DOI: 10.12890/2026_006720

False-positive HIV screening in new-onset systemic lupus erythematosus presenting with polyserositis and lupus nephritis

Authors

  • Mahima Upadhyay Department of Internal Medicine, Hurley Medicine Center, Flint, USA 0000-0003-4511-3546
  • Susheel Joshi Department of Internal Medicine, Covenant HealthCare, Saginaw, USA
  • Bibhush Shrestha Department of Internal Medicine, Shaoxing People’s Hospital, Shaoxing, China
  • Muhammad Saleem Department of Internal Medicine, Hurley Medicine Center, Flint, USA
  • Omoniyi Henry Akinpeloye Department of Internal Medicine, Hurley Medicine Center, Flint, USA
  • Hoyam Elhaj Omer Department of Internal Medicine, Hurley Medicine Center, Flint, USA

mupadhy2@hurleymc.com

Keywords

Systemic lupus erythematosus, lupus nephritis, pericardial effusion, pleural effusion, human immunodeficiency virus

Abstract

False-reactive human immunodeficiency virus (HIV) screening can occur in systemic lupus erythematosus (SLE) and may delay recognition of the underlying autoimmune disease.
A 23-year-old woman presented with weight loss, polyserositis and nephrotic-range proteinuria. Her HIV antigen/antibody screen was reactive, but supplemental testing did not confirm HIV infection. Lupus serologies, hypocomplementemia and kidney biopsy established SLE with mixed proliferative and membranous lupus nephritis. Recurrent pleural and progressive pericardial effusions required immunosuppression, pericardial drainage, a surgical window and pleural decortication.
The reactive HIV screen initially favoured an infectious diagnosis; however, proteinuria, haematuria and low complement levels suggested immune-complex disease. This illustrates the risk of diagnostic anchoring on a preliminary screening result. A reactive HIV screen is not diagnostic. Prompt supplemental testing and parallel evaluation for autoimmune disease can prevent delayed diagnosis of SLE.

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References

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Published

2026-09-25

Issue

Vol. 13 No. 10 (2026)

Categories

How to Cite

1.
Upadhyay M, Joshi S, Shrestha B, Saleem M, Akinpeloye OH, Omer HE. False-positive HIV screening in new-onset systemic lupus erythematosus presenting with polyserositis and lupus nephritis. EJCRIM [Internet]. 2026 Sep. 25 [cited 2026 Nov. 3];13(10). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6720

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