3 types of elisa test are positive, do i need to go for WB?

Question

I am 27 years old pregnant lady. During pregnancy, i got to know that i am hiv +ve. Then I was tested through 3 methods of ELISA - Combo aids rs, Retroquick, and hiv bi dot. All three tests have come positive. My doctor is suggesting i do not need to go for Western Blot test as all three types of ELISA test are more sensitive tests and hence I am HIV +ve. I never had any exposure to HIV and my husband has been tested as hiv negative. Please advise if I need to go for Western Blot or is it not required now. My CD4 counts are around 560. Please help!

Answer

Hello,

The ELISA tests are very sensitive; however, the Western Blot test is more specific. Any (even three in a row) ELISA test (or EIA or rapid test) absolutely needs a confirmatory Western Blot test before someone can be diagnosed HIV positive. You have essentially no HIV-exposure risk and your husband is HIV negative; consequently, there is a good chance your positive ELISA tests are false positives. Pregnancy can induce cross-reacting nonspecific antibodies that can confound HIV-antibody tests, leading to false-positive or indeterminate results.

There was absolutely no reason to obtain a CD4 cell count prior to confirming your HIV diagnosis! Your count of 560 is considered within the normal limits for most clinical laboratories.

Write back when your diagnostic workup is complete and I'll post your follow-up for our forum readers. Your experience may well help others in a similar situation.

Good luck!

Dr. Bob