In developing countries both malaria and HIV can infect residents and travelers. Some rapid tests for HIV may give a false-positive reaction in a patient with malaria. It is important to perform appropriate confirmatory testing before making the diagnosis of HIV.
Patient selection: positive rapid test for HIV
Clinical features:
(1) evidence of malaria
(2) negative confirmatory tests for HIV-1 and HIV-2
(3) negative HIV testing in follow-up
Pathogenesis:
(1) cross-reactivity of antibodies to Pl falciparum with HIV1/HIV 2 (primarily in early generations of HIV tests)
(2) hypergammaglobulinemia, probably related to rheumatoid factor
(3) possibly human anti-animal antibodies (HAMA)
Other causes of a false positive HIV test:
(1) schistosomiasis
(2) recent vaccination
(3) SLE or other autoimmune disease
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