Aa
broken condom CSW encounter/western blot
hi doctors,
This forum is extremely helpful, I really have learned a lot reading through all the informative answers!
About seven weeks ago, I experienced a broken condom during intercourse with a CSW in China. She insisted she was clean, that she takes her own health very seriously and gets tested every month during her period, which is somewhat reassuring. I went to get tested twice for HIV1/HIV2, the first 26 days post exposure, and the second 38 days. Both tests were taken here in China, both were standalone western blots, and both were negative.
Though I was quite confident in the 38 day negative result, the reason i paid for expert opinion is that the contributors for the HIV community forum (Teak, amongst others) are quite adamant in that the proper way to get HIV antibody testing is to get an ELISA test first, then followed by a WB only after a positive ELISA, never a standalone western blot, and i couldn't find many posts by people who have only received WB tests. Why is western blot generally not used as a standalone testing method? Are the results less accurate? Teak says the western blot test is not a diagnostic test, only as a confirmatory test, what is the difference between the two? I know there can be indeterminate results, and the criteria for distinguishing indeterminate results from negative can be different from place to place. Can i trust fully in my results, even though the testing center didnt seem to follow what seems to be normal testing procedure in testing for HIV antibodies?
This forum is extremely helpful, I really have learned a lot reading through all the informative answers!
About seven weeks ago, I experienced a broken condom during intercourse with a CSW in China. She insisted she was clean, that she takes her own health very seriously and gets tested every month during her period, which is somewhat reassuring. I went to get tested twice for HIV1/HIV2, the first 26 days post exposure, and the second 38 days. Both tests were taken here in China, both were standalone western blots, and both were negative.
Though I was quite confident in the 38 day negative result, the reason i paid for expert opinion is that the contributors for the HIV community forum (Teak, amongst others) are quite adamant in that the proper way to get HIV antibody testing is to get an ELISA test first, then followed by a WB only after a positive ELISA, never a standalone western blot, and i couldn't find many posts by people who have only received WB tests. Why is western blot generally not used as a standalone testing method? Are the results less accurate? Teak says the western blot test is not a diagnostic test, only as a confirmatory test, what is the difference between the two? I know there can be indeterminate results, and the criteria for distinguishing indeterminate results from negative can be different from place to place. Can i trust fully in my results, even though the testing center didnt seem to follow what seems to be normal testing procedure in testing for HIV antibodies?
thank you very much for your answer doctor
MEDICAL PROFESSIONAL
Hello
Lots of questions there.
ELISA's are the tests of choice for diagnosis and certainly in the UK, Western Blots are used very rarely for confirmatory tests.
The reason is that whilst once the gold standard for HIV diagnostics in fact they:-
1) take often much longer to yield a correct positive result
2) have been superseded by far superior ELISA's and other testing methods which provide very accurate very early diagnosis.
3) vary widely from country to country as to which proteins they look for so there is no standard.
At our clinic we maybe ask for a Western Blot perhaps once a year out of the many thousands of tests we do. This is usually at the request of a patient who is misinformed regarding the usefullness of the test.
With respect to your particular situation I would think that the 38 day westen blot will probably be accurate - although as I say, they are far inferiro to ELISA's. If you can take an ELISA then a third generation will give you certainty at this point.
Best regards, Sean
Lots of questions there.
ELISA's are the tests of choice for diagnosis and certainly in the UK, Western Blots are used very rarely for confirmatory tests.
The reason is that whilst once the gold standard for HIV diagnostics in fact they:-
1) take often much longer to yield a correct positive result
2) have been superseded by far superior ELISA's and other testing methods which provide very accurate very early diagnosis.
3) vary widely from country to country as to which proteins they look for so there is no standard.
At our clinic we maybe ask for a Western Blot perhaps once a year out of the many thousands of tests we do. This is usually at the request of a patient who is misinformed regarding the usefullness of the test.
With respect to your particular situation I would think that the 38 day westen blot will probably be accurate - although as I say, they are far inferiro to ELISA's. If you can take an ELISA then a third generation will give you certainty at this point.
Best regards, Sean
poor wording on one of my questions, i meant to ask why the western blot is only used as a confirmatory test and never used as a diagnostic test?
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