Non-seroconversion in an HIV-tuberculosis co-infected patient-case report
Authors: Fatima Kanani, Nadia Asher, Maliha Zubairy
Background: Most cases of negative serology in proven human immunodeficiency virus (HIV) patients occur due to testing during the window period. However, true non-seroconversion is a phenomenon that should always be considered. Case Presentation: A 13-year-old female with a family history of multi-drug resistant tuberculosis (MDR-TB) presented with cough without fever for 1 month. She was vitally stable and the physical examination was unremarkable. Chest X-ray was suggestive of active TB, sputum positive for acid-fast bacilli, and GeneXpert positive for Mycobacterium tuberculosis. Her HIV RNA polymerase chain reaction (PCR) was positive at 28,866 IU/ml. She was registered as presumed MDR-TB and started on anti-tuberculosis treatment. Serum specimen sent inadvertently 6 weeks later was positive for HIV- p24 antigen while negative for anti-HIV ½ on Determine HIV Early Detect fourth generation lateral flow assay. A fresh specimen 2 weeks later showed similar results and was also negative by Alinity HIV Ag/antibody Combo (Abbott Diagnostics) and Bio-Rad Geenius HIV-1/2 Supplemental Assay. HIV antibodies were still negative at 20 weeks (5 months) after positive PCR. Conclusion: This is a case of a seronegative HIV/TB co-infected patient. Non-seroconversion should always be considered in patients with clinical suspicion and discordant results.
Keywords: Seroconversion, tuberculosis, acquired immunodeficiency syndrome, human immunodeficiency virus, case report.
Authors
Correspondence to:
Fatima Kanani, Department of Chemical Pathology, Indus Hospital and Health Network Karachi, Pakistan fatima.kanani@tih.org.pk
Publication history:
Received 04 Jul 2022
Revised 01 Sep 2022
Accepted 02 Sep 2022
Published online 16 Oct 2022
Published in print 21 Nov 2022
Kanani F, Asher N, Zubairy M. Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. EJMCR. 2022; 6(7): 126-130. doi:
10.24911/ejmcr/173-1656920865
Kanani F, Asher N, Zubairy M. Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. https://www.ejmcr.com/?mno=75735 [Access: March 29, 2024]. doi:
10.24911/ejmcr/173-1656920865
Kanani F, Asher N, Zubairy M. Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. EJMCR. 2022; 6(7): 126-130. doi:
10.24911/ejmcr/173-1656920865
Kanani F, Asher N, Zubairy M. Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. EJMCR. (2022), [cited March 29, 2024]; 6(7): 126-130. doi:
10.24911/ejmcr/173-1656920865
Kanani, F., Asher, . N. & Zubairy, . M. (2022) Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. EJMCR, 6 (7), 126-130. doi:
10.24911/ejmcr/173-1656920865
Kanani, Fatima, Nadia Asher, and Maliha Zubairy. 2022. Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. European Journal of Medical Case Reports, 6 (7), 126-130. doi:
10.24911/ejmcr/173-1656920865
Kanani, Fatima, Nadia Asher, and Maliha Zubairy. "Non-seroconversion in an HIV-tuberculosis co-infected patient-case report." European Journal of Medical Case Reports 6 (2022), 126-130. doi:
10.24911/ejmcr/173-1656920865
Kanani, Fatima, Nadia Asher, and Maliha Zubairy. "Non-seroconversion in an HIV-tuberculosis co-infected patient-case report." European Journal of Medical Case Reports 6.7 (2022), 126-130. Print. doi:
10.24911/ejmcr/173-1656920865
Kanani, F., Asher, . N. & Zubairy, . M. (2022) Non-seroconversion in an HIV-tuberculosis co-infected patient-case report. European Journal of Medical Case Reports, 6 (7), 126-130. doi:
10.24911/ejmcr/173-1656920865