Concurrent COVID-19 and Acute HIV: A Case Report and Diagnostic Review.
Kelly A JohnsonSally GragliaElizabeth D LynchJoanna De MesaErin AntunezSandra TorresSusa CoffeyStephanie E CohenPublished in: Case reports in medicine (2021)
A 26-year-old male presented to the emergency department feeling unwell in February of 2021 with symptoms including diaphoresis, loose stools, and loss of taste sensation. Workup not only confirmed a diagnosis of COVID-19 but also revealed discordant HIV test results, with a reactive fourth-generation antigen/antibody test but a negative HIV-1/2 differentiation immunoassay. Subsequent HIV viral load testing obtained two days later ultimately established a diagnosis of acute HIV (AHI). Screening for HIV and other sexually transmitted infections decreased during the COVID-19 pandemic. It is critical that providers (1) continue recommended screening for HIV as an essential service; (2) consider acute HIV in the differential when evaluating patients with acute viral syndromes; (3) recognize that AHI can occur concurrently with other infections, including COVID-19; and (4) understand the differential diagnosis for discordant HIV test results and know when HIV viral load testing is needed to resolve such discordant results.
Keyphrases
- antiretroviral therapy
- hiv positive
- hiv infected
- hiv testing
- human immunodeficiency virus
- hiv aids
- hepatitis c virus
- men who have sex with men
- emergency department
- sars cov
- liver failure
- mental health
- intensive care unit
- respiratory failure
- rectal cancer
- extracorporeal membrane oxygenation
- mechanical ventilation
- adverse drug