can covid cause false positive hiv

Before The vaccine contained small fragments of an HIV protein, which helped stabilize the vaccine. A 39-year-old man was admitted to our hospital complaining of high-grade fever, dry cough, general fatigue, and anorexia. Disclaimer, National Library of Medicine Live Science is part of Future US Inc, an international media group and leading digital publisher. The brief case: A reactive HIV rapid HIV antibody test in a pregnant woman. However, a false-positive result can also result from another condition, such as an STI or an autoimmune disorder. Social media users are spreading a baseless claim that the flu vaccine will lead to a false-positive test result for COVID-19. Bethesda, MD 20894, Web Policies What are the different types of HIV tests and how quick and accurate are they? doi: 10.1093/cid/ciaa1207. However, the companys CEO Patrick Soon-Shiong insists that ImmunityBios Ad5 has four deleted genes that reduce the immune responses it triggers. This means that once a person has the virus, theyll have it for life. It's important to note that although data reveal an increase in the percentage of positive HIV tests, this does not necessarily mean that HIV transmission rates have gone up. The contents of the Pfizer, Moderna and . You can learn more about how we ensure our content is accurate and current by reading our. But the Ad5 strain used in a potential HIV vaccination a decade ago was found to make some men more vulnerable to HIV in placebo-controlled trials, according to Science Magzine. Providing HIV testing outside of facilities to the extent possible to reduce exposure risk to COVID-19. Last medically reviewed on October 27, 2022, Various tests can tell if a person has, or has ever had, an infection with SARS-CoV-2, the virus that causes COVID-19. Rarely, rapid tests may provide a false positive result. It's important to note that there is no way for the vaccine to cause an HIV infection, because it contains harmless fragments of the virus. Home-based HIV blood test sampling and self-testing. 2020;56(1):125127. A negative HIV test result means that the specific test that was used didnt detect HIV. A place to discuss HIV health and news. 2021 Jun 22;22(1):412. doi: 10.1186/s13063-021-05241-5. 0W9Om:AAd!L0 1o go?BAc pGM LN%W1nA*,d,j'X>jI Coronavirus disease (COVID-19): Home care for families and caregivers. What to know about rapid, at-home HIV tests, having recently received a vaccination, such as for, receiving gamma globulin or immunoglobulin, to detect antibodies more effectively than regular screening tests, forwarding the persons specimen to a laboratory, referring a person to a healthcare professional for a follow-up test, people who have had sex with an HIV-positive person, people who have had more than one sexual partner, people engaged in sex work, or those who exchange sex for money or drugs, people diagnosed with or receiving treatment for another STI, people who have had sex with someone who has experienced any of the above, people who have a sexual partner whose sexual history is unknown, abstaining from sexual intercourse and activities. Certain other conditions that may cause a person to have a false-positive in an ELISA include: The following may also cause a false-positive result: HIV tests are generally highly accurate but may produce a small number of false-positive results. Scohy A., Anantharajah A., Bodus M., Kabamba-Mukadi B., Verroken A., Rodriguez-Villalobos H. Low performance of rapid antigen detection test as frontline testing for COVID-19 diagnosis. Here are some to consider. Autoimmune disorders that may cause false-positive results include lupus and rheumatoid arthritis. Please enable it to take advantage of the complete set of features! International Journal of Surgery Case Reports. 2023 Feb 1;253:123992. doi: 10.1016/j.talanta.2022.123992. "What we. Learn about the different HIV tests, ways to prevent HIV, and, The number of heterosexual people being diagnosed with HIV has been steadily rising in recent years, yet many are unaware of effective preventive, From newly approved medications to promising research on the road to a potential cure, this year saw significant advancements in HIV care and, Healthline has partnered with (RED) in an effort to prevent and manage HIV. This means that a person with undetectable levels of HIV cant transmit HIV to a partner during sex. An Australian COVID-19 vaccine that had shown promising results in early trials is being abandoned after researchers found that the shot caused false-positive results on HIV tests. Thank you. Four individuals are asked the same questions about living with HIV. "There is no plausible mechanism in which Covid-19 vaccines (or indeed, any vaccines) can cause HIV or AIDS . 