ELISA NEG, PCR NEG, WB POSITIVE. HELP!!!

[JaymzLeutz]

Please guys, I need help with a situation

I got negative ELISA 4th generation (HIV I/II AB and p24 antigen) tests for 9 1/2 months where the risk exposure was touching a sex worker´s vagina with the tip of my tongue. 2 doctors told me I did not even need to be tested because of that.

After the 7 month, 2 doctors said I was clean and sent me back home and told me loudly "live your life. forget this subject".

with 7 1/2 months I got a PCR - NEGATIVE

with 8 1/2 months I went for donating blood.

My tests were fine (negative for siphilis, hep A, B and C and HIV, where they had made 2 HIV tests)

Now at 9 1/2 months I took another ELISA 4th generation and 3 days later I took a WESTERN BLOT, just for a fool extra ensurance.

For my surprise, the ELISA 4th generation came back negative but I was asked back for retesting for the WESTERN BLOT. I do not know if it will come back indeterminate or positive. The lab would not tell me, but a employee of the lab put some papers at sight where I could clearly see where it said I was called for retesting because the first WB was reactive...

I have ssen a lot of orientation where ELISAS are POSITIVE and WB are NEGATIVES, but what to do know???

ANTIBODIES HIV I/II and p24 tests NEGATIVE at 9 1/2 months
PCR NEGATIVE at 7 1/2 months
BLOOD DONATED AT 8 1/2 months where ALL the tests were NEGATIVE
ANTIBODIES HIV I/II and p24 tests NEGATIVE at 9 months

WB asked for retesting (positive or indeterminate...) at 9 1/2 months
and my last ELISA was taken only 3 days before the WB. This last 4th ELISA was also NEGATIVE...

I know that WBs are asked only when ELISAS are positive, but its made... I can not get back to the past and forget about it. Have not seen any orientation about this particular situation.

Plase, help me.

Best regards.

[JaymzLeutz]

I would like to thank you all guys ho have supported along these 10 days of pure anxiety...

I was asked for retesting, I saw the papers saying that it was because the first test reacted but yesterday I got my results and, thank Jesus for that, not a single band reacted... It was 10000% negative!!!

Lab would never tell me why exactly they called me back for retesting but I do not want to now the why too... I wanna live from now on.

Thank you very much indeed to joggen, Teak, Vance2335 and all the people that had the patience to talk to me along those hard moments...

Thank you very much and God bless you all...

[rio_branco]

ELISA is highly sensitive, but less specific, while WB is highly specific, but less sensitive. This is why WB is NEVER used alone to detect HIV, because it's not as accurate as ELISA. It's a confirmatory test, meaning that ONLY IF your ELISA shows that you're positive will they do WB test on you. Your ELISA shows that you're negative, so you shouldn't have taken the WB and I don't understand why they called you back to do WB. I honestly think that's a crap and their marketing strategy to get more money. You're HIV negative because your ELISA proves so.  

[Teak]

Yes I would ignore it. You should have never been given a WB.

[joggen]

Do you even know what bands were positive on your WB? If you don't know then you are jumping to conclusions assuming it was positive.

[JaymzLeutz]

Ok, that I understood, but and what about a positive result? Meanin, that 3 kind of group bands you told me before (p24, gp 41 and gp120/160)?  Is that possible that antibodies to other protein react on these 3 groups, making a false-positive?

Would you still ignore it after the several Elisas and the PCR?

[Teak]

WB tests are approved to confirm not to diagnose. Cross contamination is one of the reason you could get an indeterminate result.

[JaymzLeutz]

I know you are not a doctor, but man, I would like to understand why a test that is made to be more sensitive than specific (ELISA) can be negative and a test that is suposed to be  more specific and less sensitive can detect something that the ELISA could not...

If I had not made a ELISA before the WB, I think I would be scare to death by now...just as in the begining of this painful situation...  And how can this WB detect a antibody to a antigen that simply does not exist (based on the PCR)?!?!?

Man... one lesson I have learnt: everything around the subject hiv testing is too much confused =/

Thank you again for your support...

[Teak]

Of course. You didn't have a risk to begin with.

[JaymzLeutz]

In my situation, would you ignore the second WB result (be it positive or indeterminate) and move on?

[Teak]

There was no reason for you to take another test after you recieved a negative result way outside the window period.

[JaymzLeutz]

The problem is that in Brazil the lab will ask for a second test imediately after a 1st test only if the 1st is positive. If the 1st is indeterminate they tell the person have to wait 30 days and repeat...

In this case, they asked for a second test imediately...

[Vance2335]

As joggen said your WB is not positive but indererminate. Which can happen. I have seen at least 5 people in the past year post inderteminate WB tests with negative antibody tests. Strengths the case to only use a WB after a positive antibody test.

[JaymzLeutz]

Thank you for your support and comprehension... I keep just wondering why the WB could be positive without a ELISA positive neither a PCR positive...

Is it possible to occur cross-reactions with antibodies like a false positive on ELISA?

[Vance2335]

I went beyond your question and answered the basic question which you did not ask.

Your trying to find a why that you have HIV? Even though you never had a risk? Even though you over tested?

WB is a confirmation test. You never had a positive antibody test. You don't have HIV.

[JaymzLeutz]

Buddy,your answer really did not help me.. If you could answer me the question " When a Elisa is negative the WB should not be considered, no matter what bands react? Is it that?", this would be very much apreciated indeed....

[Vance2335]

Means you have way over tested for a no risk situation and should probably seek a therapist to help deal with your anxiety issue.

[JaymzLeutz]

This your statement is valid only if one single band reacted or doesn't matter which and how many bands? What might be counted is the ELISA? When a Elisa is negative the WB should not be considered no matter what bands react? Is it that?

[joggen]

Your WB is indeterminate not positive and you are HIV negative by virtue of your negative ELISA tests (assuming you haven't had a true exposure). The WB is never used as a stand alone test for diagnosis (as you seem to understand) because it is a somewhat 'messy' test in the sense that some bands will falsely show up on occasion. If you saw the word "reactive" on the papers then it was probably just a single band. The negative ELISA trumps your indeterminate WB if you have not recently had a REAL exposure (unprotected vaginal or anal sex). If the tongue incident is your only possible 'exposure' then you clearly don't have HIV- you never had a risk to start with.

It was indeed a mistake on your part to keep testing after your doctors told you to move on. The more you test the more likely it is that you will get some kind of false result. Instead of continuing to waste time and energy in the testing process I think your best course of action at this point is to seek professional mental help to help you understand why you cannot accept that you are HIV negative. Most likely your issue is guilt or regret over your encounter which you are conflating with HIV risk.