What should be done if a person on antiretroviral therapy is suspected to have been misdiagnosed with HIV?
WHO recommends that people with HIV who are on antiretroviral therapy should not be retested for HIV due to the risk of false negative results. People diagnosed with HIV who are on antiretroviral therapy but suspected of misdiagnosis should not have their antiretroviral therapy discontinued to retest and confirm misdiagnosis.
Self-testing, using blood-based and oral fluid tests is not recommended for people on antiretroviral therapy.
Occasionally a person may have been started on antiretroviral therapy on the basis of a single reactive HIV test result. In such cases there is a small chance that this single result was a false reactive result. These cases should be considered on an individual basis by review of the person’s clinical records and medical history, exposure risk and partner’s HIV status (if this is known), and an assessment on how to proceed made by their clinician.
It is important therefore that all people testing for HIV are informed that if they are taking antiretroviral therapy, that they should not test again. If they have concerns about the possibility of being misdiagnosed they should discuss their concerns with their clinician.
WHO is working to assess new evidence on providing additional guidance on retesting people using PrEP and possible testing strategies or approaches for retesting people on antiretroviral therapy and further guidance will follow