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knowledge is power
Apr 14, 2008

hi dr.bob!! this is the third time i have written in to you. i apoligize for that as i know you are a busy man. i am grasping for some sort of hope right now. i was recently tested at approx. 5 weeks post exposure and my results for both tests came back indeterminate. well i have driven myself almost mad looking for something to make me feel more confident. it is almost definantly going to be a long 3 months until i am tested again!! ok, so here is what i found in the archives that could apply to me. an indeterminant result can occur if :1.a woman has had 2 or more pregnancies in the past 2. you have recieved blood transfusions 3. you have had recent viral infections 4. any malignancies. ok, so that being said, i have had 3 past pregnancies. i have had the rhogham shot a number of times in the past 5 years due to these pregnancies. i have recently had sinus infections(i get them yearly and struggle to get rid of them). and last but not least, i have recently been treated for cervical cancer. it was in the early stages and i had a procedure done back in september of 2007. could any of these things be contributing to my indeterminate results? what is the time gap for these things?? how recent do they have to be would you say?? also, how can multiple pregnancies affect hiv tests?? i am new to all of this and i find a lot of it very confusing. it is very complex and i am one of those people who need to know how and why. if you could just give me some sort of insight please!! i have been reading the archives for what seems like weeks now with no answers to my specific questions. no matter what the end result, i am a huge fan and will continue to read. knowledge is power right?? all my love and support to you and your team!! what you do here is great!! p.s. could you maybe send me some of your good luck karma?? please??

Response from Dr. Frascino

Hi,

I addressed some of your questions previously (see below). Your research in the archives has been fruitful. Yes, the four scenarios you reference could indeed be responsible for your indeterminate test results. One thing you could consider, if indeed you are freaking out about your indeterminate five-week results, is getting a qualitative HIV DNA PCR test. These tests are not recommended for routine HIV screening for a variety of reasons, but they can be helpful in sorting out unclear or indeterminate antibody-test results. HIV DNA PCR tests do not rely on anti-HIV antibodies; consequently, these tests are not affected by the four potentially confounding conditions you list above.

Good karma signed, sealed and sent! Good luck.

Dr. Bob

me again: inconclusive?? Apr 13, 2008

going slowly insane!! please help!!

hi dr. bob! before i get started i would just like to sing some praises your way. this is a great set up you have here. i'm sure it is very useful to many people as it has been to me. ok, so here goes. i was an idoit about 2 months ago and went out drinking. well, quite a few too many drinks later i found myself having unprotected sex with a man i barely knew. it was very brief, there was penetration but no ejaculation. i did somehow come to my senses after it started. however, i was an idoit again about 6 weeks after this incident and decided to go get bloodwork done. i know i should have waited the full 3 months, but the stress was killing me. so my results came in, no std's, perfect cbc, hiv "inconclusive". how could this be?? does a good cbc mean anything? i have become addicted to this forum, scanning for the answers i need. i have found a lot of useful info, but i was just wondering if you could tell me specifically if cbc and no other std's means anything. also, what are the main factors in recieving an inconclusive result? my doctor told me they would just use the same blood sample to do the other tests. i find this odd. wouldn't they want a fresh sample? does that mean anything? i do plan to disregard the first result anyway and go again when i hit the 3 month mark, but in the mean time i am going completely nuts. i have had to start anti-depressants in order to get through my days normally. can you give me any idea what all this means? your insight would be greatly apprieciated. thank you soooo much.

hello dr.bob.

me again. i just wrote to you yesterday (inconclusive?) and asked some questions about indeterminate results. well i am back today because i just came home from the doctor with yet another indeterminate result. she wants to re-test in three months. so now i have a few more questions. i am a single mother of two. my blood type is B- so that means with both pregnancies i had to have the rhogham shots. it had been around 11 months after the rhogham when i got tested this last time. could that be interfering with my test results? also i know that you insist that a three month test is definate but my doc says that it can live in the body un-detected for years after transmission. i am so confused as to what to believe. another thing she said is that if i am positive i may have contracted it while i was pregnant. why would i be more likely to get it then? wouldn't that mean that one or both of my kids would be positive as well? i tested negative with both pregnancies. she says not to worry about it but considering i am still in the window period i can't help but be a nervous wreck. i feel like i have sooo many things going against me right now. i think i could deal quite well with having hiv myself but if my babies have it too.... i just don't know. i am from a very small community where everyone knows everything about everyone. besides that they are mostly uneducated about hiv/aids. dr. bob, it isn't the disease so much that i am afraid of. it is how my children and i will be treated. i just don't know what to do at this point. i am almost certain that my final result will be postitive. what do you think?? any advice on any of these things will be appreciated greatly. thank you much, and keep up the good work. i love what you have going on here!

Response from Dr. Frascino

Hello Going Slowly Insane,

I combined your two posts so that I could address all your questions in a single response.

Your risk is unprotected sex (penetration but no ejaculation) with a guy of unknown HIV status. This does place you at some degree of risk for STDs, including HIV. Your STD screen at six weeks was negative (good news). HIV tests taken prior to three months are not considered to be definitive, as you know. Your six-week HIV test is "inconclusive." I'm not exactly sure what you mean by "inconclusive." Was your ELISA test reactive (positive) and confirmatory Western Blot indeterminate? We generally refer to this combination of tests as an "indeterminate HIV test." There are a variety of potential causes for an indeterminate HIV test, including testing during the seroconversion process, non-specific cross-reacting antibodies, technical or clerical error, etc. You can read more about these potential causes in the archives. My simple advice is for you to wait for your definitive three-month HIV test. If that test is indeterminate you could follow up with an HIV DNA PCR qualitative test. HIV DNA PCR qualitative tests are not used for routine HIV screening for a variety of reasons; however, they can be useful in sorting out unclear or indeterminate HIV-antibody test results.

Regarding your specific questions:

1. A "good cbc" means you have a good complete blood count. It doesn't tell you anything about whether you are HIV infected or not.

2. As far as using the same blood sample for the "other tests," I have no idea what other tests your doctor is referring to.

3. As for Rhogam shots, these would not affect HIV-antibody test results 11 months after administration.

4. As for your doctor stating HIV "can live in the body undetected for years after transmission," this just isn't true. You might want to consider switching to a more knowledgeable physician. I also don't know what she was referring to by her comment that you could have contracted HIV while pregnant. The risk of contracting HIV is related to unprotected sex whether you've got a bun in the oven or not.

5. If you life in a community that is mostly "uneducated about HIV/AIDS" (including perhaps the physicians!), why not do something about it! Begin an HIV/AIDS awareness/prevention campaign or work with local AIDS service organizations to get the word out. You just might save a life!

6. You state, "I am certain that my final result will be positive," and ask what I think. I am not a clairvoyant and I cannot predict the future. What I know is that you've placed yourself at some degree of risk for HIV and that you need an HIV-antibody test at the three-month mark.

Good luck on your three-month test. Write back if your results are not clear at that time or if you need additional advice based on the result. Also to avoid future bouts of uncertainty and worry, use a latex condom for all penetrative sex, OK?

Dr. Bob



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