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"weakly positive" elisa after blood transfusion
Dec 19, 2004

HI.

I'm a 3rd year medical student who has had what my PCP describes as a "weakly positive" elisa. A WB has been sent, but I'm freaking out. I am a gay male who has been in a monogamous relationship with the same guy for 3 years. He is the only person I have ever had sex with, protected or otherwise. He and I both tested negative before our first sexual contact over 3 years ago. Here's the kicker, so I consider myself to be very low risk. I have Crohn's disease which has caused me to be iron-deficiency anemic to the point that I needed blood transfusions over the past year (while doing my 3rd year rotatins, no less). I had 2 units in October. That's why I got tested in the first place. I'm wodering what the likelihood is that this represents a false negative. Thanks in advance, I'm trying to remain rational but I can't stop thinking my life might be over.

Response from Dr. Frascino

Hello 3rd Year Med. Stud.,

Positive HIV ELISAs ("weakly" or otherwise) always need to be confirmed by a more specific test, such as a Western Blot (WB). HIV disease resulting from a blood transfusion would be an extremely unlikely event if you are writing from the U.S. (or a developed country).

Could this be a "false negative?" No, not a "false negative," but it could certainly be a "false positive!" In fact, from what you've written, that would be the most likely cause for your "weakly positive" screening ELISA. Certainly if your WB is positive, your "monogamous" boyfriend will also need to be tested and the blood bank should be notified if the transfusion turns out to be your only potential risk.

Finally, 3rd-year rotations or not, you need to have your Crohn's disease better monitored and controlled to avoid becoming anemic!

Your life is not over. You still have 4th-year electives, internship, residency, fellowship and lots more to look forward to!

Good luck!

Dr. Bob



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