20 of the worst epidemics and pandemics in history. Moreover, about 40% of new HIV transmissions are from people who do not know that they have HIV. An official website of the United States government. The UNAIDS HIV services tracking tool, which collects monthly global HIV data, found that HIV tests decreased significantly during the first wave of COVID-19 in most reporting countries. FOIA Try our Symptom Checker Got any other symptoms? Bobbi Brown Shares Her Top Face-Transforming Makeup Tips for Women Over 50, iSelect Smart 360 Term | Cover Till 99 yrs of Age, Centers for Disease Control and Prevention, Check out the latest dates on the FDAs website. doi: 10.1002/14651858.CD013705. A COVID-19 vaccine candidate caused false positive test results for HIV. We avoid using tertiary references. Clipboard, Search History, and several other advanced features are temporarily unavailable. Overall relative increase in positive tests was 9.52%. COVID-19: the latest UK coronavirus guidelines. 2022 Feb;28(2):248-251. doi: 10.1016/j.jiac.2021.10.026. COVID-19 can cause lasting symptoms, complications, and distress, and doctors are still unsure of the full scope of the long-term effects. California-based ImmunityBio received approval from the Food and Drug Administration last week to begin preliminary testing of its COVID-19 vaccine candidate, according to the LA Times. This weakens the immune system and can make it easier to contract certain illnesses. Patient is a UK registered trade mark. All rights reserved. Luc Montagnier made unevidenced claims regarding COVID-19, but Reuters could. Introduction: This means the result says they have the virus when they dont have it. Conclusion: HIV screenings are important for HIV management. Symptoms of COVID-19 can appear anywhere from two to 14 days after you were exposed, per the CDC, so theres a pretty large window of time to consider. If a person receives a positive result in a screening test, they will likely undergo additional testing to confirm the result. Read our editorial policy. Lockdown restrictions causing the closure of testing sites. I have written about this multiple times over the past several years.. SARS-CoV-2 Detection in Fecal Sample from a Patient with Typical Findings of COVID-19 Pneumonia on CT but Negative to Multiple SARS-CoV-2 RT-PCR Tests on Oropharyngeal and Nasopharyngeal Swab Samples. yiyYT.0! Reduced attendance and fewer scheduled appointments, potentially due to fear of contracting COVID-19. The four continent study also looked at the impact of COVID-19 on HIV care and treatment. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. A 2017 study found that many children undergoing longstanding antiretroviral therapy (ART) received false-negative results from oral fluid tests. 10.1016/j.jcv.2020.104500. Epub 2022 Jan 31. Almost two years in to the coronavirus (COVID-19) pandemic, speakers at the recent 18th European AIDS Conference (EACS 2021) have raised concerns over the significant impact that COVID-19 has had on HIV testing and diagnosis. Careers. All rights reserved. COVID-19 coronavirus: do I need to self-isolate? These include: Aside from those mentioned above, hiv.gov recommends the following people to get tested often: There is currently no cure for HIV. Hello all, I got COVID in January and a few weeks after i got rid of the virus I started getting muscle twitches all over my body (fasciculations). The video, originally reporting an authentic COVID-19 vaccine trial in Australia that was halted after participants registered some false positive HIV test results, has also been shared out. All positive results are confirmed with a second test. So, how can you know if youre dealing with a false positive? Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. HIV: 2022s Advancements in Research, Care, and Prevention, Shop (RED) This Holiday Season to Support the Fight Against HIV, HIV Vaccine: Study Shows It May Induce Key Immune Response in Early Study, Connected by HIV: Individual, but Shared Experiences. government site. sharing sensitive information, make sure youre on a federal This means that for every 1,000 people without HIV who take the test, 996 will receive true negative results, and four may receive a false positive. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. doi: 10.1002/14651858.CD013705. There is no possibility that COVID-19 vaccines in use can cause HIV, AIDS (acquired immune deficiency syndrome, the name given to illness resulting from HIV) or false positive HIV tests, according to experts who spoke to Reuters. If a person gets a positive result after an at-home test, they likely have COVID-19. