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Intermediate Westernblot followed by undetectable viral load
Hello Dr.Hook,
I had an sexual intercourse with a sex worker(White women) for at most 1 min(Protected , used condom). I had an unprotected oral sex(Cullingues) for at most 2 mins. My oral condition was good.I had a small cut on one of my 2nd small finger of left leg. It was a small cut where little blood came out. As far as i know she was not having any wounds nor she was bleeding. I am not sure of tiny wounds on her. Seeing that small wound i got scared and started panicking.Then after 8 days i started feeling my lymph nodes are swollen and reddish skin on my chest which comes and goes as hiv rash. I DID NOT have FEVER,COLD,SORE THROAT,THRUSH etc .I went for HIV DNA PCR and Antibody Testing after 15 days which came out to be NEGATIVE. Then after 4 weeks post incident i went to physician saying my lymph nodes are swollen . He said they are fine but to my satisfaction he ordered an ultra sound of my neck which said every thing is normal. Just to make sure of my self i went for a WESTERNBLOT at 6 weeks post incident. To my shocking it came INTERMEDIATE with p18 Band EQUIVOCAL. Then immediately i went for HIV RNA PCR Real Time Quantitative which came out NEGATIVE saying HIV-1 RNA NOT DETECTED(<20 copies/ml). But that one EQUIVOCAL band is killing me. I am being sleepless.
This incident happened 8 months ago. Till now am very healthy without at least cold. I know HIV RNA PCR are approved for diagnostic purposes. I heard that they are helpful during Intermediate Western blot results. I see all people online with same pattern p18 Band EQUIVOCAL has been ELISA positive. That is the reason am scared now to take ELISA (Al tough every one was false positive). My Questions are as follows
1: Do i need further testing?
2: How typical is only P18 Equivocal on westernblot. Does it occur in Men frequently(I am from India if at all it matters).
3: Does undetectable viral load by HIV RNA PCR after Intermediate Westernblot will rule out my HIV concern?
I had an sexual intercourse with a sex worker(White women) for at most 1 min(Protected , used condom). I had an unprotected oral sex(Cullingues) for at most 2 mins. My oral condition was good.I had a small cut on one of my 2nd small finger of left leg. It was a small cut where little blood came out. As far as i know she was not having any wounds nor she was bleeding. I am not sure of tiny wounds on her. Seeing that small wound i got scared and started panicking.Then after 8 days i started feeling my lymph nodes are swollen and reddish skin on my chest which comes and goes as hiv rash. I DID NOT have FEVER,COLD,SORE THROAT,THRUSH etc .I went for HIV DNA PCR and Antibody Testing after 15 days which came out to be NEGATIVE. Then after 4 weeks post incident i went to physician saying my lymph nodes are swollen . He said they are fine but to my satisfaction he ordered an ultra sound of my neck which said every thing is normal. Just to make sure of my self i went for a WESTERNBLOT at 6 weeks post incident. To my shocking it came INTERMEDIATE with p18 Band EQUIVOCAL. Then immediately i went for HIV RNA PCR Real Time Quantitative which came out NEGATIVE saying HIV-1 RNA NOT DETECTED(<20 copies/ml). But that one EQUIVOCAL band is killing me. I am being sleepless.
This incident happened 8 months ago. Till now am very healthy without at least cold. I know HIV RNA PCR are approved for diagnostic purposes. I heard that they are helpful during Intermediate Western blot results. I see all people online with same pattern p18 Band EQUIVOCAL has been ELISA positive. That is the reason am scared now to take ELISA (Al tough every one was false positive). My Questions are as follows
1: Do i need further testing?
2: How typical is only P18 Equivocal on westernblot. Does it occur in Men frequently(I am from India if at all it matters).
3: Does undetectable viral load by HIV RNA PCR after Intermediate Westernblot will rule out my HIV concern?
A related discussion, Chances of HIV was started.
MEDICAL PROFESSIONAL
Glad I could help. Take care., EWH
Hello Dr.Hook..For peace of my mind I took a HIV-1 ICMA antibody test and the result came back NEGATIVE... I am very very happy seeing that negative result...Thank You very much for all the support you gave me. I am once again sorry for bugging you with stupid questions....
MEDICAL PROFESSIONAL
I have already provided my feedback to you. I'll have nothing more to say. EWH
Even I decided not to go for any further testing Dr.Hook because of the confidence that you gave me by saying that you will ignore that one equivocal band in the light of follow up negative RNA PCR test...
Thank You So much for answering all my questions patiently... From now even i will not be worried i guess...
