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reactive P24 in indeterminate western blot (PREGNANCY AND INDETERMINATE WESTERN BLOT RESULT, 2011)

Apr 21, 2011

I am 32 yrs old and I am 16 weeks along on my third pregnancy. During my last two pregancies my tests came back negative, but for some reason this time my HIV test came back ineterminate on the western blot. Dr sent me for more extensive testing in which case everything was negative except the wstern blot which again came back indeterminate with a reactive P24. My Dr seemed a little nervous about this and said that in all his years of practicing he hs only seen this happen 3 times including me. I have been married to the same man for 7 years and I give blood frequently. I am freaking out and dont know why this would happen to me and why it wouldnt have happened during my other pregnancies. Any help you can give e would be greatly appreciated.

Response from Dr. Frascino


When you report your HIV test "came back indeterminate on the Western blot" and that "more extensive testing was negative except the Western blot came back indeterminate with a reactive p24," are you indicating that only the Western Blot (WB) had an indeterminate/reactive result? That the screening ELISA was negative? If so, your doctor is ordering HIV screening tests inappropriately! A WB test should only be run to confirm a repeatedly reactive screening ELISA (or rapid test). An indeterminate/reactive WB with a negative screening ELISA means nothing. It's a false-indeterminate/reactive test. So if your doctor ordered a WB inappropriately, you can relax; you are HIV negative. This is to be expected, as you had essentially no HIV-exposure risk! Someone should advise your doctor of his "misunderstanding." Frankly, he should know better!! (You may want to consider switching to a more competent/knowledgeable physician!)

If, on the other hand, the tests were ordered appropriately and you have a reactive/positive ELISA plus an indeterminate WB, I would advise that your result is still most likely a false-positive/indeterminate result for two reasons:

1. You have essentially no HIV risk and therefore have no potential to be HIV infected.

2. Pregnancy can cause nonspecific cross-reacting antibodies in the blood, which can result in false-positive or indeterminate HIV test results. You can read much more about this in the archives of this forum in the chapter devoted to pregnancy. Have a look.

Dr. Bob

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