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Please Help - Indeterminate WB - p24
My wife just had a baby a couple of days ago. Three weeks prior, she had tested negative for the HIV screening as well as during her first trimester. Right before the delivery, they did a rapid test where HIV came back positive. They said it could be a false negative so they sent it for a WB. We got the results of the WB today and they said it was indeterminate because all the strands were negative except there was a reaction to p24.
I went out yesterday and got a home access test done on myself and the results came back negative. The last time my wife and I had sexual intercourse was 8 weeks ago.
1. I'm looking for some serious help here to figure out if there are any reasons that someone could test positive on the p24 strand but not be HIV+?
2. Could I have infected her 8 weeks ago and yet my antibody test still comes up negative? I was involved with a low risk situation 3 months ago but you advised me on this forum that there was nothing to worry about from it.
Right now they're saying to keep our baby on HIV medication until we get another WB test in 3 more months.
Please help?
I went out yesterday and got a home access test done on myself and the results came back negative. The last time my wife and I had sexual intercourse was 8 weeks ago.
1. I'm looking for some serious help here to figure out if there are any reasons that someone could test positive on the p24 strand but not be HIV+?
2. Could I have infected her 8 weeks ago and yet my antibody test still comes up negative? I was involved with a low risk situation 3 months ago but you advised me on this forum that there was nothing to worry about from it.
Right now they're saying to keep our baby on HIV medication until we get another WB test in 3 more months.
Please help?
MEDICAL PROFESSIONAL
There is virtually no chance you, your wife, or your baby have HIV and most likely your ID specialist agrees and is just being cautious and conservative, which is the right thing to do. In any case, he probably knows more about this than I do; I have had no personal experience caring for patients in your situation. You need to stop relying on this or any other online resource; now that you are in the care of an appropriate specialist, any and all future questions should go to him. In the meantime, stay cool. This is all going to turn out all right.
That ends this thread. Best wishes.
That ends this thread. Best wishes.
MEDICAL PROFESSIONAL
This is additional strong evidence you don't have HIV.
In addition to (or instead of) an adult ID specialist, consider insisting that your pediatrian(s) consult with a pediatric ID specialist about whether your child should continue anti-HIV therapy. Personally, I don't see the need. But as I said, this is not my area of expertise.
In addition to (or instead of) an adult ID specialist, consider insisting that your pediatrian(s) consult with a pediatric ID specialist about whether your child should continue anti-HIV therapy. Personally, I don't see the need. But as I said, this is not my area of expertise.
MEDICAL PROFESSIONAL
Yes, most p24-only WB result do come from things other than HIV. What those "things" are isn't known.
As all my comments above make very clear, it is very unlikely your wife has HIV. The answer will become clear very soon with additional testing. Try to stay calm in the meantime. I'll be happy to comment further as other tests become available, or after you have seen the ID specialist -- but won't have any other advice until then.
As all my comments above make very clear, it is very unlikely your wife has HIV. The answer will become clear very soon with additional testing. Try to stay calm in the meantime. I'll be happy to comment further as other tests become available, or after you have seen the ID specialist -- but won't have any other advice until then.
Last question for now.
"it is true that a p24-only WB finding, if due to HIV at all, means a very early infection "
I think you answered my question here, but the comment you made above implies that there are cases that the p24 finding could come from things OTHER than HIV which would cause a positive on the initial screen as well?
"it is true that a p24-only WB finding, if due to HIV at all, means a very early infection "
I think you answered my question here, but the comment you made above implies that there are cases that the p24 finding could come from things OTHER than HIV which would cause a positive on the initial screen as well?
MEDICAL PROFESSIONAL
Glad to have helped. Best wishes for your growing family.
Doc,
My wife just got back her WB and it was fully negative. Thank you for all of your help here. I can't describe how much this site has helped us cope with the news we got just two weeks ago. It created hope where there originally was none.
Thanks again and know that you truly do make a difference in people's lives with this forum.
My wife just got back her WB and it was fully negative. Thank you for all of your help here. I can't describe how much this site has helped us cope with the news we got just two weeks ago. It created hope where there originally was none.
Thanks again and know that you truly do make a difference in people's lives with this forum.
Doc, we just saw our ID specialist for the first time and he said that the Viral Load wasn't a conclusive test for him and he wanted to run a p24 antigen test before he could sign off on the false positive. In the meantime, he suggested that we keep our daughter off breast milk and keep her on azt.
