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Positive or Negative?
Oct 21, 2009

Dear Dr. Bob, I donated blood for a function at my college through the American Red Cross. The results were as follows: HIV 1/2 antibodies - Positive Western Blot- - IND HIV-1 Antigen confirmatory test (neutralization)- NEG HIV NAT - NEG

I have read numerous other entries with results similar to mine, but some of these women are pregnant or have received a vaccine of some sort...neither of which apply to me. Perhaps it was just clinical error? I know the system wants to protect the blood. If the EIA is positive, but NAT is negative, does that mean I am negative? Especially with an inconclusive western blot?

I feel like my past sexual history puts me at very low risk...but I just want to be sure. The flyer that came with the letter said it was very highly unlikely that I had HIV, but I am still worried!!

Response from Dr. Frascino

Hi,

I would agree with letter/flyer: It is highly unlikely that you are HIV infected. In fact, I'm just about certain you are not, particularly in light of your "very low risk" sexual history. I do not believe your results are a clerical error. Rather, you most likely have some type of non-specific cross-reacting antibody in your blood that caused the initial positive HIV-1/2 antibody test and indeterminate Western Blot. That your p24 antigen is negative and NAT is undetectable would certainly strongly suggest you are HIV negative. I would suggest you repeat a standard ELISA (or EIA) with reflex Western Blot in two to three months. If negative, you're negative. If the results remain indeterminate again, I'd suggest getting a qualitative DNA PCR. You can read much more about these tests and indeterminate (as well as false-positive) HIV-antibody tests in the archives of this forum.

Good luck.

Dr. Bob



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