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3rd time asking...ppplease advise!
Nov 28, 2006

Dr. Bob,

I wrote you yesterday about my situation and just wanted to add a couple of pieces of information. I was the person who wrote that she had an indeterminate antibody test followed by some type of negative nucleic acid test and about how my Dr. got two indeterminates back from the lab on the same day. Well, I saw my Dr. today and she said it was highly unlikely that I was infected because the nucleic acid test she did was an ultra sensitive RNA nucleic acid test and she also advised me that the other anonymous individual who was also indeterminate, tested negative on both the RNA and 2nd Antibody test. I'm now awaiting the results of my 2nd antibody test and still very scared. I'm wondering how conclusive the RNA test is if my antibody test, which I had a week prior, read 'indeterminate - weakly reactive p24 antibody'?? And also, I'm wondering what type, if any, errors could occur in a lab that would result in two indeterminates that are weakly reactive to the p24? My Dr. said that it was bizarre because myself and the other individual were only the 2nd and 3rd indeterminate results she has ever gotten back and she's an OBGYN that has been in practice for 8 years. Based on my last e-mail and this one, could you advise further? I trust my Dr.'s instincts but I don't get the sense that she is extremely informed about these tests and I'm very,very scared. I would be so, so appreciative to hear back. In addition, as a reminder, my lymph-nodes in my neck have been tender and somewhat swollen for two months and I've had pain in my pelvic reigion for several months that has gone undiagnosed but seems like it could be from swollen lymph-nodes. All other STDs have been ruled out. I've had no other acute symptoms that I can remember. My risk would have been August through late september during which I had the sexual relationship with a male and we had unprotected vaginal intercourse. He went and got the orasure quick advance HIV1/2 test last month and it was just about three months out from his last sexual partner and it was negative... but he has non-hodgkins lymphoma and had gotten some chemo earlier during the summer as well as a cortisone shot just weeks before this test..could either of these affected the test? His risk for HIV does not seem extremely significant but he did have an unprotectd sexual relationship with a woman, before myself, who's HIV status is unknown except that she had an HIV test before her marriage and it was negative and he was the first person she was with since her marriage ended. I got my antibody test at the end of Sept. and my RNA test a week later. And again, the RNA test was negative.

I really hope to hear from you. Thanks again for all you do...and I must say...I appreciate your humor and sarcasm because I think it can really help make light of some situations and bring comfort to many.

Response from Dr. Frascino

Hello,

Based on all the information you provided, I would assume you are HIV negative. Although without more information, I cannot definitively say so.

It's important to note than an indeterminate antibody test is not a positive test by definition. It's indeterminate (not positive, but not quite negative either). I'm also not exactly sure what you mean by "indeterminate antibody" test. Was this an indeterminate Western Blot following a positive ELISA? There are a number of reasons for an indeterminate antibody test and you can read about these in detail in the archives. Laboratory and clerical errors can occur, but in general are rare. I agree that repeating your antibody test (ELISA and Western Blot, if the ELISA is reactive), is the next step. Certainly your negative NAT test is extremely encouraging. I would not be at all concerned about your symptoms. They are not suggestive of HIV ARS. Also, your risk seems minimal. I'll refrain from discussing all the hypotheticals surrounding your partner's test results, as it's really beyond the point of your question.

If, for whatever reason, your repeated tests continue to show indeterminate status, write back, OK? Also, try not to worry. As I mentioned above, based on what I know so far, I would assume you are indeed HIV negative.

Dr. Bob



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