My wife was devastated all over again because the HIV specialist that gave us the viral load told us earlier this week that with a reading of under >20 copies on both of us, there is a 99.99% chance that everything is ok. Unfortunately, we just didn't get that impression from the ID Specialist but I suppose he's just being overly cautious.
I've asked Joggen and Teak on the other forum, but I'll ask you the same because the doctor that we were with seemed rushed and I was busy consoling my wife so I didn't ask a lot of questions. I have one main one...
1. Would there be a case where she tested under 20 copies on the viral load but STILL had antigens in her system? If there were a case where that could happen, what would it look like? Would there have to be a window period in which she was exposed for this combination? (she hasn't had intercourse in over 8 weeks)
Thanks Doctor.
My wife was devastated all over again because the HIV specialist that gave us the viral load told us earlier this week that with a reading of under >20 copies on both of us, there is a 99.99% chance that everything is ok. Unfortunately, we just didn't get that impression from the ID Specialist but I suppose he's just being overly cautious.
I've asked Joggen and Teak on the other forum, but I'll ask you the same because the doctor that we were with seemed rushed and I was busy consoling my wife so I didn't ask a lot of questions. I have one main one...
1. Would there be a case where she tested under 20 copies on the viral load but STILL had antigens in her system? If there were a case where that could happen, what would it look like? Would there have to be a window period in which she was exposed for this combination? (she hasn't had intercourse in over 8 weeks)
Thanks Doctor.
MEDICAL PROFESSIONAL
You should be relying primarily on the doctors who are ordering your tests, especially if you are now under the care of an ID specialist. My belief is that these results should be considered definitive, but additional testing may still be recommended.
Doc,
My wife and I both took PCR tests and the results came back negative. I'm under the impression that this should be conclusive? Thanks again for all of your help here.
My wife and I both took PCR tests and the results came back negative. I'm under the impression that this should be conclusive? Thanks again for all of your help here.
Doc,
Just wanted to give you an update. I had someone come into our home today and give both my wife and I RAPID Oraquick tests. Both of our results came back negative.
Not sure what to do though because the pediatricians probably don't want us to take the baby off medication until we have a follow up WB.
Anyway, I think this is good news. Just letting you know.
Just wanted to give you an update. I had someone come into our home today and give both my wife and I RAPID Oraquick tests. Both of our results came back negative.
Not sure what to do though because the pediatricians probably don't want us to take the baby off medication until we have a follow up WB.
Anyway, I think this is good news. Just letting you know.
We're calling an infectious disease specialist tomorrow to try and get in. I'll keep you updated. Thank you doctor.
MEDICAL PROFESSIONAL
1) Yes. If she were infected 8 weeks ago, her test would not be indeterminate. It would be positive. And as I said above, it is true that a p24-only WB finding, if due to HIV at all, means a very early infection -- which is why I said another WB in only 1-2 weeks would sort this out quite well.
2) The reasons for indeterminate WB results are not well known. There are some reports of an increased frequency during pregnancy. Other antibody tests also give atypical results more frequently in pregnant women; the syphilis blood test is an example. However, it is never possible to pinpoint a specific reason in any individual patient.
Have your wife's doctors, or the baby's doctor, consulted with experts in HIV, such as infectious diseases specialists? Your own doctors may be genuine HIV/AIDS experts, but if not you should insist on such an expert.
You don't need to donate anything more. If Dr. Hook and I depended on MedHelp for our income, we would starve. And it's certainly understandable that people forget their usernames. Don't worry about it.
2) The reasons for indeterminate WB results are not well known. There are some reports of an increased frequency during pregnancy. Other antibody tests also give atypical results more frequently in pregnant women; the syphilis blood test is an example. However, it is never possible to pinpoint a specific reason in any individual patient.
Have your wife's doctors, or the baby's doctor, consulted with experts in HIV, such as infectious diseases specialists? Your own doctors may be genuine HIV/AIDS experts, but if not you should insist on such an expert.
You don't need to donate anything more. If Dr. Hook and I depended on MedHelp for our income, we would starve. And it's certainly understandable that people forget their usernames. Don't worry about it.
"A positive p24 antibody band, by itself, is the most common cause of an indeterminate result, so your wife's test result is typical in that regard. "
Do the majority of p24 indeterminate's also end up negative?
Do the majority of p24 indeterminate's also end up negative?
Thank you Dr. Handsfield. Your information is all we have to go on this evening and I can't tell you how helpful it is.
I have posted before but to be honest, I couldn't remember my other username. I meant nothing by it and apologize if I violated any rules.
