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Weakpositive Elisa, Indeterminate Western Blot
May 12, 2009

Hi DR. Last time that I was sexually active was in August, 2008. In October I had full STI/HIV testing done. No STI's came back, but the blood Elisa test for HIV showed up as "weakpositive". I repeated the test about 10 days later and it came back the exact same. The lab that conducted the test told my doctor that their evaluation was that I was not HIV positive. Also, when I went back to the doctors to give more blood for the re-test, he gave me a rapid, blood HIV test that came back negative. I could never shake that feeling of "weakpositive" and wanted a clear negative or positive. I've gotten 2 rapid HIV tests (OraSure, I believe) since, one around January 2009 and another at the end of March 2009, 9 months since I was last sexually active and 3 months over the window period. Both of those tests came back as HIV negative, non-reactive. Being slightly hypocondriacal and after too much googling I decided to get a Western Blot as this was advised for people with reactive HIV test (mine being the weakpositive that I've been finding hard to shake). I got the WB on Tuesday and got the results today indeterminate.

Western Blot results/bands:

gp160, absent gp120, absent p65, absent p55, absent gp41, absent gp40, absent p31, equivocal p24, absent p18, absent

So, only one band showing, equivocal at that, but still, worried sick now that 9 months since being sexually active a HIV WB is coming back indeterminate. After another Googling bout since I've received the results earlier, I see that p31 is a high HIV band unlike some others.

Any advice/expertise, etc. would be greatly appreciated. What's my next step? The lab said another WB test in 4 to 6 weeks but I'm not sure that I can wait that long. I've read that after indeterminate WB tests, PCR tests are the next step? Just as a side note, I got my WB through requestatest.com, gave blood at LabCorp.

Many thanks in advance,

Response from Dr. Frascino

Hi,

You are another victim of overtesting! I would agree with the lab interpretation of your initial tests: HIV negative! This would be confirmed by your three negative follow-up rapid tests out to nine months from the time of your potential exposure. There is absolutely no reason to get a Western Blot test following three negative rapid tests! In fact the reason not to get an unwarranted Western Blot is risk of a false-positive (or indeterminate) result. This is exactly what happened to you.

My assessment is that you are HIV negative. NO additional HIV tests are warranted. (You've had too many already!) When HIV-antibody tests are in dispute or unclear (yours are not!), I would get a qualitative HIV DNA PCR test.

Remember to always play safe to avoid ever having to endure these worries in the future, OK?

Good luck. Be well.

Dr. Bob



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