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spell check guy (LOL)
Nov 23, 2007

Hi Dr.

I will be careful what keys I hit. I am the guy who is going thru IVF and received a positive Elisa and Indeterminate western blot with p24 only. You recomended a DNA-PCR to sort out the indeterminate result. I just left the lab and the tests the DR. ordered were as follows: 1. HIV viral load(quantitative ultra sensitive) 2.cbc (with differential)Manuel 3.comprehensive metabolic panel 4.lipid profile 5.t-cell subset 6.limphocyte subset

My question is why do you think they ordered the HIV viral load quantitative ultra sensitive rather than the DNA-PCR? Is it the same test? Also I was curious why the DR. did not order another elisa and western blot. Finally were all these other tests necessary in your opinion?

I really appreciate you taking the time to answer my questions. I would like to send a donation to your Foundation. please advise me the easiest way to do so.

Thank you Robert

Response from Dr. Frascino

Hello,

The HIV viral load (quantitative ultra sensitive) test is an HIV RNA PCR test. This test is used to determine how much HIV is actively replicating.

A DNA PCR test is used to determine if any HIV is present whatsoever. A person can have a very low RNA level but still have a positive DNA. That would indicate HIV is present but not actively replicating very much. (The PCR RNA would be "undetectable"). That is why I would recommend a qualitative DNA PCR to sort out disputed or indeterminate serological tests.

I can't really explain why your physician ordered the laboratory tests you listed. That combination of tests would be appropriate for someone who is definitively HIV positive. This has not been established in your particular case. Perhaps you could discuss this with your doctor or, alternatively, consider seeing an HIV specialist physician to quickly and conclusively sort out your HIV status.

Good luck and I'm glad you've learned where the spell check key is on the computer!

Dr. Bob

very confused Nov 16, 2007

Hi there

I am freaing out

My wife and I are having fertility problems and went to IVF. I was tested for HIV and the icma or elias came back positive. the western blot came back indeterminate with only p24 showing up. I have never used drugs and consider my self very safe. I have been tested 4 times in my life and all tests have been negative. I was given factor 8 about 15 years ago for a mild vonwillebrands disorder. basically a facto 8 defficiancy. About four years ago I was treated for hepatitis c probabily from the blood product. I have been undetectible for 3.5 years. the last time I was tested for hiv was when I went for my initial blood work for the hepatitis treatment. It was negative. That was four year ago. I have been with my wife for 3 years and she was tested 2 years ago and is negative. before my I was in a very safe long term relationship. So basically my question is can the hepatitis c treatment of interferon have caused these results? I have also had a tetnis shot a year ago as well as a hepatitis b vaccine a few years ago.Are there other reasons for these results.

in your opinion should I be having paniv attacks? Thanks

Response from Dr. Frascino

Hello Very Confused,

You're "freaing" out and having "paniv" attaches??? Hmm . . . no doubt we have an emergency here, a spelling emergency!

From your history your HIV risk is essentially nonexistent. You contracted hepatitis C from your factor 8 infusion 15 years ago and have been successfully treated for that. You have tested repeatedly negative for HIV, most recently four years ago. You've had no subsequent HIV-transmission risks and your wife tested HIV negative two years ago. Your recent HIV screening tests at the fertility clinic showed a positive ELISA and indeterminate Western Blot, showing only a p24 band. If indeed you had no HIV risk and tested repeatedly HIV negative in the past, you should still be HIV negative. There are a variety of potential causes for indeterminate HIV test results, including nonspecific cross-reacting antibodies, technical errors, clerical errors, etc. You can read about these in the archives. The most important factor in evaluating indeterminate results in folks like you is risk assessment. Low-risk folks with indeterminate tests almost never are infected with HIV-1 or HIV-2. I would advise: (1) you get a DNA-PCR to sort out your indeterminate results and (2) you use spell check!

Good luck.

Dr. Bob



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