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Author Topic: Need guidance  (Read 3965 times)

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Offline want to help

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Need guidance
« on: November 15, 2008, 05:08:33 PM »
A relative of mine has just tested positive. He is in a state of shock; we are trying to be as loving and supportive as we can be. He told us that he took his test 2 weeks ago. A few days later he called the clinic for the results and they told him he was negative the other STD's he was tested for but he needed to come in person for the HIV results. He didn't think anything of it and waited two weeks to come in and got the results yesterday. After he received the results he took a rapid blood test and it confirmed the finding.  He does not know what test he was given two weeks ago nor the test he was given yesterday as he can not locate the piece of paper they gave him with the results. The clinic is closed for the weekend and we are trying to understand where he stands in the process.  My questions:

- Should we assume that the original test wherein they reported the results to him included an ELISA and Western Blot test?

- Does a rapid blood test (it took 20 minutes) include both an ELISA and Western Blot?

-Should he be retested at another location before we take him to a specialist- it will probably take a few days to get an appt

- Would the paper he was given include an analysis of his viral load and T-Cells?

We are not in denial; we are trying to understand what the next step should be and also be a little more educated when we take him to see a specialist and make sure we ask the right questions.

Thank you in advance.

Offline RapidRod

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Re: Need guidance
« Reply #1 on: November 15, 2008, 05:46:00 PM »
This should have been posted in the "Someone I Care About Has HIV Forum."

Offline want to help

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Re: Need guidance
« Reply #2 on: November 15, 2008, 05:54:20 PM »
Sorry for my mistake. I am not in the greatest frame of mind. I see that my post has been moved and hope that someone qualified to respond will respond ASAP.

Thanks you

Offline Ann

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Re: Need guidance
« Reply #3 on: November 15, 2008, 06:02:07 PM »
Agreed, Rod, and moved.

Want,

A rapid test (the second test he took) does not include a Western Blot. If he is throwing false positives, a rapid test will not weed this out. False positives do happen and are often caused by autoimmune problems. People don't always know they have an autoimmune disease when they test for hiv.

I urge you to read - and get your relative to read, either by sending him a link via email or printing out our Testing Lesson and giving it to him.

Blood tests for CD4 and Viral Load are not done until the patient has been confirmed as hiv positive via the combination of a positive ELISA (standard hiv antibody test) and the Western Blot test. So no, these results would not have been included.

Any reputable testing center will follow up a positive ELISA result with WB testing. I urge you to tell him to go to one such center before he shells out money for a specialist. A listing for hiv testing centers in the US can be found at http://directory.poz.com/

Good luck,

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline want to help

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Re: Need guidance
« Reply #4 on: November 15, 2008, 06:08:58 PM »
Thank you Ann.

Would you please clarify whether the first test he took (which was not a rapid test) would have been automatically submitted to a Western Blot by the lab/testing center or if they would have had him come in for that confirming test?

Thanks

Offline Ann

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Re: Need guidance
« Reply #5 on: November 15, 2008, 06:28:18 PM »
Want,

It depends. If the first test he took was any sort of a rapid test, either by the oral or the finger-prick blood route, then no, WB testing would not have been included before notification. Only when blood is drawn into a vial can the WB test be subsequently conducted (with the left over sample). However, not all testing centers will preform this automatically. He'll have to ask where the test was conducted at.

The problem here is that different places operate differently.

I've seen it all too many times here that people will be told they are hiv positive, without the confirmatory WB result. It happens. It isn't right, but it happens. Without knowing what your relative's exposures were it's totally impossible to even speculate as to what's going on.

The bottom line is that he MUST be confirmed as hiv positive with a WB result that agrees with his standard antibody result.

In short, he either needs to find his original paperwork, which should show whether or not he's had a WB confirmation, or he needs to go elsewhere and explain what's happened and have an ELISA run with the assurance that a WB will be run if the ELISA returns positive.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline want to help

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Re: Need guidance
« Reply #6 on: November 15, 2008, 06:48:28 PM »
Thank you, Ann. I guess we will have to wait until Monday to find out if the WB test was performed.  From what he can remember the blood was taken from his arm and that there was some mention of the WB test on the paperwork but doesn't know what the reference was (whether WB was performed or whether it needed to be performed).

The risk was unprotected vaginal intercourse with his girlfriend who he thought was monogamous.  This occurred several years ago. Before engaging in unprotected sex they both tested for HIV and were negative. The girl cheated on him and when he found out he broke off the relationship. He is guessing that she contracted HIV from the other guy and then he did from her. He has told us that he used a condom with all other women that he was with before and after.

The counselor at the clinic told him that he could tell that he contracted HIV years ago as the test revealed 5 of 6 "bands" in the blood sample hence his belief that he was exposed by his ex-girlfriend years ago.  Have you ever heard of being able to determine an approximate date when HIV was contracted from the blood sample?

Thank you for being there for us. He is very shaken up and we are trying to do our best to offer our love and support and at the same time helping determine the path he needs to follow.




