A False-Positive Repeat HIV Test during Labor in Poorly Controlled Seropositive Rheumatoid Arthritis in a Rural Kenyan Hospital

Abstract: The Kenya Ministry of Health guidelines for HIV screening and testing recommend the use of facility-based point-of-care antibody-based rapid diagnostic tests. A positive HIV test is made using 3 consecutive reactive assays in a 3-test algorithm that ensures the maintenance of about 99% positive predictive value. However, false positive HIV tests have been reported in pregnancy, COVID-19, lymphomas, metastatic cancers, viral infections, and autoimmune diseases. Seropositive rheumatoid arthritis (RA) has been particularly associated with false positive HIV antibody tests due to a cross-reactivity of the autoantibodies to the rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) with the HIV-specific antigens. The result may lead to unnecessary treatment of patients with antiretroviral therapy (ARVs). In this study, we report the case of a 44-year-old Kenyan woman with poorly controlled seropositive RA in pregnancy whose repeat HIV test during labor was falsely positive, leading to her and her baby being inadvertently treated with ARVs. We point out the value of a cautious interpretation of a positive HIV test in this population, the need for confirmatory testing, and call for clear algorithms in managing false positive HIV tests in the Kenyan guidelines. Keywords: HIV testing, false positive HIV test, seropositive RA, RF-positive, anti-CCP, Kenya. Title: A False-Positive Repeat HIV Test during Labor in Poorly Controlled Seropositive Rheumatoid Arthritis in a Rural Kenyan Hospital Author: Onyango C. Vonwicks, Kibet Peter, Fryda C. William International Journal of Novel Research in Healthcare and Nursing ISSN 2394-7330 Vol. 12, Issue 3, September 2025 - December 2025 Page No: 61-64 Novelty Journals Website: www.noveltyjournals.com Published Date: 04-November-2025 DOI: https://doi.org/10.5281/zenodo.17521455 Paper Download Link (Source) https://www.noveltyjournals.com/upload/paper/A%20False-Positive%20Repeat%20HIV%20Test%20during-04112025-3.pdf