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Western Blot Indeterminate.... what to do?
by ntjock, Dec 15, 2007 11:58AM
I'm worried about my status and considering getting a PCR test.
On the 19th of November I started to come down with a cold. minor aches. On the 20th and 21st I took dayquil to ward off what I thought was just a cold. I had hung out with a friend on the 18th and 17th who had a cold that made him lose his voice. So the exposure time was right for a cold at 24 to 36 hours. On the 22 and 23rd I had a fever and some chills and decided to basically take a dayquil and sleep it off. I did continue to eat normal food but was eating light. I did have a few instances of waking up all sweaty and so I took a shower to deal with that. I also had the thermostat on 81 and was under the covers, so that would definately make me sweat. The fever cleared after a 2 days and became a sore throat. The sore throat stressed me a bit and my cold sores (aka herpes simplex) became activated. They happened to form on my tonsils which is particularly unpleasant. on the 24th and 25th I was basically taking it easy and pretty worn out. On the 25th I noticed a rash on my chest. The 26th and 27th I was active and able to work but not 100%. On the 29th I decided to go get a HIV and syphillus test after talking to some friends. The counselor at the testing site suggested going to the clinic the next day and getting tested.
Now the interesting part. They did a Oraquick test (elisa) and it came back HIV neg. Previous Negative result August 29th. The doctor seemed to think I was having seroconversion sickness. He also thought I probably had syphillus. I was given two shots of bicillin, bloodwork was drawn and a test for hiv, syphillis, and hep was ordered.
Within 36 hours I felt great and my symptoms vanished. Rash cleared up, etc. I still had a cough that I still have (3 weeks later). Also have a couple of swollen lymph nodes (literally 2). Got another dose of bicillin on the 7th, no test results back yet.
Went in yesterday 14 Dec, and the test results were in. Syphillis was positive, hep was immune (i had been vaccinated previously to hep b) and negative, and they said my western blot was indeterminate. I had a reaction to one band. I don't think they ran an ELISA blood test. However, I'm not certain.
The dr. yesterday wants me to wait 30 days and come back in for another test. It will of course take 2 weeks to get the results. I really don't want to stew on this for another 45 days. I've also taken time to think through my risk factors and I can't find a smoking gun so to speak. In the 14 days prior to my illness I was only with 3 partners. 2 of them were limited to oral sex and jacking off. 1 of them was risky, but I was the top. That encounter was on the 6th. Timing isn't quite right, but still is possible for an hiv exposure.
My problem is that I've been told that seroconversion illness is the worst, nastiest illness you've ever had. I think I was sick, but it wasn't that bad. I've had food poisoning and that was 10 times worse then this. It's within the 14 day window to barely at the end of it, but I was under the impression that seroconversion illness happens almost immediately.
I also have read that past or present syphillis infection can mess up western blot results, resulting in an indeterminate. I've had syphillis before, and I had it at the time the blood was drawn for the western blot. In fact the western blot blood was drawn about an hour after I was given the bicillin. I think I had a cold and syphillus, but not HIV. Yes, I realize it's a bit of denial potentially. But I can't find concrete support for an HIV infection.
I should have been sick a week earlier if it was HIV. It should have been much more severe. The research I've read suggests that a blood test at 21 days should show antibodies. It didn't.
I don't like being in limbo. It's actually worse then being poz or neg. I'm a bit annoyed that the dr didn't suggest a PCR test. But I understand that the clinic has limited funds and needs to do the most with it and that they have a protocol they follow. I still feel like I should have been given the option.
If I am positive, I want to know asap so that I can get on with living with it. Waiting 45 days to figure it out just bothers me. I'm now at 45 days since the suspected exposure and 30 days from the illness. Oh, and my titer score for the syphillus was 1 to 16 which the doctor said was pretty low. That supports a infection at about 2 to 3 weeks and in my mind confirms where I caught it.
I'm hoping for some support and ideas here. Monday I'm going to go back and get a copy of my lab results so I can find out which band I tested positive for in the western blot. I also want to know if the ELISA test was done and if it came back positive or negative. Considering that I had a negative ora-quick (elisa) that would be particularly interesting. I'm also considering have a PCR test done and the biggest factor there is getting the results quickly. I think they can be done for $250 to $300 from what I've seen. And I'm not worried about that cost at this moment.
On the 19th of November I started to come down with a cold. minor aches. On the 20th and 21st I took dayquil to ward off what I thought was just a cold. I had hung out with a friend on the 18th and 17th who had a cold that made him lose his voice. So the exposure time was right for a cold at 24 to 36 hours. On the 22 and 23rd I had a fever and some chills and decided to basically take a dayquil and sleep it off. I did continue to eat normal food but was eating light. I did have a few instances of waking up all sweaty and so I took a shower to deal with that. I also had the thermostat on 81 and was under the covers, so that would definately make me sweat. The fever cleared after a 2 days and became a sore throat. The sore throat stressed me a bit and my cold sores (aka herpes simplex) became activated. They happened to form on my tonsils which is particularly unpleasant. on the 24th and 25th I was basically taking it easy and pretty worn out. On the 25th I noticed a rash on my chest. The 26th and 27th I was active and able to work but not 100%. On the 29th I decided to go get a HIV and syphillus test after talking to some friends. The counselor at the testing site suggested going to the clinic the next day and getting tested.
Now the interesting part. They did a Oraquick test (elisa) and it came back HIV neg. Previous Negative result August 29th. The doctor seemed to think I was having seroconversion sickness. He also thought I probably had syphillus. I was given two shots of bicillin, bloodwork was drawn and a test for hiv, syphillis, and hep was ordered.
