Once you have been diagnosed with the HIV virus, a lot of things may begin to cross your mind. You may worry about how this will affect your significant relationships, your work and of course your health in general. One important thing you need to have in mind is what to expect from HIV therapy. Will HIV medication affect your drug tests and cost you a potential job or similar opportunity?
Standard drug tests
Drug tests may be ordered by employers or government agencies when they want to rule out a history of drug abuse. They usually come in panels; 5 panel tests, 10 panel tests and 15 panel tests. The psychoactive compound in marijuana (THC) is screened for in all three panels. Usually, a urine sample is used and THC amounts exceeding 50 nanograms per millimeter of the sample will test positive for marijuana.
False Positive Results
A positive result for marijuana means that the amount of THC in the sample indicates active use of marijuana in the recent past. On some occasions, a sample may test positive while in the actual sense the person may not have used marijuana in the recent past or ever in their lifetime. When this happens, the result is referred to as a false positive result, meaning that the positive result is untrue.
If it shows positive – the sample will be tested using confirmatory gas chromatography test that is much more precise.
False positive results usually occur when the test picks up a different metabolite in the sample whose structure may resemble that of the metabolite being screened for. False positives may also occur as a result of passive smoking, mixed samples or faulty kits.
HIV medication and False Positive Results
The ARV drug Efavirenz has been associated with false positive results for marijuana tests. Efavirez is a non-nucleoside reverse transcriptase inhibitor which is used together with other drugs to treat patients infected with the HIV virus.
However, recent evidence has found no positive correlation between the two. A study conducted by the International University of Medicine in Malaysia tested the urine samples of 51 patients on efavirenz for HIV treatment. All but one tested negative for marijuana, and the one who tested positive had used marijuana the day before. This confirmed that efavirenz does not cause false positive results for marijuana tests.
Efavirenz and False Positive Results for Benzodiazepines
On the other hand, studies have shown that efavirenz gives false positive results for benzodiazepines. Benzodiazepines are tested for in 10 panel tests because they have the potential for abuse, even though they are pharmaceutical drugs with known medical value. Benzodiazepines include drugs such as valium and Lorazepam.
One study published in the Oxford Academic enrolled 100 HIV positive patients, 50% of whom were on efavirenz.
Of the 50 patients not receiving efavirenz, all but one tested negative for benzodiazepines. Of the group that was receiving efavirenz, all but one tested positive for benzodiazepines.
As much as ARVs (efavirenz specifically) may not give false positive results for marijuana, they may still make you fail a drug test that is screening for benzodiazepines.
What about Marinol?
Marinol is a drug containing synthetic THC and is usually given to HIV patients to help in relieving pain and loss of appetite. Because Marinol contains synthetic THC, it will most likely result in a positive marijuana test. This is not per se a false positive, as the THC metabolite is present in Marinol.
Should you be taking Marinol to alleviate some of your symptoms, you need to notify the lab about this. They may ask for a valid Marinol prescription to confirm the claim.
What About Your Privacy?
Unfortunately, you may be forced to divulge your HIV status in the course of declaring your ARV regimen which may have contributed to a false negative result. But even with that, this does not give anyone legal ground to discriminate against you based on your HIV status.
In Case of a Dispute
Getting a false positive result should not ruin your chances of getting the opportunity that you were looking for. Should this happen to you, feel free to contest the results and demand a repeat test. You may be required to declare all the drugs that you are taking and whether you may be exposed to passive smoking. Some companies however may require you to pay for the repeat test yourself.
Remember that you are neither the first nor the last person to get a false positive result for marijuana. Simple OTC drugs such as Ibrupofen are also known to cause false positive results.