

Dr. Bob,

You are the man! Can autoimmune disorders delay seroconversion of HIV? Should people with autoimmune disorders test beyond the 3 month window period? What types of autoimmune disorders could cause a false negative outside of the 3 month window period? Would you reccommend they test out to 6 months or maybe even 1 year?

Response from Dr. Frascino


This question comes up frequently for unclear reasons as it is not really a problem. See below and stop worrying, OK?

Dr. Bob


Hello Could you please tell me whether a negative Elisa test at 3 months is conclusive for someone who has lupus. I have read that having an autoimmune disease like lupus may cause a false positive or false negative result. What causes a false negative result? Would you reccommend another test at 6 months and is the Elisa test still suitable for someone with Lupus? Finally, will someone with lupus still produce hiv antibodies?

many thanks Patrick

Response from Dr. Frascino

Hello Patrick,

Yes, a negative HIV test (ELISA) is conclusive, even if the person getting tested has lupus. No additional testing would be warranted due to a concurrent lupus diagnosis. I am aware of only a single case in which a false-positive HIV test was attributed to autoantibodies in a patient with systemic lupus erythematosus and end-stage renal (kidney) disease. This was reported in 1993. Interestingly enough this patient ultimately turned out to actually be HIV positive, which was verified by positive cultures. (The follow-up report was published in J. Med in 1994.) I have also read two other reports of patients with autoantibodies possibly causing indeterminate results (false-positive ELISA and indeterminate Western Blots). Both of these patients were HIV negative by viral culture.

False-negative HIV test results are not caused by lupus or other autoimmune illnesses. False-positives can be caused by (1) testing in the window period, (2) agammaglobulinemia, or (3) technical or clerical error.

Dr. Bob

Ice Cream Man *Corrected*
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