Within 36 hours I felt great and my symptoms vanished. Rash cleared up, etc. I still had a cough that I still have (3 weeks later). Also have a couple of swollen lymph nodes (literally 2). Got another dose of bicillin on the 7th, no test results back yet.
Went in yesterday 14 Dec, and the test results were in. Syphillis was positive, hep was immune (i had been vaccinated previously to hep b) and negative, and they said my western blot was indeterminate. I had a reaction to one band. I don't think they ran an ELISA blood test. However, I'm not certain.
The dr. yesterday wants me to wait 30 days and come back in for another test. It will of course take 2 weeks to get the results. I really don't want to stew on this for another 45 days. I've also taken time to think through my risk factors and I can't find a smoking gun so to speak. In the 14 days prior to my illness I was only with 3 partners. 2 of them were limited to oral sex and jacking off. 1 of them was risky, but I was the top. That encounter was on the 6th. Timing isn't quite right, but still is possible for an hiv exposure.
My problem is that I've been told that seroconversion illness is the worst, nastiest illness you've ever had. I think I was sick, but it wasn't that bad. I've had food poisoning and that was 10 times worse then this. It's within the 14 day window to barely at the end of it, but I was under the impression that seroconversion illness happens almost immediately.
I also have read that past or present syphillis infection can mess up western blot results, resulting in an indeterminate. I've had syphillis before, and I had it at the time the blood was drawn for the western blot. In fact the western blot blood was drawn about an hour after I was given the bicillin. I think I had a cold and syphillus, but not HIV. Yes, I realize it's a bit of denial potentially. But I can't find concrete support for an HIV infection.
I should have been sick a week earlier if it was HIV. It should have been much more severe. The research I've read suggests that a blood test at 21 days should show antibodies. It didn't.
I don't like being in limbo. It's actually worse then being poz or neg. I'm a bit annoyed that the dr didn't suggest a PCR test. But I understand that the clinic has limited funds and needs to do the most with it and that they have a protocol they follow. I still feel like I should have been given the option.
If I am positive, I want to know asap so that I can get on with living with it. Waiting 45 days to figure it out just bothers me. I'm now at 45 days since the suspected exposure and 30 days from the illness. Oh, and my titer score for the syphillus was 1 to 16 which the doctor said was pretty low. That supports a infection at about 2 to 3 weeks and in my mind confirms where I caught it.
I'm hoping for some support and ideas here. Monday I'm going to go back and get a copy of my lab results so I can find out which band I tested positive for in the western blot. I also want to know if the ELISA test was done and if it came back positive or negative. Considering that I had a negative ora-quick (elisa) that would be particularly interesting. I'm also considering have a PCR test done and the biggest factor there is getting the results quickly. I think they can be done for $250 to $300 from what I've seen. And I'm not worried about that cost at this moment.
A WB test would not have been performed unless the ELISA was reactive.
I would agree with your MD, however, that a PCR should not be done.
Now, for the brief lecture....and believe me, I have had mine before.
(1)You NEED to be using condoms for all anal/vaginal sex that you are having outside a committed, monogomous relationship. And even in a committed, monogomous relationship, you shoud be aware of the other partner's status.
(2) You state that you "ONLY had 3 partners in the last 14 days". That is a high-risk lifestyle. You lack of contiuance to using condoms is going to have you infected with HIV...someday, ...if not sooner than later.
(3) Your pase approach to having syphils before somewhat frightens me. You said that you have had syphilis before, and seem as though that it is no big deal. Well, it is. No less the fact that you are haivng HSV lesions on your tonsils is another facet that is alarming. You seem to be rather sexually active. Considering the past STI's and the mere fact that you are coming here today to ask us about a rather lengthy epsiode of your sexual health history demonstrates a sever need to be using protection ALL the time.
I do hope that you come out of this ok.
But please, unless your purposely looking to get HIV, you BEST be using condoms for sex. Putting on a condom only takes a few seconds dude!!
Read my #3 reply.
The MD thought that symptoms were indicative of primary HIV infection despite a antibody negative Elisa. I don't understand why a PCR wasn't run as it's nonsense to run a WB when there are not antibodies. I know this now, but at the time I didn't know any better and thought a WB was the best possible test.
What I was hoping is that some of the people here might have more insight into the small population, statistically, that I'm in. Indeterminate WB results are extremely unusual (.00004%) because it is typically used as a confirmatory test after a antibody positive Elisa. The fact that the MD ordered a more advanced test isn't a surprise. He genuinely thought it was a primary hiv infection. I'm not convinced that I was that sick. As for sickness, according to NYU's first call site (which I think is a reputable source), 80% of those infected with HIV experience what is called "seroconversion sickness." Everyone I know that has had it said it is the absolute worst cold you have ever had in your life. I'd like more information about that, but again can't seem to find it.
I am gay, so you are preaching to the choir there bud.
1. As for HSV, it is not stress-induced, FYI, that is an old wise-tale.
2. having syphilis is not a walk-in-the-park. Having a concurrent STI while having sexual relations with someone significantly increases your risk for HIV, for starters. That includes HSV, gonnorhea, or chlamydia. And besides, HSV in the mouth is NOT a common occurence, it may eb an oral ulcer, not HSV.
3. 50-80% of persons are the stated risks for seroconversion, and it is not like a cold, more like the worst FLU you would ever have.
4. I think the lecture is IMPORTANT. As much as you may not know me, I am telling you this (and writing this) in the sincere hopes that you see that someone does care. (The fact that I am spending a colossal amount of time writing this info.)
5. The confusion to whether or not you received an ELISA test is still unclear. Your MD should not have ordered a WB unless an