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HIV Testing & Falses HIV Testing
Apr 4, 2006

This past week I went in for my annual blood HIV testing because my spouse has HIV. My initial HIV test this week returned with an abnormal result which inspired that lab to test with the additional Western Blot exam. This too returned inconclusive. They said that there was light banding on two of the protein indicators, but not all were present nor was this test showing a conclusive response. I was told to return next week for further repeat testing and for the additional viral load blood test. My question is: For those of us who are in a relationship with someone who is HIV positive are we more likely to acquire a false positive HIV test because of low viral exposure or naturally killed viral exposure? Could our own immune systems be picking up immune responses from out significant other through casual contact? Have there been any studies with serodiscordent couples showing any immune response or echoing immune response to their spouse's infection. I know I may be desperately grasping at straws in hopes that I have not acquired this infection, but I thought I would ask the experts if this was a significant probability. One would think that if there were naturally killed virus proteins in our spouse's mucous then the negative partner may come in contact with this material though kissing and hence over time may begin to show immune responses against these killed proteins in our own immune systems. This may eventually show up as a false positive HIV result. Maybe the viral load testing should be done initially with any serodiscordant negative spouse to rule out any false positive tests initially and to prevent unnecessary anxiety regarding these false positive results. Anyhow, it has made for an anxious Thanksgiving weekend. I will see next week if anything else shows up in my blood-work.

Response from Dr. Conway

The pattern of testing that you describe (with a positive screening antibody ELISA and an indeterminate Western blot confirmatory test) may be the prelude to a full antibody response and needs to be followed up quickly. We would do a viral load and a CD4 test to see if this is acute HIV infection, as some people (including our own group) believe that intervention at that early time may help control the infection in the long term. This is why it is most important to make the diagnosis with certainty as soon as possible.

If the Western blot test remains indeterminate, then it may well represent the fact that you have developed some immune response to HIV through repeated expsoure but have avoided infection to date. This is certainly described in the past and may help you continue to avoid infection in the future, but it is difficult to be sure about this.

I wish you clarity of mind and all the support you need in facing this important time in your life.



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