Simultaneous detection of p24 antigen and antibody outside the acute phase of HIV infection: A case report

Abstract

We report a man in his thirties living with advanced HIV presenting with Pneumocystis pneumonia, cytomegalovirus colitis and HIV retinopathy. Initial HIV screening was positive, and immunochromatographic testing demonstrated simultaneous p24 antigen and antibody bands, an exceptionally rare finding outside the acute seroconversion phase. Despite profound immunosuppression (CD4 3 cells/µL), initiation of antiretroviral therapy led to rapid disappearance of the p24 antigen, while antibody positivity persisted. This case illustrates how severe cellular immune deficiency can allow concurrent antigen/antibody positivity, likely due to high viremia and impaired antibody responses. Clinicians should be aware that point-of-care HIV test results may vary depending on the stage of infection and the timing of therapeutic intervention.