Can Testing Positive Prevent a Correct Diagnosis?

Dear Christine,

My brother just tested HIV positive. This happened while he was hospitalized with a sudden, severe illness. Just two weeks before though, he had tested HIV negative at a doctor who ran an extensive series of tests trying to figure out what was wrong. Even though my brother is not at risk for HIV and tested negative just a few weeks ago, all the doctors are now convinced he has AIDS.

I feel like everyone is too eager to say he has AIDS, like they’re so relieved to have an explanation for what happened that they may be overlooking the real reason for what’s going on. After coming home from the hospital, he’s been eating, gaining weight and feeling better even though he’s not taking any AIDS medication.

What do you think we should do?

Thanks,

Brian

Dear Brian,

I'm sorry to learn about the situation with your brother. I know how frightening it is to suddenly test positive, and how frustrating it can feel when the diagnosis makes little sense.

Some forms of illness that have nothing to do with HIV or AIDS produce antibodies that may cause positive reactions on HIV tests. Tests conducted on risk free individuals hospitalized with non-AIDS conditions show that the chances of testing positive increase for people who are ill and far exceed rates for the general population. Interestingly, these studies found that risk-free male patients hospitalized for non-AIDS illnesses were several times more likely to test positive than women in similar circumstances.

HIV antibody tests work by measuring a person’s antibody response to a series of proteins thought to represent various components of HIV. One problem with these tests is that none of the proteins they use are unique or specific to HIV. This means any number of health conditions ranging from incidental to serious can evoke positive responses. Viral load tests are often given in attempt to verify HIV infection although they are not able to detect or measure HIV either and are known to be skewed by a variety of illnesses and infections.

If I were you, I would encourage your brother to seek a second opinion from outside the hospital staff, preferably in consultation with a physician that would approach the situation with more objectivity. When an illness is written off to HIV, it prevents further investigation that could lead to a true cause of ill health—a situation that may put someone’s life in danger.

I know three different people here in Los Angeles whose symptoms were attributed to HIV when in fact they had appendicitis. In two cases, the appendix burst before the real cause of their problem was diagnosed, and one of these two almost died as a result. Another man I knew who tested HIV positive had his complaints of severe headaches blamed on HIV and his refusal to take AIDS drugs. After many weeks and much insistence that his doctor look further, a brain aneurysm was found but he died before making it to the operating table. In another case, someone’s thyroid problems were not noticed over preference to focusing on their HIV status causing years of needless suffering.

In this era of beleaguered health care systems, unreliable diagnostic technologies, understaffed and underfunded hospitals, skyrocketing rates of iatrogenic illness, medical mistakes, and busy doctors often biased toward their area of specialty, we all need to be our own health advocates and learn to evaluate, monitor and sometimes even direct our treatment to make sure we’re getting the kind of care we need and deserve.

I hope your brother will find his way to recovery.

Christine

HIV Antibody Test Certificate of Accuracy

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References

to Questioning The Test FAQ's - Are There Reliable HIV or AIDS Tests?

to T Cells and Viral Load