Aa
ELISA NEG, PCR NEG, WB POSITIVE
Hi doctor, 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 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...) 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.
Some guys on the forums told me the WB would be indeterminate and so, no worry about that but I asked for brazilian health services rules and I realize that they only ask a second WB test to be made IMEDIATELY after the first one when the first is POSITIVE. When it is indeterminate it would be asked to be made only 30 days after..
Please...what do you think about it? I am 1000% regretful of making this WB...
Thanks
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 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...) 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.
Some guys on the forums told me the WB would be indeterminate and so, no worry about that but I asked for brazilian health services rules and I realize that they only ask a second WB test to be made IMEDIATELY after the first one when the first is POSITIVE. When it is indeterminate it would be asked to be made only 30 days after..
Please...what do you think about it? I am 1000% regretful of making this WB...
Thanks
MEDICAL PROFESSIONAL
Welcome to the forum.
Like you, I am puzzled that a Western blot was done. You are correct that normally WB is not performed except to confirm a positive or indeterminant initial test. It seems likely that one of your ELISAs showed a weakly positive or uncertain result. However, that also doesn't really make sense. In that circumstance, the standard approach is to do the WB on the same blood specimen. But maybe your specimen was inadvertantly discarded before the WB could be done.
In any case, it is also true that the WB itself can show indeterminate results, usually for the reason you understand -- incomplete or atypical bands positive. Such results virtually never indicate HIV.
Even with the question mark about the WB, you can be 100% certain you do not have HIV. It is impossible to have HIV with both negative tests for the virus itself (PCR and p24 antigen, which is included in the 4th generation tests) and antibody by ELISA. Further, you describe an exposure that was impossible as a source of HIV transmission, which has never been reported to occur by cunnilingus (oral-vaginal contact).
In other words, the two doctors who originally advised against testing were exactly right: you should never have been tested in the first place. In fact, this is the second question in 2 days in which someone got into trouble with false results because of anxieties that led them to excess testing -- with the result of simply increasing your anxieties. See http://www.medhelp.org/posts/HIV-Prevention/Test-result/show/1509802. I'll say again what I said there: nobody should ever be tested for HIV beyond the recommended intervals, e.g. after a negative antibody test at 3 months. Excess testing never makes it more certain that someone isn't infected, and sometimes raises doubts that simply inflame an already anxious and overwrought mind.
Anyway, you can be sure you don't have HIV. If you have other questions about it, please discuss them with the doctors in charge of your care. They are in a much better position than I am to clarify any remaining doubts.
Regards-- HHH, MD
Like you, I am puzzled that a Western blot was done. You are correct that normally WB is not performed except to confirm a positive or indeterminant initial test. It seems likely that one of your ELISAs showed a weakly positive or uncertain result. However, that also doesn't really make sense. In that circumstance, the standard approach is to do the WB on the same blood specimen. But maybe your specimen was inadvertantly discarded before the WB could be done.
In any case, it is also true that the WB itself can show indeterminate results, usually for the reason you understand -- incomplete or atypical bands positive. Such results virtually never indicate HIV.
Even with the question mark about the WB, you can be 100% certain you do not have HIV. It is impossible to have HIV with both negative tests for the virus itself (PCR and p24 antigen, which is included in the 4th generation tests) and antibody by ELISA. Further, you describe an exposure that was impossible as a source of HIV transmission, which has never been reported to occur by cunnilingus (oral-vaginal contact).
In other words, the two doctors who originally advised against testing were exactly right: you should never have been tested in the first place. In fact, this is the second question in 2 days in which someone got into trouble with false results because of anxieties that led them to excess testing -- with the result of simply increasing your anxieties. See http://www.medhelp.org/posts/HIV-Prevention/Test-result/show/1509802. I'll say again what I said there: nobody should ever be tested for HIV beyond the recommended intervals, e.g. after a negative antibody test at 3 months. Excess testing never makes it more certain that someone isn't infected, and sometimes raises doubts that simply inflame an already anxious and overwrought mind.
Anyway, you can be sure you don't have HIV. If you have other questions about it, please discuss them with the doctors in charge of your care. They are in a much better position than I am to clarify any remaining doubts.
Regards-- HHH, MD
Do not think it was necessary or even expected such a rude answer from you.
I am not looking for anyone "holding my hand" here.
If I got all the answers I would not need to come here. And if you are not available for answering then tell me who could help me as you are not available anymore.
I made a question about the oscillation of Elisas tests and not based on "anxiety driven thoughts".
And you are the doctor. You may say "The biological reasons for that certainty are irrelevant" because you know these biological reasons. I do not. And that´s why we pay looking for answers, because you doctors have the knowledge that we "common people" do not.
Thank you anyway. And I am sorry for bothering you so much.
I am not looking for anyone "holding my hand" here.
If I got all the answers I would not need to come here. And if you are not available for answering then tell me who could help me as you are not available anymore.
I made a question about the oscillation of Elisas tests and not based on "anxiety driven thoughts".
And you are the doctor. You may say "The biological reasons for that certainty are irrelevant" because you know these biological reasons. I do not. And that´s why we pay looking for answers, because you doctors have the knowledge that we "common people" do not.
Thank you anyway. And I am sorry for bothering you so much.
