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indeterminate negative
May 13, 2008

hi i am a police officer so for a saftey issue i decided to get tested for hiv. i figured why not thinking i would be fine. my first test result for hiv-1 ab western blot came back indeterminate negative with reactive p24. my doc tested me again and the hiv-1 ab came back indeterminate negative with weakly reactive p24 the other test hiv 2 antibody eia came back non-reactive and the hiv 1 rna qn pcr came back in range. my doc is sending me to an infectious disease doc because she is unsure if i am negative. i am losing my mind and i have no symptoms and feel find but i am super scared. can you please tell me if i am negative? my doc said she thinks i am negative but because of my line of work she is sending me to an infectious disease doc. please help

Response from Dr. Frascino

Hello,

It's a bit difficult for me to determine what you mean by "indeterminate negative with reactive p24." Was your HIV-1 antibody test repeatedly reactive (positive) and the follow-up Western Blot indeterminate, showing only a p24 protein band? Or perhaps your HIV-1 antibody test was negative (non-reactive), but a Western Blot was done anyway (inappropriately) and revealed the p24 band.

In the first case, if you have had several HIV-screening tests showing positive (reactive) HIV-1 antibody tests (ELISA, EIA, rapid tests) followed by repeatedly indeterminate confirmatory Western Blot tests, I would recommend you get a qualitative PCR DNA test. The PCR DNA test does not rely on anti-HIV antibodies, but rather detects a piece of the virus's genetic material instead. It is not recommended for routine HIV screening, but it can be helpful in sorting out unclear or indeterminate antibody test results.

If, on the other hand, you have had several screening HIV-1 antibody tests that were negative (non-reactive) and despite these negative tests had Western Blot tests done (inappropriately), which were repeatedly indeterminate, then there is no need for additional testing. You would be considered definitively HIV negative, as the Western Blot tests would have been run inappropriately. Due to the rate of false-positives or indeterminate results, a Western Blot test should only be used as a confirmatory test after someone has tested repeatedly positive on ELISA, EIA or rapid tests.

With either scenario, the odds are astronomically in your favor that you are HIV negative. It's unfortunate that physicians ordering theses diagnostic tests are inadequately informed on how to interpret the results!

I see no reason to be super-scared. I'm very confident all will turn out to be "well," including you!

Dr. Bob



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