You are working in a community health clinic and you have just taken C.Q., a 38-year-old woman, into
the consultation room. C.Q. has been divorced for 5 years, has two daughters (ages 14 and 16), and works
full time as a legal secretary.
She is here for her yearly routine physical examination C.Q. states she is in a
serious relationship, is contemplating marriage, and just wants to make certain she is "okay." No abnormalities were noted during C.Q.'s physical examination. Blood was drawn for routine blood chemistries
and hematology studies; since she has never been tested, C.Q. agrees to a human immunodeficiency
virus (HIV) test. The physician requests you perform a rapid HIV test, which is an antibody test. Within 20
minutes, the results are available and are positive.
Does a positive rapid HIV test mean that C.Q. definitely has HIV? If it is negative, does it
mean she definitely does not have HIV?
A rapid HIV test detects antibodies against the HIV virus. Anyone who has a positive rapid HIV test
result needs to have additional testing with a Western blot test to confirm or rule out the diagnosis
of HIV. False-positive results depend on the prevalence of HIV within a community and are higher
in areas of lower HIV prevalence. False-positive results can occur in pregnant women and women
who have had children, recently vaccinated individuals, injection drug users, people who have had
malaria, and patients with lymphomas and other conditions.
Because standard test results will not be positive for 2 – 8 weeks after exposure to the HIV virus, if
the patient has been exposed to HIV within this period, the result might still be negative. Retesting
would be recommended, particularly if the person is at risk for infection.
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