MEDICAL PROFESSIONAL
You may not keep returning with every anxiety-driven additonal thought that comes to mind. My advice to you is the same as it would have been to a patient in my clinic: you are not infected and indeed I "consider it end of story". The biological reasons for that certainty are irrelevant. I suggest you stop reading or searching the internet about it. No more comments on this thread, and do not be tempted to start a new thread with the same questions; it would be deleted without reply (and without refund of the posting fee). This isn't a hand-holding service for people who have trouble believing or accepting our advice and reassurance.
Doctor Hunter,
Please let me bother you with 2 last questions:
1-) Why the 4th generation with p24 is considered definitive if it tracks only HIV-1 and not HIV-2 (whose glycoprotein is the gp36)? Eventhough HIV 1 is responsible for the majority of infections, nowadays industrialyzed countries already have HIV 2 infected people...
2-) In my specific case, my first elisas (at 3, 4 and 5 months mark) had values between 0,057 and 0,070.
At the 6, 7 and 8 months mark it had values of 0.101, 0.110 and 0.089
At the 8 ½, 9 and 9 months 10 days mark it had values of 0.158, 0,148 and 0.128
The indeterminate value for this test is > 0.90
The positive value for this test is > 2.00
All the tests were made at the same laboratory (ABBOT Ab/Ag Combo).
Do consider this oscillation/variation on the values normal, even being a increasing oscillation instead of a decreasing oscilation?
If a pacient you have been caring for, appeared with these results would you consider it end of story?
thank you very much in advance.
Please let me bother you with 2 last questions:
1-) Why the 4th generation with p24 is considered definitive if it tracks only HIV-1 and not HIV-2 (whose glycoprotein is the gp36)? Eventhough HIV 1 is responsible for the majority of infections, nowadays industrialyzed countries already have HIV 2 infected people...
2-) In my specific case, my first elisas (at 3, 4 and 5 months mark) had values between 0,057 and 0,070.
At the 6, 7 and 8 months mark it had values of 0.101, 0.110 and 0.089
At the 8 ½, 9 and 9 months 10 days mark it had values of 0.158, 0,148 and 0.128
The indeterminate value for this test is > 0.90
The positive value for this test is > 2.00
All the tests were made at the same laboratory (ABBOT Ab/Ag Combo).
Do consider this oscillation/variation on the values normal, even being a increasing oscillation instead of a decreasing oscilation?
If a pacient you have been caring for, appeared with these results would you consider it end of story?
thank you very much in advance.
MEDICAL PROFESSIONAL
Glad to hear it -- not surprised, but happy you're feeling better. Thanks for the thanks.
Good evening, Dr. Hunter,
I would like to tell you that yesterday I finally got my WB results and it was 10000% negative!! Glory to Jesus for that!
Not a single band reacted! These were the worst 10 days of my life,,, I was asked to retest but the results were 100% negative... Do not know why they called me for retesting. Lab would not tell me...
Thank you for all your support.
I would like to tell you that yesterday I finally got my WB results and it was 10000% negative!! Glory to Jesus for that!
Not a single band reacted! These were the worst 10 days of my life,,, I was asked to retest but the results were 100% negative... Do not know why they called me for retesting. Lab would not tell me...
Thank you for all your support.
MEDICAL PROFESSIONAL
You should clarify the WB result, i.e. whether it was truly positive or indeterminate. If indeterminate, ignore it and move on. If it was truly positive, then I still believe you don't have HIV -- for example, maybe your WB blood sample was mixed up with someone else's. However, if the official WB report is positive, you should be evaluated by an HIV/infectious diseases expert to explain your discrepant test results.
If and when you can confirm once and for all what your WB result was, please return with a follow-up comment about it. Otherwise, this thread is closed to any other comments.
If and when you can confirm once and for all what your WB result was, please return with a follow-up comment about it. Otherwise, this thread is closed to any other comments.
You believe I should ignore it and move on then?
MEDICAL PROFESSIONAL
Even if your WB were truly positive, the weight of evidence remains that you do not have HIV. As I said, to my knowledge it is not possible to have HIV with negative results on both viral testing and standard antibody testing.
Having never heard of a situation with a truly positive WB with negative ELISA, I cannot speculate on possible causes. If your own doctor cannot satisfactory answer this, I suggest you ask for referral for consultation by an infectious disease/HIV expert.
Having never heard of a situation with a truly positive WB with negative ELISA, I cannot speculate on possible causes. If your own doctor cannot satisfactory answer this, I suggest you ask for referral for consultation by an infectious disease/HIV expert.
Thank you for all your explanation, Dr. Hunter.
2 last questions:
1-) what could make a WB be positive and a ELISA negative?
2-) Even if this WB I have made comes as POSITIVE instead of INDETERMINATE, you believe I should just ignore it, no matter what bands have reacted?
Thank you very much again.
2 last questions:
1-) what could make a WB be positive and a ELISA negative?
2-) Even if this WB I have made comes as POSITIVE instead of INDETERMINATE, you believe I should just ignore it, no matter what bands have reacted?
Thank you very much again.
extra info: by brazilian rules a WB is positive when 2 bands of the gp 160/120; gp41; p24 appear as reactive...
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