SARS-COV-2 Infection and Potentially COVID-19 Vaccination Associated with False Positive HIV Tests

This article originally appeared in Courageous Discourse and was republished with permission.

Guest post by Peter A. McCullough, MD, MPH

A recent paper by Feldman et al. reporting a young man who attempted to commit suicide caught my attention. It read:

“Our team became aware of the possibility of false positive HIV tests (all but HIV PCR) in individuals vaccinated against Sars-CoV-2 when a laboratory technician attempted suicide. The reason: five months after his second vaccination against Sars-CoV-2 (being negative for Sars-CoV-2 nucleocapsid antibodies at all times) his HIV antibody tests as well as the usual confirmatory HIV tests yielded positive results. Only multiple controls by means of PCR in various centers of competence showed that the human HIV-virus (all HIV subtypes) was and is not detectable in this patient. After such cases became more frequent in our international network, we asked for documentation and reporting. Result: there seems to be a genuine effect, although rather small in magnitude. However, when it comes to HIV and the associated consequences, each individual case is worth taking a closer look at.”

An Australian vaccine trial was abandoned in 2020 because of a high number of participants turning HIV false positive. “Australia had previously agreed to buy 51 million doses of the COVID-19 vaccine being developed by Australian firm CSL and the University of Queensland,” the BBC reported.

Now cases of HIV false positive testing are coming in for both patients who had SARS-CoV-2 infection and some who had COVID-19 vaccination. Gudipati et al. from Henry Ford did a search in their data system among 39,110 records and found 87 false positive HIV results distributed across patients who had COVID-19, vaccination, and presumably both. However, the study mostly focused on the link between false positives and COVID infection.

Balasubramanian et al. reported a temporal relationship between COVID-19 test positivity and the false positive HIV result from multiple studies.

Hakobyan et al. reported more cases of false positive HIV enzyme-linked immunosorbent assay (ELISA) tests without PCR confirmation that the virus was actually present and summarized these putative mechanisms:

“The literature suggests that the spike proteins of SARS-CoV-2 have structural similarities to some viruses, thereby making anti-body cross-reactivity between the two viruses feasible. HIV-1 gp41 and SARS-CoV-2 share several structural sequences and motifs, including the N-terminal leucine/isoleucine repeat sequence and the C-terminal leucine/isoleucine repeat motif. In addition, the helix structures of SARS-CoV-2 and HIV gp41 are very similar, suggesting that both viruses are able to fuse their membranes through the same mechanism. A spike protein present on the outer surface of SARS-CoV-2 is capable of cross-reacting with antibodies from other closely related coronaviruses. Therefore, it is possible for immunoassay tests to be adversely affected, leading to false-positive results. The literature indicates that seasonal enteroviruses, such as HCoV-OC43 and HCoV-HKU1, cross-react strongly with SARS-CoV-2.”

There are now many questions that need urgent answers:

• How common is HIV ELISA positivity after COVID-19 infection and vaccination?
• When, if ever, should HIV screening be performed?
• How will patients handle the potential stigma of being “HIV positive” when the test is actually false positive?
• Does HIV false positivity imply a post-infection or vaccine-associated immunodeficiency state?

Copyright 2023 Peter McCullough MD MPH