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Folow up results, donation made
Dec 12, 2007

Hi Dr.

This is the guy who does not use spell check. I am the guy who had a positive elisa and indeterminate western blot with p24 only. This was discovered during IVF testing. The last few weeks have been very stressful for me and my wife.

So my last email I told you that I went for additional testing. The results are in.

RNA, Real Time PCR (Graph) HIV-1 RNA by PCR Less than 48 copies/ml, HIV-1 RNA not detected. The doctor also added a bunch of other tests that were all normal except for 1 test. That was CD3+CD25+Lymphs--result was 3.8 limit was 4.93-25.85. The doctor wasn't really concerned with it. The other thing she pointed out was my t-cell tests were all normal absolute cd 3 was 1511.

The doctor is very confident that the first hiv test was a false positive. However she wants to be 100% sure and ordered me to do 1 more set of tests.Elisa, Western Blot, and HIV viral load by pcr (quantitative).

The first tests were done 10/25/07. The second tests were done 11/21/07.

I guess I would like your opinion about having to do this last set of tests. Does the HIV-1 RNA by PCR that was just done give me a pretty good chance of being HIV negative. Thank You So much for all your information. You have been very helpful and I really appreciate the time you have taken to respond to my questions.

Response from Dr. Frascino

Hi,

I do not recommend quantitative PCR RNA tests for routine HIV screening or sorting out disputed or indeterminate HIV serologic tests. Nor do I recommend T-cell subset analyses for this indication. For disputed or indeterminate HIV serologic tests I would recommend repeating the ELISA and then Western Blot if the ELISA is positive. If results are still uncertain, then a DNA PCR (qualitative) may be helpful in determining HIV serostatus.

From the tests you've had done so far, I agree your initial test (positive ELISA, indeterminate Western Blot) was most likely falsely reactive. I would not recommend repeating your PCR RNA due to the rate of false-positives, technical issues and cost. Rather just repeat your ELISA. If negative, that's all you need. If reactive, proceed with the Western Blot. If it's once again indeterminate, get a qualitative DNA PCR. That's the algorithm I use to sort out situations like yours.

Good luck. I'm willing to bet your results will ultimately be HIV-negative.

Dr. Bob



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