Yamaniha Kazutaka, Kinjo Takeshi, Akamine Morikazu, Setoguchi Michika, Tateyama Masao, Fujita Jiro
Department of Respiratory Medicine, Okinawa Red Cross Hospital, Okinawa, Japan; Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
J Infect Chemother. 2021 Jul;27(7):1112-1114. doi: 10.1016/j.jiac.2021.04.011. Epub 2021 Apr 15.
Although rapid antigen tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is convenient, some articles have demonstrated their low sensitivity indicating false-negative results should always be considered. Here, we raise the issue of false-positive on rapid antigen tests for SARS-CoV-2 with the first case of acute HIV infection who repeatedly positive for the rapid antigen test. A 39-year-old man was admitted to our hospital complaining of high-grade fever, dry cough, general fatigue, and anorexia. The rapid antigen test performed on a nasopharyngeal swab sample was positive, therefore the patient was separated in an isolated room apart from the COVID-19 ward while awaiting the confirmatory RT-PCR result. However, the RT-PCR for SARS-CoV-2 performed on nasopharyngeal swabs was repeatedly negative (three times), while the antigen test was repeatedly positive (three times in total). This patient was eventually diagnosed with acute human immunodeficiency virus (HIV) infection based on a high titer of HIV-RNA and absence of plasma HIV-1/2 antibodies. Physicians should consider the possibility of false-positive results in addition to false-negative results when using a rapid antigen test for SARS-CoV-2, and keep in mind that nucleic acid amplification tests are needed to confirm the diagnosis.
尽管严重急性呼吸综合征冠状病毒2（SARS-CoV-2）快速抗原检测很方便，但一些文章表明其灵敏度较低，提示应始终考虑假阴性结果。在此，我们通过首例急性HIV感染患者快速抗原检测反复呈阳性的病例，提出SARS-CoV-2快速抗原检测假阳性的问题。一名39岁男性因高热、干咳、全身乏力和厌食入院。对鼻咽拭子样本进行的快速抗原检测呈阳性，因此患者在等待确诊性逆转录聚合酶链反应（RT-PCR）结果期间，被安置在与新冠病房分开的隔离病房。然而，对鼻咽拭子进行的SARS-CoV-2 RT-PCR检测反复呈阴性（三次），而抗原检测反复呈阳性（总共三次）。该患者最终根据高滴度的HIV-RNA以及血浆中HIV-1/2抗体的缺失，被诊断为急性人类免疫缺陷病毒（HIV）感染。医生在使用SARS-CoV-2快速抗原检测时，除了假阴性结果外，还应考虑假阳性结果的可能性，并牢记需要进行核酸扩增检测来确诊。
