Indeterminate ELISA Indeterminate Western Blot - scared

Question

Hello Dr. Bob - Really appreciate the work with your website.

I am a 30 year old man.30 days before ( Sep 20 2010), I had unprotected oral sex with a female sex worker. She cleaned up my penis before oral with a towel and I am not sure if it had someone else's semen. Also, I ejaculated directly into the same towel with the towel hard-pressed against my penis. There were no other activities.

Similarly, on Oct 6, I had a similar encounter. A sex worker gave me an oral and cleaned me up with a towel before and after. Again, I am not sure if the towel was used on someone else.

I got very scared and went for a HIV test on Oct 15. The Doctor called me today and indicated that results were indeterminate - both ELISA and Western Blot.

I have been very clean all these years and I am really scared now. I am on regular medicine for asthma - Singulair, Advair, Desloratidine and levosalbutamol. Not in the recent past ( 2 - 3 months), but pretty regularly over the years I have taken anotbiotics like Norfloxacin for my stomach upset and IBS. Though I do not remember, my asthma Doctor in India had given me some antigen ( I believe so ) to help with my dust mite allergy and I was on it for an year or so till some time in 2008.

I am really scared. Please let me know what I should do and how to stay positive

Answer

Hi,

Unprotected insertive oral sex carries only a very slight chance for HIV transmission/acquisition. The spunked-up cum towel would not be an HIV risk.

Regarding the test results, I don't understand the indeterminate ELISA. That test is either reactive (positive) or nonreactive (negative). There is no indeterminate ELISA result! If, and only if, the ELISA is reactive (positive), a Western Blot (WB) should be done as a confirmatory test. It can be positive, negative or indeterminate. Your asthma medication from 2-3 months ago would not alter the HIV-antibody test results. Likewise, your dust mite allergy immunotherapy (allergy shots) from 2008 would not affect the validity of your recent HIV-antibody test results.

My advice is to repeat your ELISA (and WB if the ELISA is positive) at the three-month mark (from the date of your last potential exposure). If the test is negative, you are HIV negative. If the test shows a positive ELISA and indeterminate confirmatory WB, you should get an HIV PCR DNA test. This type of test does not rely on anti-HIV antibodies, but rather assays for a piece of the virus's genetic material. It can help sort out inconclusive HIV-antibody test results. If your ELISA and WB are positive, you should see an HIV specialist physician for further evaluation.

I don't think you have to worry about "how to stay positive," because from what you've written, you are most likely "negative"!

Good luck.

Dr. Bob