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scary test results
Feb 11, 2001

hi. i donate blood every 2 months, but this last time i donated, i received a letter that my results were abnormal. it turns out that my antigen test was positive, my nucleic acid test was negative and my antibody test was indeterminate. about 16 days prior to this last donation, i had unprotected sex (and i know this probably doesn't lessen my chances of becoming infected, but he did not finish inside of me). anyways, the counselor that i have been talking with keeps telling me that i probably have nothing to be worried about, but sometimes i just think she tells me that so i don't ruin my life (or at least these next few weeks) worrying about it. so, i was wondering about the nucleic acid result...is that accurate? and in general, how worried should i be? would my antigen levels be detectable after a little over 2 weeks? thank you so very much...i really appreciate it.

Response from Dr. Pavia

First of all, take a deep breath. Even if you are infected, learning about it within a few days of being infected may be a huge blessing, since treatment early may allow your immune system to deal with the virus later on. Now let's look at the facts.

The antigen test measures p24 antigen, a part of the virus. This test may be positive within 2 weeks of infection, before the antibody test turns positive. In general, though, PCR testing for nucleic acid (RNA) is more sensitive. That is, if you have a positive antigen test you generally will have an positive RNA as well. However, you have an indeterminate antibody test and you have had a high risk exposure (this is where you are supposed to swear permanent devotion to safer sex). So it is too early to tell.

The answer will come from repeating the antibody test and an RNA PCR (or bDNA test). It can be done relatively soon after the first set of tests. It might require an additional test a few weeks after that to be really certain. I would get in to see an experienced HIV provider who really understands testing and let them do the follow-up testing so you don't get confusing answers, and, if worst comes to worst, you will be in good hands. Good luck

ATP



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