High Risk & Indeterminate
Mar 26, 2005
Thank you for all you do, Dr. Bob. I am newly married and my husband recently tested +. We'd been having unprotected sex for 7 months up to this point (we figure his last test was during his window period) so I've been tested twice in the 50 days since my last exposure and both times the results have been indeterminate. The health nurse who is handling my testing say this makes her "very uneasy". I am past the hysteria and the depression - I feel pretty close to being emotionally ready to cope with a + result but I have this silly glimmer of hope that maybe I'm not really in the process of seroconverting and there is some other reason for the two indeterminate tests (I'm otherwise perfectly healthy and not pregnant.) I understand I have another 1 1/2 months to wait for a definitive result but please feel free to dash and shatter this ridiculous hope so I can move on to my next issue: My husband and I were planning to get pregnant this year and having this disease hasn't entirely changed our mind. Before we decide, I would like to know -going on the probability that I am a recent seroconverter- if treatment is always a must during pregnancy to prevent transmission to the baby and if I did get pregnant and started treatment would I need to stay on treatment even after the pregnancy was over. My understanding is that being treated too soon can lead to drug resistance and increased complications do to the high toxicity in the drugs. Any light you can shed on this for me would be greatly appreciated. (I appologize if this has already been addressed in the archive) Thank you so much. Live a blessed life. (female, 23)
Response from Dr. Frascino
Hello Female 23,
Actually, I'm not going to "dash and shatter" your hope. I also do not find such hope at all "ridiculous".
Indeterminate results can result from someone in the process of seroconversion. This is true, but there are other causes as well. I don't know what type of band pattern your test is showing, but at this point, it does not meet the criteria for a positive test. In folks seroconverting, "anti-p24" is usually the first antibody to appear. To help sort out your indeterminate status, PCR testing may well be helpful. I would discuss this with an HIV specialist rather than the "health nurse" who is handling your testing and feeling "very uneasy."
The discussion about treatment for recent seroconverters, treatment to prevent mother-to-infant transmission, drug resistance and drug toxicities is complex and at this point still hypothetical and premature for you. You can read about these issues in the archives, but for now, I suggest you focus on one issue at a time.
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