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Reactive Elisa, WB indeterminate, PCR RNA undetectable
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Reactive Elisa, WB indeterminate, PCR RNA undetectable

Dear Drs,
On 21 and 28 of Sep 2012 I went to a gay sauna and had unprotected oral sex with 2-3 men. I gave oral without ejaculation. in the beging of Oct I was feeling a flu like sympthoms so I visited my Dr on 9th Oct 2012 and he got me tested for all STD and HIV. My test was a 4th generation Elisa which came back reactive and it was sent to the public health laboratory of quebec to have confirmitory tests. They did the WB and LIA for hiv 1/2 and Eia for p24.I did not see the result but my dr told me that It came back negative.

I was still nervous so I went to a HIV clinic in Montreal and I talked to a Dr on Nov 5th 2012(almost 5 weeks after last exp). He drew some blood ( 4 weeks after intial tests) and a week later he called me and told me the result was reactive and he wanted to run PCR RNA test. So I did the test and it was undetectable and meanwhile the confirmtion test came,the WB indeterminate and lia hiv 1/2 negative and Eia p24 negative.
My dr again run the PCR RNA test at 26 the NOV 2010 it was undetectable and again he sent some samples to the laboratories for HIV tests. Also, he run a rapid insti test on 26th Nov( 8 weeks post exposure) and it was negative.
I am waiting for the results and since oral sex is considered low risk activity, I am confused.

Welcome to the forum.

First, your sexual exposure was very low risk.  Catching HIV by oral sex is extremely rare.

Second and most important, it seems you are under the care of an expert.  My guess is that your Montreal doctor knows as much or more about acute HIV infections and the HIV diagnostic tests as I do.  As I'm sure he told you, the large majority of people with blood tests like yours do not have HIV.  Most people with indeterminate Western blot results do not have HIV, and the latest tests -- the RNA test, p24 antigen, and the latest antibody test -- all confirm that you are not infected.

My advice is that you continue with the Montreal doctor and follow his advice about any further confirmatory testing.  In the meantime, you can relax:  almost certainly you do not have HIV.

I hope this has helped.  Best wishes to you--  HHH, MD
Thanks a lot for the fast response.
There are 2 questions in my mind.
1-I did the first Elisa test on Oct 9th( it was 18 days after my first exposure and 9 days after the last one). This test was reactive. The confirmatory tests like lia anti hiv 1-2 and Eia antigen p24 were both negative. I I had been infected wouldnt the western blot done after one month would have been postive instaed of indeterminate?
2-Also, I have done 2 PCR-RNA abott tests 6 and 8 weeks after the last exposure. If I were infected would they showed sth by then?
3-Also, the insti test which I did 8 weeks after last exposure was negative. If I the reactive elsa which done on Oct 9th was due to HIV infection wouldnt the rapid test would be reactive by 26th Nov?

I do appreciate your time and I am reallly confused. Thanks for the advice, I will be working with my Dr to sort it out.
Thank you indeed one again
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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