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INDETERMINATE WESTERN BLOT.
Mar 5, 2007

HI I have been diagnosed as HIV positive by 2 doctors and as HIV Indeterminate by one doctor, in the same town, in the last few weeks, based on blood test results that came back with the same findings to each doctor. I do not know if I am HIV positive or HIV Indeterminate. I am HIV positive on Elisa and my western blot is positive for P24 and GP 160 (not gp120). All 3 doctors found these results independantly and just interpreted the results differently. I tested HIV negative on Elisa on October 21st 2006. I tested HIV positive on Elisa January 15th 2007 and this was followed shortly after with the western blot results above. Going back carefully over my sexual history the only time since June 2006 up to today, that I could have been infected was one sexual encounter around October 20th 2006 with a male (well transexual) prostitute. We used a condom, both of us. We performed oral sex on each other withouth a condom and withouth ejeculating. I am hetrosexual and my current partner tested HIV negative this week . We have been using a condom since my positive elisa test on Jan 15th and had unprotected sex last time on Jan 7th. The doctor who declared me HIV positive declared her with a 98% chance of being HIV free because its about 7 weeks since the last possible time of infection. Is he correct? What about me? Am I indeterminate or posiitive? I would like to ad that I was not immunized as a child and from September 2006 started to get immunization for just about everything. taking 4 or 5 shots at a time (Rabies, hepatitise A,B, etc.

Thanks

Response from Dr. Frascino

Hello,

I can't tell from your post if you've had three separate tests or just three separate opinions on the same test results.

Here's what I can say based on the information you've provided:

1. Your HIV risk would be negligible, if indeed your only potential HIV exposure was a single episode of condom-protected tranny-sex and unprotected bilateral oral.

2. The interpretation of confirmatory Western Blot tests is as follows:

a. Negative equals no bands.

b. Positive equals band reactivity to gp 120/160 plus either gp41 or p24.

c. Indeterminate equals any band pattern not meeting the criteria for a positive test.

3. The sensitivity of HIV Western Blot tests is 99.5% and the specificity is 99.994%.

4. False-positive results for both ELISA plus Western Blot range from 0.0004% to 0.0007%.

5. The causes of false-positive tests can include autoantibodies, HIV vaccines, factitious HIV, technical error and clerical error.

Could your recent vaccinations cause false-positive results? It's more likely that vaccine-induced antibody production may cross react on an ELISA test than on an HIV-specific Western Blot.

At this point, if the situation remains uncertain or disputed, I would repeat the ELISA and, if positive, the Western Blot plus get an HIV plasma viral load and T-cell subsets analysis. If that doesn't definitively resolve the issue, I'd suggest you have your entire medical record reviewed by an HIV specialist.

Keep us informed of your evaluation, OK?

Good luck.

Dr. Bob



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