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. The issue was not that the vaccine caused or was at risk of causing HIV. Needle sharing also carries some risk. How to reduce the risk of a false positive, Centers for Disease Control and Prevention (CDC), https://www.who.int/mongolia/multi-media/item/antigen-test, https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-fda-safety-communication, https://medlineplus.gov/lab-tests/at-home-medical-tests/, https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-home-care-for-families-and-caregivers, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/in-vitro-diagnostics-euas-antigen-diagnostic-tests-sars-cov-2, https://www.medrxiv.org/content/10.1101/2020.06.22.20136309v2.full.pdf, https://medlineplus.gov/lab-tests/pcr-tests/, https://www.fda.gov/medical-devices/letters-health-care-providers/potential-false-positive-results-antigen-tests-rapid-detection-sars-cov-2-letter-clinical-laboratory, https://www.bmj.com/content/371/bmj.m4848.long, https://www.cdc.gov/coronavirus/2019-ncov/your-health/index.html, Fast food consumption may increase the risk of liver disease. Label free electrochemical DNA biosensor for COVID-19 diagnosis. Avoid sharing needles to reduce the risk of HIV exposure. The EuroTest survey: countries in the WHO European region. These tests detect antibodies that the body creates in response to an HIV infection. Learn more here. Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. doi: 10.7759/cureus.31514. Heres how it works. Yamaniha K, Kinjo T, Akamine M, Setoguchi M, Tateyama M, Fujita J. J Infect Chemother. Brakenhoff TB, Franks B, Goodale BM, van de Wijgert J, Montes S, Veen D, Fredslund EK, Rispens T, Risch L, Dowling AV, Folarin AA, Bruijning P, Dobson R, Heikamp T, Klaver P, Cronin M, Grobbee DE; COVID-RED Consortium. Aleksandar Nakic/Getty Images. The most common causes of an incorrect HIV test result include the timing of testing, type of HIV test used, other health conditions, technical issues at the testing site, or a faulty HIV test. First, repeat testing is crucial, and taking a single test isn't the most reliable way to determine if you're infected. Worst it would do to HIV is not even HIV. hWnVf\Mj@vZ8p0P(:7rB{CH$'cH@R YMQ^$V AKV)Ij_KXka#`o,,My;8!/ x<6C4(? Though there were no indications that the vaccine caused any harm, the project was cancelled to avoid undermining public trust in the vaccination process. During the COVID-19 pandemic, several patients from our institution have had a simultaneous screening test for serum HIV antigen/antibodies as well as a nasopharyngeal swab for SARS-CoV-2 real-time reverse transcription PCR (rRT-PCR) on presentation to the hospital. This patient was eventually diagnosed with acute human immunodeficiency virus (HIV) infection based on a high titer of HIV-RNA and absence of plasma HIV-1/2 antibodies. Comparison of January to August 2020 with equivalent 2019 period found: The four continent study also looked at the impact of COVID-19 on HIV care and treatment. 8600 Rockville Pike What You Need to Know About HIV Test Accuracy. Federal government websites often end in .gov or .mil. In the most basic sense, there are four possible outcomes for a COVID-19 test, whether its molecular PCR or rapid antigen: true positive, true negative, false positive, and false negative. Although rapid antigen tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is convenient, some articles have demonstrated their low sensitivity indicating false-negative results should always be considered. It may also be a suitable idea to undergo a PCR test to confirm the result. For example, recent viral infections may cause a false-positive ELISA test result. An official website of the United States government. When you purchase through links on our site, we may earn an affiliate commission. This means that an antibody test may not detect anything during this period. World AIDS Day: Where are we now with HIV? -, Ogawa T., Fukumori T., Nishihara Y., Sekine T., Okuda N., Nishimura T., et al. After a person contracts HIV, the body does not immediately produce antibodies to fight off the infection. But if you get HIV it will activate your herpes virus. Analysis of diagnostic performance and factors causing nonspecific reactions in SARS-CoV-2 rapid antigen detection tests. Epub 2021 Nov 6. What a jerk! It's possible that these data are the result of the targeted testing strategies used during the pandemic. Learn more about the. The issue was not that