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Got another indeterminate Western Blot.? Please advise
Dec 10, 2006

Dear Dr. Bob,

Thank you so much for responding to my last e-mail about a week and a half ago. I was the female that had an indeterminate western blot result with a weakly reactive p-24 followed by a negative ultra sensitive RNA test which can detect as low as 50 copies per ml. a week later...you said to e-mail you if I get another indeterminate on my next elisa/western blot. Well... I waited 2 months since I got the western blot result to get another, and just got the result back today...again weakly reactive p24 and also, now weakly reactive p40. Is this a normal pattern for the early stages of HIV? Oddly, the day after I got my blood drawn for this 2nd test, I was so nervous about waiting a week for the result, that I went and got a rapid Unigold test at a clinic, and this test is supposed to be ultra sensitive...I was told more than an elisa, and it came back negative. I have several questions... 1) How is it that the rapid, a day later, was negative and the Elisa on my other test must have been reactive in order for them to confirm it on the Western blot?

2) I'm very nervous...my lymph nodes in my neck and I think in my groin have been swollen for several months including aching in my lower pelvic reigion for 4 months that was worse earlier on and now mild. Sometimes it seems the pain shoots into my legs and my upper thighs are achy at times and I have chills from time to time that run up and down my back...you had said this didn't sound like ARS but now that I'm more descriptive do think it's a possibiltiy? My doctor said she consulted with a Infectious Disease Dr. who believes that these are not results from HIV infection, but rather, cross- reacting antibodies with some other virus. I will be seeing this other Dr. soon but in the meantime, I am very worried and would like to hear your take on this. 3) Also, I'm a little confused because I thought the western blot for HIV had a p-41 not a p-40 indicator so how am I weakly reactive to P-40?

4)Finally, the only person I could have contracted HIV from has now tested negative at 3 months and 5 months from his last sexual relationship on the rapid orasure advance HIV1/2. Despite having received plasma once in the meantime. He has been battling non-hodgkin's lymphoma for years but has had a healthy blood count these past few months and has been doing well...could his illness casue hime to seroconvert later than 5 months out?

5) And whoops, one more question... sorry...should I be concerned about HIV-2 and if not, what are some of the other things I should make sure they test for. I may be a candidate for lyme disease being that I am from the northeast and had two deer sized ticks attached to me for a short period of time this past summer but no rash.. would weakly reactive p-24/ p-40 possibly be indicative of this? Also, I am around a lot of dogs and actually volunteered at a humane society over the summer...I keep reading that the Borna viurs is diagnosed by p-24 and p-40 antibodies...are you familiar with this?

Still really nervous about the possiblility of HIV infection so any insight you may have would be greatly appreciated...I apologize for the length of this e-mail and my never ending hypotheticals which I know, will in due time, be cleared up. But in the meantime I'm in dire need of some answers for I am in a lot of distress. Thanks Again Dr. Bob!

Sincerely, Woman in Crisis.

Response from Dr. Frascino

Hello Woman in Crisis,

This forum (Fatigue and Anemia) is dedicated to HIV-positive folks with specific questions related to fatigue and anemia. Your question should have been posted to the Forum on HIV Prevention and Safer Sex. Consequently, I'll only respond very briefly and post the answer to both forums.

You are HIV negative. Your problem is stress, anxiety and irrational HIV fears, not HIV itself. We have seen many cases like yours at the Frascino Medical Group and they always ultimately prove to be negative. Lengthy complex details about p-41 versus p-40 will not help decrease your anxiety levels. Your HIV risk is apparently nonexistent. Your symptoms are not at all consistent with HIV ARS or HIV disease. The sum of your HIV testing indicates you are definitively HIV negative. Yes, cross-reacting antibodies could be responsible for your indeterminate Western Blot test. One thing that's certain: HIV is not your problem. No way. No how.

Dr. Bob


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