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What is my HIV status?
Jul 29, 2009

Dear Doctor Sir, I am 48 yrs old Indian male living in Indonesia. I am in the lowest risk group (no unprotected sex outside marriage, No IV drugs etc).During my routine HIV test (for life insurance requirement) a series of tests and their results are as follows: 1.Method MEIA: Reactive (s/co ratio 5.85) 2. Method Immunochromatographic Assay: Non Reactive 3.Enzyme linked fluorescent Assay (ELFA): Non Reactive 4.Western Blot: Positive (no details of bands were given) 5.CD4 : Normal (Abs 663 and %: 35%) 6.HIV-1 RNA (by RT-PCR): Virus non detected 7.MEIA on my wife: Non Reactive Based on these results what is my status? Positive or Negative? I am sure I did not get any possible exposure during last 3 years and never had any symptoms of HIV. Do I need any further test for confirmation? Except for WB tests all other tests were in reputed lab whereas WB was conducted at a government hospital.The doctor in Indonesia says my MEIA was false positive and does not believe WB test and assures me of Negative.Please tell me a final test which will clarify my final status Positive or Negative.

Response from Dr. Frascino

Hi,

I agree with your Indonesian doctor's assessment. You are HIV negative. You do not provide the dates of your HIV testing in your question; however, here is how I would interpret your results, assuming they were done sequentially. Your reactive initial HIV screening for life insurance (MEIA) was a "false" positive as evidenced by your subsequent non-reactive (negative) confirmatory immunochromatographic assay (a more specific test for HIV than the MEIA). Your subsequent non-reactive ELFA further confirms your negative status. The Western Blot test should not have been done at that time because it is warranted only for confirming a repeatedly reactive HIV-antibody screening test! Consequently the "positive" Western Blot is a "false" positive. The normal CD4 absolute count and CD4 percentage is to be expected, as you are HIV negative. (These tests were also not indicated, by the way.) Your plasma HIV RNA PCR viral load was undetectable. This too would be anticipated, as you are definitively HIV negative. This test was also not warranted based on your previous negative tests. Finally you have had a follow-up MEIA (the same test that started all this confusion!) and it was non-reactive.

The bottom line is that you are conclusively and definitively HIV negative. No additional HIV tests are warranted. You've had far too many already!

Dr. Bob



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