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Indeterminate HIV test (different than the others, I think)
Aug 13, 2009

Hi Doc -

Last sex: 28 June First HIV test post-this: 21 July, roughly a month later; Oraquick (finger stick) - results non-reactive Second HIV test: 31 July. I wasn't being paranoid; my doc just did regular bloodwork and the HIV test is now opt-out, so it was already done.

Results: HIV test - ELISA repeatedly reactive, WB is indeterminate (only p24 showing). She told me I am "probably positive" (which I think was inappropriate for her to say, given what I've read about this lately)

Third HIV test: Just done yesterday. She's also doing a Cd4 and Viral load. Results won't be back for 2 weeks.

I think I've come to terms with her telling me I am "probably positive" even though I am extremely low risk (I've had sex with only one partner for a year). I'm just wondering, given that I've read a p24 is the only band, and that about 50% of people seroconvert in about 2-4 weeks, what my chances are.

Other data: the thing that got her (also) worried was a high liver function test (ten times the number of what it was 2 years ago). So she took hepatitis tests (I've been vaccinated for B and C previously; I got my most recent/last B series in Feb/March).

I'm also concerned that it could be syphilis (which would cause a p24 band alone and high liver functioning).

I am not freaking out, and I know you cannot tell me "it definitely isn't HIV" or "it probably is syphilis", but one article I read quoting Dr. Gallo (co-founder of HIV) said presence of only p24 is not necessarily a cause for panic.

But she told me I "probably" have HIV.

Who's right?

Thanks,

Sort of Calm

Response from Dr. Frascino

Hello Sort of Calm,

If you've had essentially no HIV exposures, your chance of being HIV positive are remote at best.

Regarding hepatitis C, there is no vaccine for hepatitis C. You must have been vaccinated against hepatitis A and hepatitis B.

As for syphilis, a simple screening test can give you a definitive answer.

I can't diagnose the cause of your liver enzyme elevation over the Internet; this is something your doctor will need to further evaluate.

Advising you that you are "probably positive" was premature to say the least.

Although I don't agree with getting CD4 counts yet, your follow-up lab work should provide you with a definitive answer one way or the other regarding your HIV serostatus.

Stay calm (or at least "sort of calm").

Good luck.

Dr. Bob



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