Indeterminate Result on WB HIV test

[JSJS]

I need some real healp here because I am freaking out!! On March 20th I had oral sex with a girl I know but not very well. I fingered her and I had a small cut on my finger, I licked her down there and I had a small sore on my gum. She gave me oral sex and then we were done. She had just divorced her husband who had been cheating on her but she said she got tested and was clean but I have no way of proving it.

I had the WB test done 28 days after the encounter and it came back indeterminate because the gp41 is equivicol.

gp160, absent
gp120, absent
p65, absent
p55, absent
gp41, equivicol
gp40, absent
p31, absent
p24, absent
p18, absent

Now I am freaking out and went and got another WB test today. Is this common to have a result like this 28 days after the event?

[JSJS]

I apologize for my lack of knowledge its just that I have two small children and a great wife at home. I realize I had made a big mistake and it will never happen again. It just bothers me that any of the antibodies came back as equivcol.

[H. Hunter Handsfield, M.D.]

You're obviously not understanding me.  Please re-read my replies and concentrate.  Even if the gp41 were definitely positive, it would be meaningless.  An equivocal gp41 is even stronger evidence you do not have HIV.  You never needed HIV testing in the first place, you don't have it, and you do not need any further testing.  But if you do it, an ELISA makes more sense.  In any case, do not make your own decision; follow your doctor's advice.

That is all for this thread.  I won't have any more comments of any kind.

[JSJS]

The gp41 was not positive it was equivcol. It is now almost 8 weeks since the event should I take the ELISA or just wait for the WB again.

[H. Hunter Handsfield, M.D.]

There is no cause to be "freaked out".  This is exactly how indeterminate WB results show up:  positive on one or two bands and negative on all others.

gp41 is never the only positive band in HIV infected persons and never the first band to show up.  In fact, it is usually one of the last, usually not appearing until long after gp24, gp160, and others.

I'm still wondering why your doctor ordered the WB instead of just an ELISA.  It makes no sense.  But that's between you and him or her.

[JSJS]

Thanks for the reassurance. My Dr ordered the test as they wanted to test for hepatitis also. It freaks me out as to why all the other antibodies came back absent but not this one which is one of the antibodies that determines a positive test.

I had this test done 28 days after the event so what antibody would be the one that would show up first?

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.

Most indeterminate HIV Western blots do not indicate HIV infection, and gp41 by itself is meaningless; and yours is equivocal, meaning the lab techs aren't even sure that they could see a gp41 band at all.  You don't need another WB or any other additional testing.

Your risk of HIV was too low to warrant testing at all.  Oral sex is virtually zero risk for HIV (some experts believe it is totally safe), and nobody has ever been infected by fingering, regardless of cuts on the fingers.  And if you're in the US or other industrialized country, the chance you partner had HIV is very low as well.

For any additional advice, you should speak with the provider who ordered the test.  But I'm wondering whether you tested on your own, maybe after locating a lab on line.  Any health care provider with any knowledge about HIV would have told you that your exposure was too low risk to require testing at all, and also would have done only an HIV ELISA test, with no Western blot unless the ELISA were positive.  If you were tested inappropriately without professional advice, you're on your own; or make an appointment with your personal health care provider.

In any case, you can stop worrying and stop testing.  You don't have HIV, and there is no known health problem of any kind associated with indeterminate WB results.

HHH, MD