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HIV indeterminate
Nov 14, 2007

I got positive EIA followed by indeterminate WB test in Sep,2007. At that time, no band showed up, but it marked as indeterminate. Then, I had NAT (PCR) test one month later (middle Oct.)in another hospital, the result is negative. Then, I got test again in the first place, the result was still indeterminate, but two bands showed up (gp160,p31). I am very scared. From the internet, it is said that the window period is 6 months, but i did not have any risky actions with others. The doctor told me to get test again in Jan,2008. Is it possible that I am HIV+? Some articles mentioned about these two bands, they are very dangerously related to HIV+ criteria. Can you explain it? seems the WB test results get worse and worse. Why does it develop? How to explain negative result from NAT (PCR) result? Thanks.

Response from Dr. Frascino

Hello,

Your Sep 2007 test result, "positive EIA followed by indeterminate WB test" that showed "no bands," doesn't make sense. "No bands" would be a negative WB. If that was indeed the case, your HIV test (positive EIA, negative WB) would be read as a negative HIV test. That would coincide with the NAT result in middle Oct being negative.

The confusion arises from your third test that you describe merely as "still indeterminate with two bands gp160, p31." I'm assuming the third test also revealed a positive EIA and that the WB showed the two bands. The gp160 is an anti-envelope antibody while the p31 is an antibody directed against HIV polymerase. Indeterminate test results like these occur in at least 4% of WB assays and can result from a variety of causes, including cross-reacting nonspecific antibodies. If indeed you "did not have any risky actions with others," your HIV risk would be nonexistent and therefore your "indeterminate" result most likely is not related to an evolving HIV infection. The odds you are HIV negative appear to be extremely high. Rather than wait until Jan 2008 and repeat these same tests again (often repeat testing continues to show the exact same pattern), I would recommend a DNA-PCR. This type of test does not rely on antibody formation and should be able to sort out your indeterminate status now.

Good luck.

Dr. Bob



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