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cd4, viral load...and pregnancy

Apr 3, 2011

I did a ELISA test two weeks ago (test requested by my doctor as i'm 2,5 months pregnant) and the results came out positive. I was so surprised and we (my husband and myself)went againd for the ELISA test and i was still positive but my husband was negative!. I never have any sexual relation with someone else except my husband. Then i decided to do the Western blot test and, we are still waiting for the results. Also, i did the cd4 and viral load test the same week and the results came out today. Cd4 about 280 and viral load at 2000copies/mL. My question is, does this mean i can consider myself as HIV positive? My had msicarriagede for the past 3years, and this time (almost a miracle), i got pregnant without any means than normal sexual relation with my husband. For the past 02 years, i've been thru one IVF (unsuccessful) and various medications to try to get pregnant..without success. Thank you very much.

Response from Dr. Frascino


It's a little bit difficult to sort out exactly what's going on here, as some inappropriate tests were performed and now you have to deal with trying to explain the abnormal results of that should never have been done .

HIV testing during (or pre) pregnancy is warranted and very much recommended. That said, pregnancy can, in some cases, cause non-specific antibodies, which can result in indeterminate or false-positive HIV-antibody test results. This might account for your reactive (positive) ELISA tests. However, it's important to note that an HIV-screening test is not labeled as a true positive until both an ELISA test and a confirmatory Western Blot test are determined to be positive. You are still apparently waiting for the Western Blot results, so we don't know if you've tested HIV positive or not. If you do test HIV positive (positive ELISA and WB), additional tests, such as HIV plasma viral load, would be run along with a CD4 count to ascertain the amount of viral activity (replication)amount of immune system damage that has occurred. Without a positive ELISA and Western Blot, these other tests (viral load, CD4 count) should not be run.

Your low HIV plasma viral load could be a false positive as well, particularly because you are obviously not taking antiretroviral drugs. The low CD4 count is more difficult to explain. If this is accurate, it would suggest you have been HIV infected for a number of years (maybe five to seven).

At this point, I would suggest you consult an HIV physician specialist in your area. He will be able to review all your test results and order whatever confirmatory or additional tests are indicated to confirm your HIV status. If indeed you are HIV positive, you will need to begin antiretroviral therapy to decrease the risk of passing the infection on to your unborn child. Your husband will need HIV testing at three and six months from his last exposure (unprotected sex).

Write back once your status is sorted out and I'll post your follow-up report.

Good luck!

Dr. Bob

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