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HIV Testing Indeterminate. Then Negative ELISA, What does it Mean?
Dear Ask The Doctor:
Hello first I will provide my sexual history, I have been with one person since 2009 and we had a son born in sept 2010. We broke up in January of 2011 this year and in late August 2010 I had unprotected sex with another girl. Well she contacted me saying she had tested positive for Chlamydia and she had been tested for hiv and it was negative. So I went to get tested until 10-14-11 for chlamydia and hiv, hep b, hep c, gonorrhea etc. A week later I called the Dr's office for my results, I was told "you tested negative for hiv and everything else except Chlamydia, we will call in a treatment to your pharmacy" So i started on the treatment doxycycline. I went to my Dr's appointment on the 25th which was this month because they had also done a Complete Blood Count and checked my cholesterol etc. So i wanted to know those results. The Dr started off telling me about my cholesterol and that I was ok, Then all of a sudden he says "your hiv test came back reactive". I couldn't believe it I asked to read the test results and when I read it the test said "Western Blot INDETERMINATE as it only reacted to P24" I believe they did the ELISA test before doing the Western blot to confirm. Well this Dr goes on to say I am Hiv positive and treats me like im nothing. I ask to be retested because I know I don't engage in high risk behaviors such as iv-drug usage or multiple sex partners, he says "well the results are confirmed you are hiv positive but ok, we can retest and start you on antivirals." I ask if I can have a letter to take the rest of the week off while i cope and try to deal with this and he said "You can go back to work, you have to deal with this now".. He also didn't offer any sort of counseling or anything, the guy treated me like if I was an animal. I left the Dr's office devastated and told my family and my Son's mom of the results. Everyone was devastated no one could believe it. I was urged to get a second opinion immediately, so the next day I was taken to Mexico (I live in Arizona) and they ran the Elisa test again two times. From a freshly drawn blood sample. It came back negative twice!. So I came back to Arizona and picked up my medical records and results from the Dr I had been seeing, they seemed to be hesitant in giving me the paperwork. But I insisted, afterwards I took my paperwork and results to a different Dr. This new Dr told me the First results given to me by my Dr we Indeterminate or inconclusive and that they meant nothing either way (either positive or negative) And that he couldn't go by the Studies done in Mexico. So he ordered a Viral load test saying that would detect the actual virus as soon as 1-2 weeks after infection. I went to get blood drawn for the 3rd day in a row and am anxiously awaiting the results. My question is could it just be a mistake that the first Elisa test picked up the antibodies from my Chlamydia infection and that's waht caused the false-positive and indeterminate western blot? Because on 10-26-11 I had two negative ELISA HIV tests. Is there a chance I have HIV? I'm very scared and anxious. Please help me.
Answer:This is a very difficult phase that you are going through, being told that one has HIV is very distressing and I can relate to your concern. An indeterminate or inconclusive western blot may mean that the infection is very recent and levels have not yet reached a detectable level, there may be current infections like syphillis, malaria or viruses that can cross-react with the test or there is a procedural problem in which the sample was contaminated or some clerical error.
In a general low-risk population, indeterminate results on western blot occur on in 1 in 5,000 patients. Most of the them usually can be confirmed on repeat testing within a month or in certain cases 6 months are required to tell whether the patient is positive or not. Since two ELISA tests have been negative, your chances of being tested positive in a repeat Western Blot or a Viral Load PCR is low. I hope I could clear some of your doubts and concerns.
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