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New Mom in shock...

Aug 20, 2004

Hi Dr. Bob. I am a 31 year old woman and I have been happily married for almost 10 years. My husband and I have both been 100% faithful. We recently had blood testing in order to get mortgage insurance. My husband was accepted, but mine was declined because of my HIV test. The Elisa was done twice, positive both times. The WB came out as "intermediate result". My Doctor said it was "indeterminate". I think my Doctor said there were 3 reactive bands or something. He has ordered more blood work. None of this makes sense to me at all. I know I slept around a bit in high school (I think there were 7 guys before my husband). The last guy I slept with before I met my husband was in the spring of 1993. I also donated blood after that time and never ran into any problems. (although I gave my last donation maybe in 1994 sometime) I have never used intravenous drugs. The only blood product I ever received was an injection of "Rhogam"? when I was pregnant because I am Rh negative. The really scary part for me is that I have 2 beautiful babies (they are twins, almost 4 years old). They are both very big for their age and healthy. My biggest fear is that if I have HIV, I passed it on to them! I am freaking out here. My doctor had to put me on Ativan because I am falling apart. He said that he doesn't think I am at a high risk, but he is looking into it. I can't believe this is happening. I am so scared. What I would like your opinion on is if I DO come back positive, is there a chance that my kids are OK? I'm desperate for answers. Thanks you so much and I would be glad to donate! I wrote earlier about my positive Elisa tests and "indeterminate" Western Blot. Well it turns out the Western Blot showed a result of "WEAK BANDS(S) PRESENT" and was labelled "INDETERMINATE". What does it mean to have "weak bands present"? It didn't say how many though. Sorry for the confusion....

Response from Dr. Frascino

Hello Shocked Mom,

I doubt you'll need those Ativan tablets for very long. First off, let me assure you that your results so far do not indicate you have HIV disease. An "indeterminate" Western Blot result is defined as the presence of any band pattern that does NOT meet criteria for a positive result. (Positive Western Blots need reactivity bands at gp41 + gp120/160 or p24 + gp120/160.) Indeterminate test results can account for 4% to 20% of Western Blot (WB) assays with positive bands for HIV-1 proteins. There are a variety of causes for indeterminate results, including cross-reacting nonspecific antibodies, as seen in collagen-vascular disease, autoimmune disease, lymphoma, liver disease, injection drug use, multiple sclerosis, recent immunization, and even parity (status of women who have borne children). Having had twins, you certainly qualify for the "parity" category. The most important factor in evaluating indeterminate results is risk assessment. Patients, like you, in low-risk categories with indeterminate WB tests are almost never infected with HIV-1 or HIV-2. This is one place where PCR viral load testing might help clarify the situation. From what you've told me, I would anticipate the viral load test would be undetectable. You may need the help of an HIV specialist to qualify for your mortgage insurance. He will need to write a letter explaining the "indeterminate" results and to certify that you are indeed HIV negative, once all the follow-up testing is complete.

So try not to worry too much. Get the follow-up testing to sort out the indeterminate WB results. Have an HIV specialist help you qualify for your insurance. And finally, don't bother refilling that Ativan prescription. I doubt you'll be needing it.

Thank you for your donation! Give your twins a hug from me.

Dr. Bob

I don't think you hear...

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