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False positives in screening tests

Published on March 10, 2010 at 1:37 AM · No Comments

In many jurisdictions, tests for human immunodeficiency virus (HIV) are required screening for pregnant women. Some even suggest screening the entire population for HIV. The rationale is to administer powerful antiretroviral drugs to healthy individuals to "prevent transmission."

But what if healthy people take expensive, toxic drugs for a condition they cannot transmit because they don't have it?

In the spring 2010 issue of the Journal of American Physicians and Surgeons, Henry H. Bauer, Ph.D., writes that "HIV tests are not HIV tests." A positive test does not mean that a person has or will get AIDS. It doesn't even mean that he has HIV. Rather, it is a test for antibodies, either to HIV or to something that cross-reacts with it.

The FDA said in 1987 that "the significance of antibodies in an asymptomatic individual is not known." It is still not known, as positive tests have been reported in many illnesses, including multiple sclerosis, tuberculosis, malaria, and aplastic anemia. They have also been reported after immunizations to tetanus or influenza, and may even be caused by pregnancy itself.

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