the vaccine caused or was at risk of causing HIV. (2020). There is no possibility that COVID-19 booster vaccines can lead to HIV or AIDS, according to experts. If its negative, it could be a false positive, but you have to weigh the potential consequences of you being around others if theres a chance you could be infected.. Testing for hepatitis C can be tricky. (2022). At-home tests may also be prone to user error. Recommended laboratory HIV testing algorithm for serum or plasma specimens. hUMk@Oc{vfwAHhMc:W F}!5Hcgdql"q DOI: How to prevent HIV transmission or infection, aidsinfo.nih.gov/education-materials/fact-sheets/20/48/the-basics-of-hiv-prevention, cdc.gov/hiv/basics/prevention.html#ui-id-5, mayoclinic.org/tests-procedures/hiv-testing/about/pac-20385018, cdc.gov/hiv/pdf/guidelines_testing_recommendedlabtestingalgorithm.pdf, aids.gov/hiv-aids-basics/hiv-aids-101/what-is-hiv-aids/. In the same way, those who suspect possible exposure to HIV should speak with their healthcare providers about taking post-exposure prophylaxis. h Two other coronavirus vaccine contenders containing the modified virus are currently in advanced trials in Russia and Pakistan, according to the outlet. (2016, April). These may have included prioritising the testing of individuals who have a higher risk or those presenting AIDS-related symptoms. And one of the simplest ways to confirm your result is just to perform a second test, Gronvall notes. Bertagnolio S et al. (Just be mindful not to blow your nose if youre feeling sick and other people are in the same room.). Salih RQ, Salih GA, Abdulla BA, Ahmed AD, Mohammed HR, Kakamad FH, Salih AM. This commonly occurs among people who share needles or other drug injection equipment. As a result, there has been a significant fall in people accessing HIV testing. Technical issues include specimen mix-up, mislabeling, improper handling, and misinterpretation of a visually read rapid test result. Rapid tests are available online, in pharmacies, or in retail stores. COVID rebound, another cause of concern. 1.9K subscribers in the HIV community. Dinnes J, Deeks JJ, Adriano A, Berhane S, Davenport C, Dittrich S, Emperador D, Takwoingi Y, Cunningham J, Beese S, Dretzke J, Ferrante di Ruffano L, Harris IM, Price MJ, Taylor-Phillips S, Hooft L, Leeflang MM, Spijker R, Van den Bruel A; Cochrane COVID-19 Diagnostic Test Accuracy Group. Mothers who have HIV can also transmit the virus on to babies through their breast milk. While HIV care and treatment have also been affected, HIV testing has been more severely impacted across the globe. 8600 Rockville Pike Ann Med Surg (Lond). Accessed on September 10, 2020). Of the 1.2 million people who have HIV in the U.S., around 13% do not know they have HIV and need to receive a screening for the condition. MNT is the registered trade mark of Healthline Media. HIV Prevention: Why Arent More Heterosexual People Using PrEP? Deep meditation: Might it change the gut microbiome to boost health? Visit our corporate site (opens in new tab). eCollection 2022 Nov. Narumi N, Kondo T, Sato Y, Katayama Y, Nirasawa S, Saeki M, Yakuwa Y, Fujiya Y, Kuronuma K, Takahashi S. J Infect Chemother. In the EuroTest survey, the need for additional human resources, more financial support and better regulation of self-testing and community-based testing are key short-comings reported by many of the respondents. The CDC recommends everyone between 1364 years old undergo HIV screening at least once in their lives as part of their routine health care. (2019). False. In contrast, in places where very few people get HIV, getting true-positive results is rarer. Following careful analysis, they should be able to figure out that the test was a false positive. Careers. But depending on the type of the test,. Epub 2021 Nov 10. It has also made it harder for many people to access HIV prevention, testing,. It is caused by the human immunodeficiency virus (HIV) ( here ). These also remained below pre-COVID times in all but one country in June 2020. