Positive Epstein-Barr virus heterophile antibody tests in patients with primary human immunodeficiency virus infection.
OBJECTIVE
To describe three cases of primary human immunodeficiency virus (HIV) infection in patients who had laboratory studies consistent with infectious mononucleosis.


METHODS
We describe 3 patients who presented with a viral syndrome, had a positive heterophile antibody test, and were diagnosed with primary HIV infection.


RESULTS
The results of Epstein-Barr virus serology studies in each of these patients were consistent with chronic, but not acute, Epstein-Barr virus infection. HIV antibody tests were negative, and HIV RNA was >500,000 copies/mL in each patient.


CONCLUSIONS
Clinicians should recognize that a positive heterophile antibody test in the setting of an acute viral illness does not exclude the diagnosis of primary HIV infection, although reactivation of latent Epstein-Barr virus infection cannot be ruled out. Patients presenting with nonspecific viral syndromes should be assessed for HIV risk behaviors and tested for primary HIV infection when appropriate.
Vidrih
J A
JA
Department of Medicine, Section of General Internal Medicine and Clinical AIDS Program, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
Walensky
R P
RP
Sax
P E
PE
Freedberg
K A
KA
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology; D000328:Adult; D000910:Antibodies, Heterophile / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D018791:CD4 Lymphocyte Count; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D004854:Herpesvirus 4, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007244:Infectious Mononucleosis / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D013997:Time Factors
D000910:Antibodies, Heterophile; D000914:Antibodies, Viral; D015483:HIV Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral