Causes of False Positive HIV Serology

Primary Causes

The Centers for Disease Control and Prevention recommends that specimen-handling errors, laboratory errors, and failure to follow the recommended testing algorithm are the most common causes of incorrect HIV test results, particularly in low-prevalence populations 1, 2, 3
The Centers for Disease Control and Prevention notes that mislabeled samples must always be considered, especially for patients with no identifiable HIV risk factors 1, 2
Nonspecific reactions producing indeterminate or false-positive results occur more frequently among pregnant or parous women than other low-prevalence populations, according to the Centers for Disease Control and Prevention 4, 3, 5

The Centers for Disease Control and Prevention states that HIV vaccine-induced antibodies may be detected by current tests and cause false-positive results in vaccine trial participants 1, 2

False-positive heterophile antibody tests may occur in patients with leukemia, pancreatic carcinoma, viral hepatitis, or CMV infection, as reported by the Infectious Diseases Society of America 6

The Centers for Disease Control and Prevention recommends that false-positive results when both screening AND confirmatory tests are reactive are extremely rare 1, 2, 3
In a study of approximately 290,000 blood donors, no false-positive Western blot results were detected, according to the Centers for Disease Control and Prevention 4, 3, 5
Among military applicants from low-prevalence populations, only one false-positive result occurred among 135,187 persons tested, as reported by the Centers for Disease Control and Prevention 1, 4, 3

The American Academy of HIV Medicine recommends that HIV should never be diagnosed based on screening test alone—all reactive screening tests must be confirmed with supplemental testing before diagnosis, although this specific citation is from Praxis Medical Insights, a more suitable citation is not available 7