Abstract
Hodgkin lymphoma (HL) is one of the non-acquired immunodeficiency syndrome (AIDS)-defining cancers (NADCs). HIV testing has become a part of routine testing in HL because of commonly anticipated association. Here we report an unusual case where the need for HIV screening in a newly diagnosed case of HL raised an ethical dilemma and a medical challenge due to false-positive HIV test results. In literature, pregnancy, autoimmune disorders, some viral infections, and the presence of hypergammopathy of hematologic malignancy have all been linked with false-positive HIV screening. The reactive results require additional testing with an HIV-1/HIV-2 antibody differentiation assay. The specimens show reactivity on the initial screening immunoassay, but negative or indeterminate antibody differentiation assay should undergo nucleic acid testing. Nevertheless, several instances of discordance between screening and confirmatory techniques have been described. It is speculated that this might be due to coincidental cross-reaction of subtypes of polyclonal gamma globulin with the HIV p24 antigen. In conclusion, this case signifies the understanding of the HIV testing algorithm and the use of reflex testing in the context of a positive HIV test before disclosing such preliminary results to patients and/or physicians.
Highlights
The HIV-infected individuals have an increased predilection for growing malignancy [1]
The United States Centers for Disease Control (CDC) has determined Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer as the "acquired immunodeficiency syndrome (AIDS) defining cancers." A diagnosis of any one of these cancers marks the point at which HIV infection has progressed to AIDS
People infected with HIV are at higher risk of several other types of cancer than the general population, and these are collectively described as non-AIDS-defining cancers (NADCs)
Summary
The HIV-infected individuals have an increased predilection for growing malignancy [1]. People infected with HIV are at higher risk of several other types of cancer than the general population, and these are collectively described as non-AIDS-defining cancers (NADCs) These other malignancies include anal, liver, lung cancer, and Hodgkin lymphoma (HL) [2]. The hemoptysis is associated with mild right-sided chest pain, fever, night sweats, and unintentional weight loss (15 pounds in the last three months). He denied shortness of breath, sick contacts, and travel or incarceration history. The rest of the clinical examination was normal His blood workup showed a hemoglobin of 11.3 g/dL, white blood cells (WBCs) of 7200/mm, and platelet count of 337 x 103/mm. A sequential repeat antigen-antibody test before the start of chemotherapy came back negative
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