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Inconclusive then negative?

Mar 9, 2011

Dear Dr. Bob,

Something has been bugging me for about a year and I would appreciate your advice. I had taken two HIV blood tests with my GP. Both tests came back inconclusive/indeterminant. These were standard blood tests taken to the lab and reported back. My GP did not seem concerned about it and since I had not had unprotected sex or shared any needles he said I can consider the inconclusive a negative, especially since I got two inconclusives. The blood tests were two weeks spread from each other. So I took a test, waited two weeks, took another test, waited two weeks, and got myself the second inconclusive. In the end my doctor said just don't worry about it.

But alas, I was still worried and after the second blood test I went to an STD clinic and they gave me a rapid HIV test. This rapid was a fingerstick and I got the results within a minute, I am not sure what the bloodtest is called but I had done it at the Hassle Free Clinic here in Canada which is the best known STD clinic in the country. The result was negative. The health care provider told me that lots of things can make an ELISA blood test inconclusive including allergies, other viruses (like colds, flus), and even working out. However, I've read that an inconclusive can also be indicative of an early HIV infection. The only engagements I've had that were sexual is receiving oral sex, frottage, and mutual masturbation. And the time I took that test was nearly a year after I had had any penetrative sex (with a condom) so even if the condom did break (which I'm sure did not) the test would've come back positive then, correct?

As it's been a year since my last HIV test I'm getting a new one done in the next ten days. Can I expect a negative result or will this inconclusive come to bite me in the ass as a "in the process of seroconversion"?

The test I'm taking will be done at 85 days post any sexual exposure, can I trust the result?

Thank you Dr. Bob for addressing my questions. I hope all is well with you. Your blog about the search for a cure was insightful and I've given it to my brother who is a doctor in New York to read and he found it to be very interesting.

Bless you.

Response from Dr. Frascino


Your HIV-acquisition risk is extremely low (insertive oral sex); consequently, your chance of being HIV infected is also extremely low. There are a number of reasons for "indeterminate" HIV-antibody test results, although I don't agree with the information given by the health care provider. (Working out, allergies and most "other viruses" do not cause indeterminate HIV test results!) Indeterminate HIV-antibody results can quickly be sorted out by obtaining appropriate follow-up studies. If a repeat HIV-antibody test continues to reveal indeterminate results (repeatedly positive ELISA, EIA, rapid test plus an indeterminate confirmatory Western Blot), a qualitative PCR (DNA or RNA) could be obtained, as PCR tests do not rely on antibody production; rather, they assay for a piece of the virus's genetic material.

Will you continue to have "indeterminate" HIV-antibody test results? Possibly. However, it's important to note that persistent indeterminate results do not suggest you're "in the process of seroconversion"! If someone does have an indeterminate result because they are infected and in the midst of seroconverting, a subsequent test taken months later would certainly be definitively positive, not indeterminate!

Regarding your 85-day result, yes, that would be considered definitive.

Finally, I'm glad you found the blog insightful!

Be well. (I'm quite confident you are!)

Dr. Bob

unprotected sex while taking PEP
Freaked out medical student!

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