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HIV-1 Western Blot Indeterminate
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HIV-1 Western Blot Indeterminate

I received a Indeterminate H HIV-1 WB result-        Reference range Negative:

Viral bands observed are P24, P31, P40, P55, GP120, GP160 (The intensity of p24 is less than the intensity of the control band on the weakly reactive control, therefore this pattern does not meet the criteria for a positive result).

Final:
Moderate growth of mixed enteric flora
Also usual genital flora isolated
Unable to screen for Gardnerella due to overgrowth of other organisms

I found out that my husband has been having an affair and his results were negative and I have never stepped out of the marriage. Can you please explain to me in more detail the chances of having HIV with these results. I went in again today for more blood work (9 days after the first test) to see if the results are the same. I am extremely concerned and have 2 small children to take care of.

Thanks
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With apology, I'm not an expert in the details of which Western blot bands have the greatest significance.  Most indeterminate WB results do not reflect HIV infection.  However, the more bands present, including p24, the more likely the result will sort out as truly positive for HIV.  But I cannot judge your specific situation.  You need should be under the care of a specialist in HIV diagnosis and management, such as an infectious diseases specialist, if you are not already.  Such a specialist can accurately judge the likely outcome and also could recommend other testing, such as PCR for HIV DNA.

I don't know what to make of the other test.  It sounds like you had a culture test of a vaginal swab, which in turn suggests you might have had an abnormal vaginal discharge or other symptoms of genital infection.  Perhaps tests for gonorrhea and chlamydia also should be done, if not done already -- another question to ask directly of your own health care provider or a specialist.

I hope things work out well for you, and I supsect they probably will.  Best wishes--

HHH, MD
7 Comments
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Avatar_n_tn
Thanks for your answer! Can you please tell me if you have seen results with many viral bands present on a western blot and the second test results were negative for HIV. Also what does p24 less than the intensity of the control band mean??


Thanks
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239123_tn?1267651214
I have never had a patient with the sort of indeterminate pattern you describe.  I don't know the answer your question about the relative intensity of the p24 and control bands.  Sorry.
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Avatar_n_tn
Thank you so much for the quick response!

Both my husband and I went and had the rapid HIV test (OraQuick)  today and both were negative. How effective is this test compared to the western blot blood test? Is this something that can give me enough peace of mind until my blood work comes back in 7-10 days? Does HIV show up sooner with the Western Blot test?

My husband said that the last time he had oral sex with this girl was around June 15th. I still do not understand why his blood work was negative and mine came out the way that it did??  


Thanks again!
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239123_tn?1267651214
That your husband has a negative test and you have not been at risk supports the likelihood that you aren't infected either.  And if it is true that your husband's only sexual exposures outside your marriage were oral sex alone, he really isn't at significant risk for HIV. However, it is theoretically possible for some bands to start appearing on the WB test before OraQuick or other standard tests become positive.  But with any and all HIV tests, 10 weeks (since mid-June) is plenty of time for positive results, so this information makes it very unlikely you have HIV.

You never said why a WB was done in the first place.  HIV WB is not supposed to be done except in someone with a positive standard antibody test -- but with a negative OraQuick, presumably your original HIV blood test was negative.  So I don't understand the overall situation.  You also never said whether you are seeing an infectious disease doc or other specialist with lots of experience in HIV diagnosis.  I hope you are doing that.

You're just going to have to await the follow-up tests to know for sure, but all in all, my bet is that you don't have HIV.  Let us know how the final testing turns out.
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Avatar_n_tn
Hi Doctor,

Wow these have been some of the most stressful days I have ever had in my life!

I called Qwest Diagnostics in California where they ran the WB and they said that the WB was the only test ran, no Elisa was run on Aug 20th. She said that she is awaiting my blood from Friday's blood draw and it is a Elisa for HIV-2 and another WB. She said that they always only do a WB first when testing for HIV, it has been their standard practice for some time now.

I was so concerned last night that I paged my OB doctor and he said that at his office they always run a Elisa first before a WB and he was not sure why they only did the WB. When I read him these results "(The intensity of p24 is less than the intensity of the control band on the weakly reactive control, therefore this pattern does not meet the criteria for a positive result)." he said it sounded like possibly there was a problem with the test and the main control band was messed up.

I was not told by my doctor to get a OraQuick test, it was something my husband and I decided to do on our own because of the amount of stress we were feeling and not being able to talk to a specialist about my test results and also being that it was Saturday and a long Holiday weekend. We went to planned parenthood because it was the only place open on a Sat. She said that if the OraQuick was positive that is the only way they would do a WB. It was a swab that we swabbed on our upper and lower gums and then let sit for 20 minutes.

I have been going over my personal situation in my mind and trying to think about medical procedures that I have had recently. I had a Colonoscopy done on June 27th and I had an IV put in at the time. I have had blood work drawn in labs over the past few month for other health problems. I have also thought about the fact that my husband and I share a razor in the showere and possibly could I have contracted it that way...I am just not sure and feel like I am completely losing my mind!

Do you know of a 24 hour phone number that I could call and review my test results with a HIV specialist? I have called so many phone numbers and the ones that have answered do not know anything about reading results of test. I am just so confused on what indeterminate means and why I could get test results like this when my husband is testing negative and I have not done anything to contract HIV. Could this be lab error for any reason? Is there any reason why control bands can show up when a person does not have HIV? How can I not have HIV and have 6 control bands showing up...it just does not make sense.

I truly appreciate all your professional help! It means more than you could ever imagine, especially on this long drawn out holiday weekend.

ps...what is a positive standard antibody test, is that the Elisa??

Thanks again!
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239123_tn?1267651214
Yes, ELISA is the standard antibody test.  Beyond that, I have no further comments.  Your questions are too detailed for an online servie; your own provider(s) are the ones to ask.  As I said, feel free to return to tell us the final outcome of testing -- but no further discussion until then.
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