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I hope you have correctly diagnosed me..thanks
Aug 25, 2009

Hello Dr. Bob, Good morning. I hope you are doing a miraculous job. I had posted last time about my serology report where result came back as elisa positive and indeterminate wb slightly reactive to p24 (Result date June 27 2009), pcr rna quantitative report was less than 20 copies/ml. As I told you before my last exposure was unprotected oral sex followed by protected vaginal sex with csw was in December 14 2008. Since then my wife was/is only one partner for me (we use condom nowadays). She also tested hiv negative on july 8 2009 (few days after my result). As my Doctor told me to repeat whole test after one month, I drew blood on 19th august 2009 (after 54 days from the last test) and today (24 august 2009) I got the same result positive elisa and indeterminate westernblot (Result for PCR RNA waiting). I hope you have diagnosed me very correctly. As you told that I m negative, so the result is yet to come but my hope is inclining toward your words. Just wrapping up 1. last unprotected oral + protected vaginal sex---14 December 2008 2. elisa poz + wb indeterminate + pcr rna < 20 ---27 June 2009 3. My wife negative result ----8 July 2009 4. Second (elisa poz + wb indeterminate) ----24 August 2009

I read same kind of problem where indeterminate stay even the person is not infected. But I dont know what is causing this kind of result on me if this is not HIV. In every 4 to 5 days there is white layer on my penis head and around the shaft. Is this other STDs which is causing positive and indeterminate result? Does such kind of STDs really give false positive in HIV test? Any way thank you Doctor Bob for your encouragement. I hope I will be declared as negative person after few days. Doc. Bob, what do you think about my second serology report? I will be pleasure to hear from you. Thank you very much and may the God be in your side every time.

Response from Dr. Frascino

Hi,

You "hope I'm doing a miraculous job"???? Well, OK, if you say so. (I hope so too, although I'm not sure "miraculous" is the adjective I would have chosen, but OK.)

My assessment of your HIV status remains unchanged. You are HIV negative.

The most important factor in evaluating indeterminate results is risk assessment. Folks in low-risk categories (like you) with indeterminate tests are almost never infected with either HIV-1 or HIV-2. Repeat testing often continues to show indeterminate results and the cause of this pattern is only infrequently established. HIV-infected folks with indeterminate tests who are in the process of seroconverting usually will have positive Western Blot tests within one month. Consequently, that your repeat ELISA and Western Blot (WB) done six weeks after your initial indeterminate result is still showing the same results (reactive ELISA with indeterminate WB) would indicate you are not in the process of seroconverting. I'm confident your repeat quantitative HIV plasma RNA PCR will once again be undetectable. If that is indeed the case, as I suspect, no further HIV testing is warranted.

Be well.

Dr. Bob



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