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Do I need to repeat my WB?
Dec 9, 2005

Hi Dr. Bob! I checked the archives and could not find an answer to this question. I hope that I didn't just miss it. I am an RN who had a needlestick injury at work in May. The hospital drew baseline labs. A week later they called to tell me that I was HIV positive. My ELISA had been positive and when they sent it out to confirm by Western Blot, the WB showed one strain +, two strains ++, and one strain indeterminate. This would mean, of course, that I was already positive prior to the needle stick. Of course I freaked. I have been in what I assume is a monogamous relationship for 14 years. I went to see my PCP, who drew an ELISA and did a CBC. The ELISA was negative. The CBC showed a normal white count, a low red count, and a normal H+H. I had been feeling extremely fatigued for about a year. The doc chose not to treat the low red count since my H&H was fine. The doc then drew another ELISA a month later. This was also negative. He did a third ELISA last month just to be sure. That too was negative. However, my doc refuses to do a WB, stating that those are only done with positive ELISA's. Since I've had 3 negative ELISA's, he says that he's not worried. In my case, with a previous positive WB, should I insist on a WB, or will a total of 3 positive ELISA's be conclusive? To add to this story, I was diagnosed with ovarian cancer in August. I am assuming that this could explain my prior fatigue and the low RBC's. What do you think? Should I insist on another WB? Thanks in advance for your help.

Response from Dr. Frascino

Hello RN,

I agree with your physician:

1. Western Blots should only be run as confirmatory tests following a positive ELISA.

2. Three negative ELISAs out to six months is definitive. HIV is not your problem.

I see absolutely no reason for further HIV testing. And I certainly would not insist on another Western Blot. Your initial test was unquestionably a "false positive."

Good luck with your ovarian cancer problem.

Dr. Bob

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