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Only nipple sucking but Intermediate results

Jan 5, 2004

Dr Bob , I have some confusion about my results, I have Intermediate Elisa and WB, PCR RNA is <20 copies/ml after 15 months of my exposure just for nipple sucking ( I am not sure that about any discharge from her nipples ) of a girl in night club (HIV Status is unknown). I know this is not the route of HIV transmission and I dont have any other exposure in my life till now except the above. I never thought to go for HIV testing and I found ELISA intermediate that was done for Insurance and I became crazy after this and went for WB and PCR testing. I am US citizen and had this exposure in NY , I am in India for last 11 months on long-term assignment and had all this testing in India that is high active zone for HIV. I had the regular HIV ELISA testing in USA after 4 months of my exposure before leaving to India that was NEGATIVE .

I have few questions, What is the meaning of above test results? Real Time PCR RNA < 20 copies/ml, there is no interpretation of test results on reports, they have following criteria for results: 500-100,000 - Very Week 100,000-1,000,000 Moderate 1,000,000 and above High

Lab reports say that ELISA and WB were done for HIV 1 & 2 both.

Am I suffering with some rare strain of HIV which is found in US and is not covered for the testing in India, I cant come back to US for next one year. By the way I had the Negative ELISA after 4 months of my exposure in USA. What are the other tests I need to do ?

I still believe that I am NEGATIVE but little confused and worried due to above results.

Dr. Bob please advise my because I am not able to get HIV specialist in India and I am not getting properly treated once I go to hospitals for testing in India.

Please Help!

Rodek S.

Response from Dr. Frascino

Hello Rodek,

You are absolutely correct: Nipple sucking is not considered a risk for HIV transmission (except for HIV-positive mothers breastfeeding their newborn HIV-negative babies). I, too, believe you are HIV-negative. That you had a negative ELISA four months after your "non-exposure" confirms that HIV was not transmitted by your titty-noshing at the nightclub.

Now what about your "intermediate ELISA results" Your question states that "I have intermediate ELISA and WB . . . , " but later states the intermediate ELISA was done for insurance, and because of that result, you went for WB and PCR testing. Was the WB test intermediate as well? I suspect not. Most likely, your screening ELISA test was a false positive. If the subsequent WB was negative, you are HIV-negative, particularly in light of your PCR-RNA (less than 20 copies).

To qualify for the insurance policy, you'll have to repeat your HIV test. If negative (most likely), no problem. If positive and the confirmatory WB is positive, you'll need to see an HIV specialist and repeat your viral load test as well. If your test remains intermediate (often termed "indeterminate"), and your only potential HIV exposure was the "non-exposure" you described, then I would still consider you to be HIV-negative. You may need a letter from an HIV specialist to convince the insurance carrier, but there would be no doubt in my mind.

I hope that helps!

Dr. Bob

Confused re HIV 1 AND HIV 2 ?
Thank you

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