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Avatar universal

Wife Tested Positive At Childbirth

Two days ago my wife gave birth to our first child. She had the required HIV test three weeks ago which came back negative but the rapid test they did at childbirth came back positive. She has not engaged in any risky behavior to I naturally think about if there's anything I've done to put myself in danger to pass something to her.

I went to a strip club approximately three weeks ago where there was a slight chance that the head of my penis made contact with wet underwear of a dancer. Of course, I'm thinking of worst case scenario that there was some type of direct contact made. I did a Home Access antibody test which came back negative at 7 weeks. When this happened on Monday, I immediately went and got another test. We got the results back yesterday for my test that said it was negative... 12 weeks after potential exposure (yes, I know that it was low risk).

My questions are these:

1. I've read that false positives occur more often in pregnancies. Could that be the case here?
2. Is my 12 week home access test conclusive? Can I consider that if she were to be positive, it didn't come from me?
3. If the 12 week test for me is not conclusive, the last time I had sex with my wife was two months ago. Let's say that I was a carrier at that time and had the viral count to give it to her... wouldn't I have a high enough viral count two months later to show up in the Home Access Test?

As you can see, we're trying to get some facts to support our hope that the test was a false positive. The doctors here seem to believe that it very well could be, but looking at the numbers (1 in every 10000), it's just hard to stay positive. Thanks for your speedy response. You can imagine what the last 48 hours have been like for my wife and I as our child is on HIV meds for prevention until we get her Western Blot back.
7 Responses
936016 tn?1332765604
MEDICAL PROFESSIONAL
Hello

I'm sorry to hear that - very upsetting indeed for you both to say the least.

You are right to say that false positives may occur more frequently in pregnant women.

I would be keen that your wife has a repeat test using a different methodology and also if possible an HIV RNA PCR test. Western Blots were the gold standard but in actual fact perform poorly when compared to modern third or fourth generation HIV tests.

I have looked at the Home Access test data available on the web - and the information is not terribly full. The data it relies on seems to be from 1997 which suggests to me that it might be a second generation test - I'm not sure.

I think as I say that your wife should have a test using a modern third or fourth generation test together with an HIV RNA PCR.

I think you should have a 3rd or 4th generation test now also.

I do not believe your "exposure" was significant in any sense.

I hope some of that helps.

best regards, Sean
Avatar universal
Ttt
Avatar universal
Dr. Cummings,

Thanks for your reply. Home Access uses 2nd generation testing but what I've read on the other prevention forums is that even with 2nd generation testing, it would be able to pick up any antibodies at 12 weeks. Dr H. and other mods tend to agree with that. Hope you concur but of not, please expand.
Avatar universal
Also, should have given you an update that her WB came back indeterminate with all bands negative except p24 which was reactive. Dr. Handsfield mentioned that this is not always associated with HIV but if It was, that would likely only happen if she was exposed to in the last 1-3 weeks. Otherwise, if the exposure was 8 weeks ago (the last time we had sex), then it would be positive, with more bands reacting than just that one. If you have any opinions to add to that, I would appreciate it.

Best regards,
Avatar universal
Doc,

Upon your recommendation my wife and I both took an Oraquick test today. This is a third generation test, where the Home Acccess test is second generation. Both results were negative. Thank you for that advice. Would you recommend anything further? Our baby is still on HIV medication and not breastfeeding.
936016 tn?1332765604
MEDICAL PROFESSIONAL
Good morning

Thank you for your further questions. I'm sorry I'm a bit late responding but we had a power cut affecting the whole of the street in which my office is based yesterday so we were peculiarly isolated.

Good - i think thats much better news.

As I've implied - I don't like or rate second generation tests or Western Blot and I don't believe in the modern HIV testing world that they have much of a place. Certainly 2nd generations I would not bother with.

As I have said, I think your wife - and you - should have an RNA PCR test now - that will take a few days to process but will give you clarity. Because of various factors outside the scope of this Forum, testing your new infant is not helpful. The doctors attending your infant / wife have done the right thing pending the result of a definitive test.

I hope that helps you further. The fourth generation test HIV DUO includes a p24 element to it and so if you can obtain a 4th generation test for you and your wife that would assist us in this.

best regards, Sean
Avatar universal
Dr. Cummings,

Upon your rec, my wife and I took PCR tests. Both came back negative. I'm under the impression that this is conclusive. Could you confirm?

Thank you for all your help.
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