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please help
Feb 3, 2008

Dr. Bob thank you for your help and guidance. I am going for my follow up on the negative elisa, equivocal western blot p 24. I was the one where a western blot instead of an elisa was run initially, then had the undetectible pcr viral load at two weeks, lab had me retest at 6 weeks, still negative elisa, equivocal western blot p 24, undectible pcr viral load. I really want to do a oraquick as I am greater than 3 months out to get the results as soon as possible (minimize anxiety)but do not know if this could show a false positive given the equivocal western blot. any thoughts? I really can not find any info on this so I have turned to you. Thank you.

Response from Dr. Frascino

Hi,

All of your problems stem from improper ordering of HIV testing! A Western Blot should only be done as a confirmatory test following a repeatedly positive ELISA. So your first set of tests was difficult to interpret, because an ELISA was never run and the Western Blot was "equivocal". The mistake was then compounded by ordering another unwarranted test the PCR viral load! Luckily the PCR did not give a false-positive result! Your retest in six weeks was also improperly ordered! All you needed was an ELISA. If that was negative (as it was), that should have been the end of the story. You are HIV negative! However, also ordered were additional unwarranted tests, including another Western Blot, which was again indeterminate, and another PCR viral load, which was undetectable. The sum total of this unfortunate experience is that you are HIV negative and you have a physician ordering your tests who doesn't know what he is doing and certainly isn't doing you any favors. I see no reason for additional HIV testing. However, if you want to retest with OraQuick, that would be fine. That you've had an indeterminate Western Blot would not affect the test results.

HIV is not your problem. No way. No how. Your test-ordering physician is your problem. Way and how!

Dr. Bob



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