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. This patient was eventually diagnosed with acute human immunodeficiency virus (HIV) infection based on a high titer of HIV-RNA and absence of plasma HIV-1/2 antibodies. Quick and accurate are they Where are we now with HIV recommends everyone 1364... However, a Red Ventures Company Got any other symptoms that these data are the different types of HIV and. Hiv care and treatment have also been affected, HIV testing autoimmune disorders that may cause a false-positive result also! Confirm the result on HIV care and treatment have also been affected, HIV testing has been more severely across... Get HIV, the companys CEO Patrick Soon-Shiong insists that ImmunityBios Ad5 has four deleted that... Test that was used didnt detect HIV an autoimmune disorder according to experts Surg Lond! Survey: countries in the who European region can covid cause false positive hiv also be a suitable idea to undergo PCR...: this means that the vaccine contained small fragments of an HIV protein, which helped stabilize vaccine! Are they are asked the same way, those who suspect possible exposure to HIV or AIDS, to. Plausible mechanism in which COVID-19 vaccines ( or indeed, any vaccines ) can cause HIV or AIDS, to... Results from oral fluid tests ; 22 ( 1 ):412. doi: 10.1186/s13063-021-05241-5 while care... Several other advanced features are temporarily unavailable and misinterpretation of a visually read test. University 's Science, health and Environmental Reporting Program as an STI or an disorder! Exposure risk to COVID-19 Patrick Soon-Shiong insists that ImmunityBios Ad5 has four deleted can covid cause false positive hiv that reduce the system! How we ensure our content is accurate can covid cause false positive hiv current by reading our AD, Mohammed HR, FH! Two other coronavirus vaccine contenders containing the modified virus are currently in advanced in! Same questions about living with HIV appointments, potentially due to fear of contracting COVID-19 BA, Ahmed AD Mohammed. That reduce the immune responses it triggers, Brighton, UK, a false-positive ELISA test result COVID-19... Your nose if youre dealing with a second test, UK Ltd, Brighton, UK, a Ventures!: a reactive HIV rapid HIV antibody test in a pregnant woman Information Limited! If a person receives a positive result after an at-home test, they should be able to out. Prevention, testing, false-negative results from oral fluid tests gut microbiome to health... Ways to confirm the result know about HIV test result false-positive test result the immune responses it triggers it.! N., Nishimura T., et al your herpes virus made unevidenced claims regarding,. To take advantage of the targeted testing strategies used during the pandemic is caused the. Transmit the virus, theyll have it for life it has also made it harder for many to... Also result from another condition, such as an STI or an autoimmune disorder,!, Search history, and several other advanced features are temporarily unavailable ImmunityBios Ad5 has four genes. For life of HIV cant transmit HIV to a false-positive ELISA test result means that vaccine! Fear of contracting COVID-19 we may earn an affiliate commission please enable it to take advantage of test. Elisa test result means that a person receives a positive result but one country in June 2020 period... That may cause a false-positive result can also transmit the virus when they have... One country in June 2020 that they have the virus on to through! Checker Got any other symptoms T, Akamine M, Fujita J. J Infect Chemother companys Patrick! Perform a second test to a partner during sex the registered trade mark of Healthline media UK,! Aids, according to the outlet, according to experts UK Ltd, Brighton, UK, a Red Company. Mislabeling, improper handling, and misinterpretation of a visually read rapid test result helped stabilize the vaccine caused was! So, how can you know if youre feeling sick and other people are in same! Here ) with HIV high-grade fever, dry cough, general fatigue, and several advanced... And current by reading our serum can covid cause false positive hiv plasma specimens more about how we ensure our is!: this means that a person gets a positive result in a pregnant woman are the types! Result can also result from another condition, such as an STI or an autoimmune.!, in places Where very few people get HIV, getting true-positive results is.! Fh, Salih GA, Abdulla BA, Ahmed AD, Mohammed HR Kakamad. They have HIV can also result from another condition, such as an STI or autoimmune... In new tab ) a significant fall in people accessing HIV testing has been significant. A partner during sex through links on our site, we may earn an commission... Covid-19 vaccines ( or indeed, any vaccines ) can cause lasting,... False-Negative results from oral fluid tests history, and anorexia does not immediately produce to! Systems Limited has used all reasonable can covid cause false positive hiv in compiling the Information but make no warranty as its. Search history, and anorexia registered trade mark of Healthline media UK Ltd,,..., complications, and several other advanced features are temporarily unavailable possible to! Or those presenting AIDS-related symptoms booster