A couple follow up questions:
1. IF I actually was the one that infected her 8 weeks ago, wouldn't she be showing more strands in her WB by now? It sounds like if the p24 is in fact positive, the exposure would have happened 1-3 weeks ago? Is this correct?
2. The main question is this... are there circumstances where someone like my wife would test positive for the p24 strand but be completely negative from HIV? If so, any reasons why? Would her pregnancy have anything to do with it?
Thanks and I'm more than willing to donate more money for the second round of questions if needed.
I have posted before but to be honest, I couldn't remember my other username. I meant nothing by it and apologize if I violated any rules.
A couple follow up questions:
1. IF I actually was the one that infected her 8 weeks ago, wouldn't she be showing more strands in her WB by now? It sounds like if the p24 is in fact positive, the exposure would have happened 1-3 weeks ago? Is this correct?
2. The main question is this... are there circumstances where someone like my wife would test positive for the p24 strand but be completely negative from HIV? If so, any reasons why? Would her pregnancy have anything to do with it?
Thanks and I'm more than willing to donate more money for the second round of questions if needed.
MEDICAL PROFESSIONAL
I knew that.
MEDICAL PROFESSIONAL
Welcome to the forum. I understand how upsetting this situation can be, at least the initial shock. I'll try to help, but you're going to have to rely on your wife's and the baby's doctors for definitive information and advice.
Indeterminate HIV test results, including Western blot results, are not common. But when they occur, in the large majority of cases, there is no HIV infection. A positive p24 antibody band, by itself, is the most common cause of an indeterminate result, so your wife's test result is typical in that regard.
In the very unlikely case that your wife has a very early HIV infection, her WB will become fully positive within a couple of weeks. Most likely her doctors are planning to repeat it around that time. In addition, most likely they will do (or have done) other HIV tests, such as a test for p24 antigen itself and a PCR test to check for the virus in her blood. If those are negative, it will be a strong indicator that she just has a false positve result.
If your wife does have HIV, your negative HIV test result proves you were not the source of her infection. She would have had to acquire the virus elsewhere. Assuming she hasn't had sex with someone else in the past 2-3 weeks, and is not an injection drug user, this in itself is more evidence that she isn't infected with HIV.
I'm a little surprised your baby's doctors are planning to continue antiHIV thereapy for a full 3 months. It should be possible to know for sure whether your wife has HIV within the next 1-2 weeks, as I already described. If she does not, then it would seem OK to stop the baby's treatment. However, I am not an expert in this area and have no experience of my own in treating infected newborns or using preventive therapy in them.
In any case, whatever is going on has absolutely nothing to do with the strip club event you described on the community forum (or maybe it was when you posted the question on the international forum) -- which presumably is the "low risk" situation you asked about once before. However, I can't find a previous thread from you on this forum. (If you have used a different username, you may be hearing from MedHelp administration about it. Multiple usernames are against forum policy.)
I hope this helps. Best wishes-- HHH, MD
Indeterminate HIV test results, including Western blot results, are not common. But when they occur, in the large majority of cases, there is no HIV infection. A positive p24 antibody band, by itself, is the most common cause of an indeterminate result, so your wife's test result is typical in that regard.
In the very unlikely case that your wife has a very early HIV infection, her WB will become fully positive within a couple of weeks. Most likely her doctors are planning to repeat it around that time. In addition, most likely they will do (or have done) other HIV tests, such as a test for p24 antigen itself and a PCR test to check for the virus in her blood. If those are negative, it will be a strong indicator that she just has a false positve result.
If your wife does have HIV, your negative HIV test result proves you were not the source of her infection. She would have had to acquire the virus elsewhere. Assuming she hasn't had sex with someone else in the past 2-3 weeks, and is not an injection drug user, this in itself is more evidence that she isn't infected with HIV.
I'm a little surprised your baby's doctors are planning to continue antiHIV thereapy for a full 3 months. It should be possible to know for sure whether your wife has HIV within the next 1-2 weeks, as I already described. If she does not, then it would seem OK to stop the baby's treatment. However, I am not an expert in this area and have no experience of my own in treating infected newborns or using preventive therapy in them.
In any case, whatever is going on has absolutely nothing to do with the strip club event you described on the community forum (or maybe it was when you posted the question on the international forum) -- which presumably is the "low risk" situation you asked about once before. However, I can't find a previous thread from you on this forum. (If you have used a different username, you may be hearing from MedHelp administration about it. Multiple usernames are against forum policy.)
I hope this helps. Best wishes-- HHH, MD
In my first paragraph, I meant that they thought it could be a "false positive", not a "false negative".
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