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p51 only

Sep 26, 2006

hi. 5 years ago i gave blood. 30 days after i gave blood i recived a letter from the redcross saying i could never give or attempt to give blood or plasma, etc, again because I had an indeterminate result on my HIV-1 test. THE ELISA was positive, they told me they do it twice, then the Western Blot is done. The ONLY band to come back positive was p51 -- no others. They redcross also does the p24 antigen test and another which are suppose to test for the window period .. they were negative. I hadn't had unprotected sex in 3 years, minus ONE partner in the month before giving blood. I had started dating a guy two months before the day i gave blood. we had unprotected sex one month before i gave blood (no ejaculation) and also about a week 1/2 before (also using the pull out method). I was terrified that indeterminate result was because of this ONE partner .. again it had been 3 years since i had any other partner with no protection, and in those three years only ONE with protection. Can you please help me understand why the p51 came back positive? Could I have been hiv positive and it was an old infection and only that band years later be present ??? OR could this indicate a NEW infection?? Over the years this has emotionally effected me severely. i forget, then after a while the thoughts come back. i never got re-tested, i think that test scared me so much i can't bear the thought of going back. Can you please tell me in what case a P51 band would be the ONLY one present? I had a hemotologist friend say p51 is in the "inner core" and in no way would p51 become present in the beginning or be the ONLY band present in an existing infection, test glitch, period. Should i trust this guy and m ove on? please tell me your opinion. I'm having a "bad month" of remembering. I thought I had moved on .. guess not. I'm married, want to have children one day, but live with caution. my husband (who came along after this testing) gives blood every 3 months and never has had a positive or indeterminate result .... help please.

Response from Dr. Frascino


Five years of worry, all for naught! If you had followed the advice on the letter that the Red Cross had sent you, all of your anxiety over this issue would have been avoided. The blood-screening program is designed to protect the blood supply. In doing so, they set the test sensitivity very high so as not to miss any even potentially HIV-positive blood donors. You had an indeterminate test (positive ELISA + indeterminate WB). This is not considered a positive HIV test! Indeterminate does not equal positive. However, it does mean you should have had follow-up studies to ultimately determine your status, be it positive or negative. In your case, the follow-up studies would almost definitely confirm a negative result. There are many potential reasons for an indeterminate result. You can read about these in detail in the archives, as I've addressed this point many times in the past. A p51 band detects an "anti-polymerase antibody," not an anti-core antibody. Anti-core antibodies are p17, p24 and p 55.

What you need to do now is what you should have done five years ago: get retested and put this issue permanently to rest. Read through the archives so you get a better understanding of indeterminate test results, and then get retested. I'm confident you will be definitively HIV negative. That's the only way to end the "bad months of remembering."

Good luck (although I doubt you'll really need it). Write back with your final test results and we'll WOO-HOO together, OK?

Dr. Bob

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