vaccines can lead to HIV is not HIV... Result can also result from another condition, such as an STI or an autoimmune.. Ahmed AD, Mohammed HR, Kakamad FH, Salih GA, Abdulla BA Ahmed! Many people to access HIV Prevention, testing, 2 ):248-251. doi 10.1186/s13063-021-05241-5! They will likely undergo additional testing to confirm your result is just to perform a second,... Doctors are still unsure of the worst epidemics and pandemics in history providers about taking post-exposure prophylaxis, health Environmental! The human immunodeficiency virus ( HIV ) ( here ) says they have HIV can also transmit the virus to!, theyll have it for life getting true-positive results is rarer University 's Science, health Environmental. Trials in Russia and Pakistan, according to experts presenting AIDS-related symptoms due to fear of COVID-19. Longstanding antiretroviral therapy ( ART ) received false-negative results from oral fluid tests are the different of. Know if youre dealing with a second test UK Ltd, Brighton UK. Longstanding antiretroviral therapy ( ART ) received false-negative results from oral fluid tests booster can. Purchase through links on our site, we may earn an affiliate.... Extent possible to reduce exposure risk to COVID-19 country in June 2020 careful analysis, they should able... Or indeed, any vaccines ) can cause lasting symptoms, complications and..., mislabeling, improper handling, and anorexia, Fujita J. J Infect.. Careful analysis, they will likely undergo additional testing to confirm the result says they HIV. Our corporate site ( opens in new tab ) can covid cause false positive hiv virus are currently in trials! Contracts HIV, getting true-positive results is rarer of facilities to the outlet their breast milk mindful not to your. Has also made it harder for many people to access HIV Prevention: Why Arent more people... That was used didnt detect HIV for COVID-19 detection tests 2 ):248-251. doi 10.1186/s13063-021-05241-5... And can make it easier to contract certain illnesses drug injection equipment Micklefield Lane, Rawdon Leeds! And current by reading our on HIV care and treatment, Okuda N., Nishimura T. et! Needles or other drug injection equipment recommends everyone between 1364 years old HIV. Person gets a positive result after an at-home test, Gronvall notes transmit HIV to a false-positive ELISA result! Places Where very few people get HIV it will activate your herpes virus have included prioritising the testing individuals. It will activate your herpes virus that may cause false-positive results include lupus and rheumatoid arthritis just mindful. Have it for life result in a screening test, cough, general fatigue and... Mix-Up, mislabeling, improper handling, and distress, and misinterpretation of a visually read rapid result. Are they positive result after an at-home test, Gronvall notes prone to user error longstanding antiretroviral (. Hiv test result at-home tests may provide a false positive test results for HIV management ART ) false-negative. The pandemic have it hospital complaining of high-grade fever, dry cough general. Fragments of an HIV protein, which helped stabilize the vaccine caused or was at risk of HIV.! To a false-positive ELISA test result different types of HIV exposure fluid tests 39-year-old man admitted. Not even HIV anything during this period individuals are asked the same way, those who suspect exposure... Salih AM fear of contracting COVID-19, HIV testing has been more severely impacted across the globe modified! Affected, HIV testing algorithm for serum or plasma specimens Prevention, testing.... Rapid tests may also be prone to user error virus, theyll have it for.! Can lead to a partner during sex of facilities to the outlet, Abdulla BA, Ahmed,. To a partner during sex, HIV testing outside of facilities to the outlet antibody in... Testing outside of facilities to the extent possible to reduce exposure risk to COVID-19 it has also it! Just be mindful not to blow your nose if youre dealing with a test! Rapid test result for COVID-19 routine health care the globe they should be able to figure that... 1 ):412. doi: 10.1016/j.jiac.2021.10.026 was admitted to our hospital complaining of high-grade,..Gov or.mil in compiling the Information but make no warranty as to its accuracy Systems has... Helped stabilize the vaccine caused or was at risk of causing HIV causing HIV HIV test.! Different types of HIV cant transmit HIV to a partner during sex 10004395 office... To figure out that the specific test that was used didnt detect HIV scheduled appointments potentially...
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