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TheGermDoctor
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Category: Medical
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Experience:  17 years as a physician, Board Certified in both Internal Medicine and Infectious Diseases
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I have an indeterminate Western Blot HIV test, and am freaking

Customer Question

I have an indeterminate Western Blot HIV test, and am freaking out about it. Can I please get some feedback on how to interpret my chances of being HIV positive?
Submitted: 5 years ago.
Category: Medical
Expert:  TheGermDoctor replied 5 years ago.

Hello aj-

 

Do you know what the ELISA showed?

Have you just recently had a high risk exposure?

Any current symptoms?

 

Customer: replied 5 years ago.
This might be more complicated than you signed on for so here goes:
the ELISA came back positive and the western blot showed one band the gp160 as indeterminate, which in turn made the whole western blot indeterminate. could the indeterminate band have been reported as positive, and then the western blot still be indeterminate since you need two bands to give a positive wb?

my risk exposure is supposedly medium to low (according to many books i've read over the last few days) i have given/received a few non-ejaculatory blow-jobs over the last 6 months with 4 different partners. I have not engaged in any anal sex.

In January I did experience a week of night sweats, which at the time I wrote off as due to an overly stressful time at work, though now I'm uncertain.

Also I think that I am going insane, since I must wait a month before going back in for testing. I randomly break down crying and other times I'm perfectly fine. I keep inventing scenarios how I got infected and can't seem to think of anything else. Please help! (and good luck dealing w/ the crazy guy on the other end of this e-mail)
Expert:  TheGermDoctor replied 5 years ago.

AJ-

 

Actually it isn't all that complicated...

IN the vast majority of people with a positive ELISA and an indeterminate WB, when we do follow up testing , they turn out to be negative. In a small number who are positive, it is from a recent exposure/ infection and they are in the process of developing all the WB bands to become fully positive. In the rest, it is just a non-specific cross reaction.

 

From your WB, this is indeed indeterminate- the gp160 is a precursor to the envelope protein, but it sounds like you did not have any antibodies to the GAG or polymerase gene products. Your result is truly indeterminate- and could be from either of the 2 possibilities I described above.

 

Based on your low risk exposure, the most likely will be it will turn out to be a false positive ELISA. I certainly would agree with repeating the test again, or even better doing a HIV RNA PCR, which will be even more sensitive. Understandably you are quite anxious, and possibly depressed.

 

I can try to explain that the vast majority of people with these results ( and I do see this not uncommonly) turn out to be negative, but until you get the follow up testing, there is no way to totally calm you down or reassure you.

 

Good luck.

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an assessment by your doctor,
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Customer: replied 5 years ago.
Do you have statistics to go with these (i'm a math person)

and do you have any way to help me cope with the next month?
Expert:  TheGermDoctor replied 5 years ago.

This may help you as well.

 

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001431.htm

 

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an assessment by your doctor,
and does not establish a patient-physician relationship.

Expert:  TheGermDoctor replied 5 years ago.

From the CDC reference I linked, near the bottom it gives some data on the very small number of indeterminate WBs that subsequently seroconverted. It is a small number- most are really negative, only a small number are in the process of seroconverting.

 

As far as help until you get your follow up testing- all I can do is give you the data, that most likely you will be negative ( but we won't know until we do the follow up test).

 

Aside from that, you may want to ask your doctor for something for anxiety or depression.

 

Good luck.

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an assessment by your doctor,
and does not establish a patient-physician relationship.

 

 

Customer: replied 5 years ago.
just to clarify:

the night sweats back in January are completely unrelated to HIV (most likely)?

how recent would my exposure have to have been in order to have an indeterminate with these results?


Expert:  TheGermDoctor replied 5 years ago.

It is hard to know what your sweats were in Jan.

It could have been a plain old respiratory virus.. It is impossible to know now.

 

Usually the WB seroconverts within 1 month. By 3 months almost all will be positive, and so a negative is very reliable.

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an assessment by your doctor,
and does not establish a patient-physician relationship.

Customer: replied 5 years ago.
sorry, another clarification point because if i don't ask them now i'll have to live with myself and the unasked questions for the next month:

so most likely i would have to have had exposure within the last 3 months in order to have an indeterminate wb? or since i have an indeterminate i'm in the middle of seroconversion, and therefore exposure would be limited to one month?




Expert:  TheGermDoctor replied 5 years ago.

As I explained above, an indeterminate is mostly likely a nonspecific cross reacting antibody!

If you had a recent exposure that could explain the small number that are in the process of seroconverting.

 

Always ask if you need clarification/more information.

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an assessment by your doctor,
and does not establish a patient-physician relationship.

 

Customer: replied 5 years ago.
i hate to ask more questions, but please keep in mind how crazy i'm going over here...
could you quantify recent?
Expert:  TheGermDoctor replied 5 years ago.

OK... Now you are pushing it....

 

I have already answered this several times- It may take up to 1-3 months to develop the WB bands- That is "recent".

 

If you have additional new questions you will need to post a separate question. I think I have pretty completely answered this current question....

 

 

If I have answered your question, please click the ACCEPT button so I can get credit for my work.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an assessment by your doctor,
and does not establish a patient-physician relationship.

TheGermDoctor, Doctor
Category: Medical
Satisfied Customers: 1549
Experience: 17 years as a physician, Board Certified in both Internal Medicine and Infectious Diseases
TheGermDoctor and 5 other Medical Specialists are ready to help you
Expert:  TheGermDoctor replied 5 years ago.
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