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Pregnancy, Indeterminate Elisa/Negative Western Blot?
Jun 5, 2012

I'm pregnant (5th pregnancy) and as a part of my routine prenatal labs, they ran an Elisa. The Elisa came back Indeterminate. They then ran a WB and the WB came back negative. I was told that I am HIV negative and there is nothing more that should be done. My blood has done weird things in the past. Last pregnancy I threw a positive RPR (titer 1:4) which came back with a negative FTA-ABS. Now this indeterminate Elisa with negative WB.

I wouldnt' be worried about this at all if I weren't a health care worker. I work delivering babies, and I've been splashed with mixtures of amniotic fluid and blood every now and then. However, each time I get splashed, I make sure to check the HIV status on the prenatal record and each time the women have always been noted to be negative in their prenatal records. Otherwise, I've been in a mutually monogamous relationship for 8 years and have always tested HIV negative with each pregnancy and blood donation.

My biggest concern is that I am seroconverting, which is why the Elisa was indeterminant (What does an indeterminant Elisa even mean, I"ve only heard of indeterminant WB?). But if I was seroconverting, wouldn't it be likely that the WB would also be indeterminate with at least one or two bands showing? And that was negative, so I am perplexed. I've been racking my brain about the women I've delivered in the past 6 weeks especially and I just can't remember any that were not in mutually monogamous relationships with negative HIV results in the prenatal record. So I'm not even sure where an exposure would have come from.

Any words of wisdom?

Response from Mr. Cordova

Hi, there:

A negative Western Blot would be considered conclusive outside of the three month window, although at 25 days I would feel comfortable with the results even though you would need a three month test just to be certain. An indeterminate ELISA is the same an an indeterminate Western Blot, all it means is that neither a reactive or non-reactive result could be determined.

While rare, pregnancy can affect HIV test results and cause false-positives. Your negative result would not be called into question. The only caveat is that you are within the 90 day window so a negative result cannot be considered conclusive. Being splashed with blood would only be a concern if there was direct access to your bloodstream. Unbroken skin is an effective barrier against HIV.

Bottom line: I would not be concerned. Follow up with a three month test for your peace of mind. I am confident the result will be negative.

In health,

Richard



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