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Western Blot confusion
Feb 10, 2004

Dr Bob,

I ran this past the good folks at aidsmeds as well, and I'm feeling good but a bit confused. (CDC hotline was no help at all)

My primary care physician said he saw no need to test again after a negative ELISA at 7 weeks to the day. My shrink (helping me deal with HIV fears as well as lingering trauma from the sexual assault I fear exposed me to HIV) prescribed a second test that I took at 12 weeks to the day. The lab went straight to western blot and told my shrink when he asked that they did so because of the wording of his prescription. The western blot also came back negative.

Now my primary care guy says that a 12-week western blot is not conclusive and that I need a 13th week ELISA.

Are these two tests so different that a 7-week ELISA would be considered somehow more conclusive than a 12-week WB? Is my primary care Doc right?

Response from Dr. Frascino

Hello,

Sorry you've gotten so many conflicting opinions. The answer here is relatively simple. A single three-month FDA-approved ELISA test is what should have been ordered. The seven-week ELISA, while encouraging, would not be considered definitive. Western blot testing should always be coupled with ELISA screening due to a two percent rate of false positives. The false-negative rate is much lower. Considering your test results to date, your chances of having contracted HIV from this unfortunate incident would be extremely, extremely low. However, since this is an assault situation with "lingering trauma" and "HIV fears," I'd suggest getting the recommended ELISA test at three months or longer to help you put those fears effectively, efficiently, and permanently to rest.

Good luck.

Dr. Bob



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