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Follow up to "Initial ICMA positive with Indeterminate Western Blot followed by a non-detectable HIV-1 RNA PCR test"
Sep 11, 2011

Doctor,

I am writing you to tell you about the events that followed my visit to the specialist after I posted the following message to you. (By the way Thank you for responding initially)

Question "Dr., I want to first thank you for having a forum like this.

So here it goes...about a week and a half ago (Friday August 26th) I had a blood panel done with STD testing. The doctor then called me on Tuesday (August 30th) but I missed it and he left a voicemail saying that I should call him two days later to discuss results. So I did and on Tursday September 1st he said you are HIV positive. My world was crushed. I had to tell my girlfriend and her family that I could have passed it on to her. Told my family and so on. The next day I went to my doctor's office and he was not there so I asked for a retest and the nurses showed me the results. They were as follows: ICMA HIV1/0/2 ABS Index Value 2.01 High. HIV 1/0/2 ABS, QUal Abnormal Repeatedly reactive. Western Blot Indeterminate all bands absent except P24 that had an Equivocal. I didn't understand any of it so I started researching and came accross your site that made me have hope this was a mistake. Since then I received the HIV-RNA PCR result as non-detectable less than 20 copies per mL. And my T CEll Panel has me with Absolute CD3 612/UL Low, Absolute CD4 Helper 350/UL Low, Neutrophils 82 % High and Lymphs 12% Low. Everything else was within reference interval.

Can you please help me understand these results. This has been the worst weekend of my life and my doctor doesn't even bother to call me back. I am going to see a Infectious disease specialist today (September 6th)."

Answer "Hi.

A repeatedly reactive screening HIV-antibody test (rapid test, ELISA, EIA, ICMA) plus an indeterminate Western Blot does not mean you are HIV positive! This testing pattern is "indeterminate," not "positive"! Your follow-up undetectable quantitative HIV RNA PCR indicates you are not HIV infected. There was no indication for running a T-cell panel. There are many conditions that can cause a transient drop in absolute CD4 count.

I'm glad you are planning to see another physician. Your initial physician is incompetent. Encourage the infectious disease specialist to contact your first doctor to point out his error.

Write back with a follow-up report after you've seen the infectious disease specialist.

Good luck!

Dr. Bob"

So I went to see the specialist and he immediately put my mind at ease. He said that the initial test was indeterminate and not positive...just like you said. Also he called my physician and informed him of this. The specialist went on to explain the different scenarios as to why there is no reason for concern. He even went as far as explaining to my girlfriend why we had nothing to worry about. Before I left his office he just asked that I relax and that he will call me when the rest of the results for the secondary draw were back and NOT to worry.

Leaving his office I felt this relief and hope that all would be ok. Then the following day I got a call from the specialist saying that all looked great and that it was a false positive. Also that same day my girlfriend got her tests back and she was negative for everything too. We were so relieved. Furthermore my primary physician called that night to apologize and inform me that it looks like it was a false positive.

Now it is Friday (September 9th) and things are as back to normal as they can be. This was a traumatic experience that has altered my view on life. It has also encouraged me to volunteer and in some way help those that are or will be in a position like mine.

I want to thank you for your quick response and encouraging words. Your contributions are priceless and a gift to those seeking REAL answers.

More people (including doctors) need to be educated before they incorrectly diagnose someone. This is important because if I did not have the support system that I have (family and friends) I do not think that I would have handled it like I did and looked for further answers and advice.

Thank you again for everything and sorry for going on and on.

My warmest regards,

Nelson

Response from Dr. Frascino

Hi, Nelson.

Thanks for taking the time to write back with your excellent-news follow-up report. I'm delighted my advice was both helpful and corroborated by the infectious disease specialist. WOO-HOO!!!

Be well. Stay well.

Dr. Bob



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