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About window period, PCR, western blot and conclusiveness
Feb 16, 2008

Hi. Mr Bob.

I am the one that made the question with title "tests says I am "-" . Could I have undetectable viral load?". I have to say I am sorry for asking something that stupid, I didn't know what was the process of standard HIV testings. Anyway, I have a couple of questions, about me and my partner:

about my partner:

His first results indicated he is positive. I called the labs and they said they tested twice before making a final judgement but the WB test wasn't done for that results. His doctor recommended a Western blot test and he already did it, he will get the results sometime next week. I am reading that false positive WB results aren't that uncommon.. would a positive (bad) result STILL be not conclusive?? what would you say is the best next step to take, after getting a + WB test? after what tests is someone absolutely and definitely HIV+ ?

About me:

I find myself in the window period. Our last risky contact was in mid January so that my negative result came about 3 weeks after possible infection. My partner's doctor suggested a PCR test for me but I am reading here that you guys sort of recommend against doing it. Would you say a standard HIV test after 6 months of the risky situation is far more conclusive than a PCR test?? I don't know what to do, I am not sure what I want to do :(.. 6 months is an eternity but positive PCR tests aren't uncommon as well, I am reading it isn't even a licensed (approved?) process... What do you recommend me?

thanks a lot for your time. Please receive a hug from both of us.

Will.

Response from Dr. Frascino

Hi Will,

About your partner: A "positive HIV test" consists of a repeatedly reactive ELISA test followed by a confirmatory positive Western Blot (WB) or IFA test. If he has a positive ELISA and WB, I would then repeat it to confirm his positive status as well as get other baseline studies, including a CD4 count and plasma viral load.

About you: I would recommend an HIV-antibody test at three months and, if negative, a repeat test at six months. If still negative, then you have indeed dodged the HIV bullet and are conclusively HIV negative. I don't recommend PCR tests due to the rate of false-positives, technical considerations with some of the assays and cost.

Dr. Bob



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