Indeterminate result

[rickind]

I am terrified about an indeterminate result for HIV with the presence of p24 antibody. I have never had an unprotected penis in my anus, only a condom and only twice, condom did not break and the penetration was light and not deep, no seminal fluid either. I have had many massages where sometimes your prostate is fingered and a few times the therapist rubbed their penis around the outside of my *** , no penetration. As far as I can tell I have not had the type of sexual activity required for infection. My doctor gave me a full exam, said I was in great health, he also did an inspection of anus and prostate and said I was fine. He assured me that these activities could not transmit HIV and that I am fine. Test results like this occur frequently and almost always are negative on second testing. I am scheduled for a new blood test in 3 months. I am going out of my mind, I am convincing myself that I have the infection and I am distraught beyond reality. I am going to contact a therapist to talk about my feelings but I am needing constant reassurance. Is my doctor right, am I ok?

[Edward W Hook, MD]

In the overall scheme of things, it is not unusal to see such things at sites where lots of testing is done.  In your situation it is unlikey that your result will become positive.  I understand yor concerns however.  EWH

[rickind]

I am still freaking out, do you think I am over reacting, are these results common, are there high percentages of first time indeterminate becoming positive or relatively low. Do you in your experience see this often, I am severely traumatized by this situation.

[Edward W Hook, MD]

Welcome to our Forum. I understand how concerning an indeterminate HIV test can be.   Indeterminate HIV tests can arise in two ways- either because you are in the process of developing antibodies to HIV or because your body has antibodies which happen to cross react with some of the antigens (proteins) which are part of the HIV virus.  This latter reaction is a false positive reaction.  When persons are tested for HIV they typically are tested in a two step procedure, first with an ELISA which is a general test for antibodies to many proteins which are part of HIV.  if this initial test is positive, before it is called "positive" a second test is performed- typically the Western blot test. In this test we can see which of the HIV proteins the person's antibodies are reacting to.  If people have HIV, they typically have antibodies to many proteins.  If they do not, they may have antibodies to only a single protein of which the p24 is one.  In fact, the p24 antigen is the most commonly reactive antigen (protein) in persons with falsely positive or indeterminate HIV tests.  Given your history, I suspect this is what is going on.  

A repeat test need not wait for 3 months.  If you are developing antibodies to HIV, which I doubt is the case, your test would be unequivocally positive within a month of your first test.  Alternatively, this an area where you could have a HIV PCR test done. If the PCR test is negative, you could be sure you do not have HIV.

I hope this helps.  Form what you tell me of your risks, your likelihood of HIV is very, very low, even with an indeterminate test result.  EWH