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Terrified .. Please Help
Oct 21, 2008

Dear Dr Bob,

I had a potential exposure just over 13 weeks ago. I had protective oral and some penetrative vaginal sex with a female sex worker. I believe the condom stayed intact but of course cannot be sure.

I had a HIV test at 11 and a half weeks. The ELISA was equivocal and Western Blot negative and HIV antigen negative.

I took a second test at exactly 13 weeks and the ELISA again come back equivocal but this time the Western Blot showed one weakly positive band at p24. Another ELISA (I believe a manual test not in a machine) performed on this second sample was negative. In addition the HIV antigen test was negative.

The clinic have advised me to return for a furher test in 6 weeks. In the meantime I am going out of my mind with worry.

I just do not know how to interpret these results and what my potential risk of HIV is. Can you please give me some guidance on this please?

Response from Dr. Frascino

Hello,

If a condom fails (breaks), it is not a subtle occurrence. Mr. Happy's head comes popping out just like your head does when putting on a turtle neck sweater. I think you would have noticed if this occurred. If the latex (or polyurethane) condom was used properly and did not fail, your HIV risk would be essentially nonexistent.

Your HIV-screening tests are somewhat confusing, but most likely represent false-positive/equivocal results. In sum, you've had two equivocal ELISAs, one weakly positive p24 band on a Western Blot (WB), one negative WB, two negative p24 antigen tests out to 13 weeks plus your most recent ELISA, which was negative. The sum of these tests strongly points to an HIV-negative status. If your follow-up test remains equivocal/indeterminate, I would recommend a qualitative HIV DNA PCR. This test is not routinely recommended for HIV screening, but can be helpful in sorting out indeterminate HIV-antibody tests, as it does not rely on anti-HIV antibody detection, but rather assays for a piece of the viral genetic material.

Check out the archives of this forum. There you'll find many testimonials similar to your situation. I'm confident these testimonials will be very reassuring and enlightening.

Good luck.

Dr. Bob



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