MEDICAL PROFESSIONAL
Personally I would not be worried. EWH
Hahaha!.. Intelligent answer Dr.Hook. What i meant was if you get such kind of results would you be worried (with all the experience you have) by seeing such kind of westernblot pattern or you should ignore that intermediate result because of negative RNA PCR test?
Thanks In Advance Dr.Hook
Thanks In Advance Dr.Hook
MEDICAL PROFESSIONAL
Sorry for the delay in getting back to you. Please be patient however. If I were you, and if I were worried, I would repeat ELISA, not the Western Blot. Otherwise you will continue to worry. There are 2 possible results of repeat test:
1. the test will be negative. I would not worry further
2. The tesst will be positive. If it is postive, this can be a false positve infection due to the indertminant antibodies, or true positve due to HIV. Eitehr way, knowing is better than living in fear.
I suspect that if you re-test the repeat ELISA will be negative. EWH
1. the test will be negative. I would not worry further
2. The tesst will be positive. If it is postive, this can be a false positve infection due to the indertminant antibodies, or true positve due to HIV. Eitehr way, knowing is better than living in fear.
I suspect that if you re-test the repeat ELISA will be negative. EWH
Sir Please answer the above question and i will not ask anything more than that. I am waiting for your reply since 2 hours refreshing the page. I'll not even be able to sleep if you dont reply me.....
Please forgive me for this question if am asking anything wrong . But just wanted to ask you. If you are in the same situation that i am in with these results PCR's negative and intermediate result (Equivocal p18) will you go for retesting or you will move on by ignoring that intermediate result (Equivocal p18)? Please answer this one question.
I am scared to take any more tests doctor because every one who has this p18 equivocal pattern has weak reactive or reactive ELISA. I already have a ELISA NEGATIVE 4 WEEKS before this Intermediate result. I am more worried of that ELISA becoming POSITIVE which was NEGATIVE 4 WEEKS before. Does my worry make sense ? Can I move on leaving this behind by taking one Equivocal band followed by undetectable viral load by HIV RNA PCR at 6 WEEKS post incident and 8 months of healthy life(not even cold) post incident into account that am not infected?
And according to WHO(World Health Organization) criteria very weak p17(which is also refereed as p18) is considered negative. I think equivocal means very weak. By considering all these can i move on without any additional testing?
And according to WHO(World Health Organization) criteria very weak p17(which is also refereed as p18) is considered negative. I think equivocal means very weak. By considering all these can i move on without any additional testing?
MEDICAL PROFESSIONAL
Welcome to our Forum. The "exposure" you describe carries virtually no risk for HIV. Condom protected genital sex is safe sex and the risk of HIV, IF your partner happened to have HIV (which is unlikely) is less than 1 in 10,000 (there has never been a case of HIV proven to be transmitted by receipt of oral sex).
Your Western blot results are misleading. When a Western blot is performed, the reactivity of a person's antibodies to an number of HIV proteins are tested for. To make a diagnosis of HIV a person MUST have multiple reactive bands, not one, and the sort of indeterminate results you have had are not at all uncommon. In your case with low to no risk exposures, negative ELISA tests, negative PCRs, and an indeterminate Western blot, you can be confident that you did not get HIV. If you need convincing, you could repeat the WB and I am confident your result will again be either indeterminate or negative.
In answer to your specific questions:
1: Do i need further testing?
Only for your peace of mind- see above.
2: How typical is only P18 Equivocal on westernblot. Does it occur in Men frequently(I am from India if at all it matters).
You would have to ask someone whose lab does this regularly, I do not know the answer. By no means is it unheard of or, in the context of the other results you have, worrisome.
3: Does undetectable viral load by HIV RNA PCR after Intermediate Western blot will rule out my HIV concern?
.It certainly is strong further evidence that you do not have HIV
I hope this helps. EWH
Your Western blot results are misleading. When a Western blot is performed, the reactivity of a person's antibodies to an number of HIV proteins are tested for. To make a diagnosis of HIV a person MUST have multiple reactive bands, not one, and the sort of indeterminate results you have had are not at all uncommon. In your case with low to no risk exposures, negative ELISA tests, negative PCRs, and an indeterminate Western blot, you can be confident that you did not get HIV. If you need convincing, you could repeat the WB and I am confident your result will again be either indeterminate or negative.
In answer to your specific questions:
1: Do i need further testing?
Only for your peace of mind- see above.
2: How typical is only P18 Equivocal on westernblot. Does it occur in Men frequently(I am from India if at all it matters).
You would have to ask someone whose lab does this regularly, I do not know the answer. By no means is it unheard of or, in the context of the other results you have, worrisome.
3: Does undetectable viral load by HIV RNA PCR after Intermediate Western blot will rule out my HIV concern?
.It certainly is strong further evidence that you do not have HIV
I hope this helps. EWH
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