HIV COURT CASE RAISES QUESTIONS ON TEST
By Randy Dotinga
Health Scout News 23 Jan. 2002
In a case that raises
questions about the accuracy of HIV tests, an Oklahoma man has won a
$1.4 million settlement nine years after a health clinic mistakenly
told him he was infected with the virus that causes AIDS.
Medical experts say it's nearly impossible for an HIV test to give an
incorrect -- or "false positive" -- result. However, it's widely known
that negative results can be wrong if a test is given too soon after
infection, before the virus can be detected. The weakest link in the
test process appears to be medical personnel who can mix up blood
samples or misplace paperwork.
The Centers for Disease Control and Prevention(CDC) says that, in
"ideal" testing circumstances, the odds of a false positive HIV
antibody test are less than five in 100,000, according to a report in
USA Today. However, human errors can occur.
"No test is perfect, and that goes for cancer tests, X-rays, MRIs and
blood tests," says Dr. Jeffrey D. Klausner, director of sexually
transmitted disease control services with the San Francisco Department
of Public Health.
Even so, HIV test errors are considered rare, and experts say it
shouldn't take long for any alert doctor to notice a person with a
supposed HIV infection isn't getting sick.
That didn't happen in the Oklahoma case, apparently because the
plaintiff didn't receive extensive medical attention.
According to news reports, 40-year-old Anthony Northcutt had an HIV
test in 1993 at a clinic operated by the Oklahoma City-County Health
Department. He was told he was HIV-positive.
Four years later, Northcutt obtained his file and learned he had
received the wrong test results. He was actually HIV-negative at the
time of the first test.
Two months after learning of the wrong results in 1997, Northcutt took
another test and learned he was HIV-positive. He reportedly had
engaged in unprotected sex with HIV-positive partners during the years
he thought he was infected.
In his lawsuit, Northcutt claimed he struggled with depression,
suicide attempts and a drinking problem.
According to The Daily Oklahoman, a jury found in favor of Northcutt,
but also determined he was partially negligent himself. Attorneys for
Northcutt could not be reached for comment.
HIV tests determine if a person has developed antibodies to the virus,
a sign that the immune system has kicked into action. However, it may
take several months after infection for enough antibodies to appear.
An ordinary HIV test actually consists of three or more separate blood
tests, at least in California, says Michael Allerton, who oversees HIV
policy in Northern California for the Kaiser Permanente Health Plan.
If the first test produces a "false positive," the others should catch
the error, he says. In some cases, however, the tests may conflict
with each other, and more tests are needed.
Even if an HIV-positive result is wrong, doctors should notice when a
patient doesn't show signs of the virus in his or her blood, says Dr.
Michael Horberg, a Kaiser Permanente Health Plan physician who treats
AIDS patients in Northern California.
"They'd have no detectable virus at all without any treatment,"
In one of his own cases a few years ago, he says, a woman insisted she
could not have contracted HIV. She turned out to be right. She wasn't
infected, despite a positive test result.
"We did a mega work-up, kept following her every six months, and she
was still negative," he says. "She never showed any sign of the virus,
and her [immune system strength] was better than half the U.S.
Powerful AIDS drugs can reduce the level of HIV in the blood to zero,
although the virus will continue to lurk in other parts of the body.
However, doctors wouldn't put someone on the drugs if he or she
weren't already showing symptoms of HIV infection, Horberg explains.
Some people do worry that they got the wrong test results, Horberg
Following the Oklahoma verdict, "I had tons of people calling and
saying they wanted to be re-tested. You re-test them if that's what it
takes to convince them that it's accurate," he says.