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Concurrent COVID-19 and Acute HIV: A Case Report and Diagnostic Review

Kelly A Johnson1,2,3, Sally Graglia4, Elizabeth D Lynch3

  • 1University of California San Francisco, Department of Medicine, Division of Infectious Diseases, San Francisco, CA, USA.

Case Reports in Medicine
|November 26, 2021
PubMed

Insights

This case highlights acute HIV (AHI) co-infection with COVID-19. Providers should consider AHI in patients with viral syndromes and understand discordant test results, utilizing viral load testing when necessary.

Area of Science:

  • Infectious Diseases
  • Virology
  • Public Health

Background:

  • Screening for HIV and STIs declined during the COVID-19 pandemic.
  • Acute HIV (AHI) presents with non-specific symptoms, potentially mimicking other viral illnesses.
  • Discordant HIV test results require careful interpretation and further investigation.

Observation:

  • A 26-year-old male with COVID-19 presented with symptoms including diaphoresis, loose stools, and loss of taste.
  • Initial HIV testing showed a reactive antigen/antibody test but a negative differentiation immunoassay.
  • Subsequent HIV viral load testing confirmed acute HIV infection.

Findings:

  • Acute HIV can co-occur with other infections like COVID-19.
  • Discordant HIV test results can occur, necessitating HIV viral load testing for accurate diagnosis.
  • Delayed or missed AHI diagnosis can impact patient outcomes and public health.

Implications:

  • Clinicians must maintain essential HIV screening services.
  • Consider AHI in the differential diagnosis for patients presenting with acute viral syndromes.
  • Understanding AHI and discordant testing is crucial for timely diagnosis and management, especially during concurrent outbreaks.

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