Offline Ann

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Re: Need guidance
« Reply #7 on: November 15, 2008, 07:07:35 PM »
Want,

No, I've never heard of the ELISA bands being predicative of a time-frame. However, in my own case, the ELISA bands were predicative of a positive WB result. I was told the WB was a formality (because of the amount of reactive bands), but at the same time, the WB HAD to be run as there was still a chance of it being a false positive.

Hiv is more difficult to transmit from a woman to a man. At the time of my own diagnosis, I was in a relationship with a negative man for 18 months (during which time we never used condoms) and he tested (and still tests) negative. While the odds are in your relative's favour of being negative, that does not mean he has been without risk. The man I from whom I acquired my infection is a straight man who got it from a woman. It happens - and in actual fact, heterosexuals have higher infection rates, world wide, than gay men. So much for "risk groups".

OK, so here's some hard facts.

Yes, if he is indeed positive, his life will change. Not all the changes will be bad ones. For a person being diagnosed hiv positive today, the future is very different to those who were diagnosed years ago. There are so many treatment options available today that just weren't here even a few short years ago. He, depending on other factors, both genetic and lifestyle, can live to a ripe old age, depending of course on not being hit by the proverbial bus.

He might not even need medication right away. I've been poz for eleven years and I'm still treatment naive. His mileage may vary.

And yes, he can still have relationships. Condoms effectively stop hiv transmission. Couples where the man is hiv positive and on meds with an undetectable viral load are even fathering hiv negative children to hiv negative mothers. The world is still his oyster.

The important thing is that he knows - for sure - his hiv status either way. I'm glad he's felt able to confide in his family and I'm also glad his family is reaching out for information to help him. Let's hope that he's hiv negative, but all the while knowing that his life is far from over if he is hiv positive.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline want to help

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Re: Need guidance
« Reply #8 on: November 15, 2008, 07:24:19 PM »
Thanks again, Ann, for your time and sharing your story.

You are being very patient and understanding with me. I want you to know how helpful you are and how much you are appreciated.

Your last response did open question for me and I just wanted to get this right- can blood markers or bands, or any other info received from a WB test (which we will find out whether or not he took when the clinic reopens) indicate a time period when infection took place as this counselor told him.

Thanks

Offline Ann

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Re: Need guidance
« Reply #9 on: November 15, 2008, 07:55:51 PM »
want,

Because each individual's body responds to the virus in an individual way, there's really no way of knowing when a person was infected going by blood tests alone. That includes the bands on an hiv antibody test. While it is true that someone infected within the past few weeks would have a weaker band showing, someone with a strong band show could still have been infected relatively recently, depending on how strong an immune response their body was able to mount.

I know for sure when I was infected due to a combination of a period of being sicker than I've ever been in my life combined with the outcomes of hiv tests on the sexual partners in my life. Not everyone gets a (what's called) a seroconversion illness, but some get so sick they need hospitalization. I should have been in hospital, but I was too sick to get out of bed and I didn't have a phone. On the other end of the spectrum, many people notice nothing at all. We (my doctor and I) had no idea what made me sick at the time. In retrospect when i was finally diagnosed four years later, my doc said "if you were a gay man presenting with those symptoms, the first thing I would have done was an hiv test". So you understand my abhorrence for the so-called "risk groups".

To answer your question simply, I really don't think the bands on an ELISA test could determine that an infection was any more than six to eight weeks old. Further than that, it is likely to be pure speculation.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline md

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Re: Need guidance
« Reply #10 on: November 16, 2008, 04:22:51 PM »
... can blood markers or bands, or any other info received from a WB test (which we will find out whether or not he took when the clinic reopens) indicate a time period when infection took place as this counselor told him.

As Ann has already explained there is really no way to determine when an individual was infected with HIV from tests conducted after the fact.

While it is quite natural to be curious about how and when someone was infected it usually isn't a very useful question to try to answer. Also (and please don't take this the wrong way, because I have no way of knowing whether or not it might apply to this particular situation) you should be aware that people don't always admit to all of the risks that they may have taken which might have exposed them to HIV.

For now, be thankful that your relative was able to share the information about his test result with you, help him to get the result confirmed and, if he actually is HIV+, help him to get treatment.
« Last Edit: November 16, 2008, 04:45:55 PM by md »

Offline hotpuppy

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Re: Need guidance
« Reply #11 on: November 30, 2008, 12:08:29 AM »
I think the most important thing right now is to focus on the future. 

He's lucky to have you as a friend, caring enough to be involved, and committed enough to ask questions.

The hardest part about finding out your HIV+ is that it seems like your world is ending.  It's important to emphasize that this is not the case.    Much has changed. 

I agree that route of transmisssion is not important.  There is a timely article in Poz magazine this month about a heterosexual porn star.  In that article, Darren James talks about how it is lonely to be a straight poz guy.  Undoubtedly your relative is going to be going through this.  You might print the article for him.  I would also encourage you to get him the magazine.  It comes in a black wrapper and you would have no idea what it was.  It is empowering to see the stories, the people, and that there is more to life than just being a number or victim.

Lastly, I would encourage you to not get too attached to your notions of your relative.  Specifically he might be straight, he might not be.  He might have gotten it from the girlfriend, and might not have.  None of that really matters right now.  As someone else pointed out, people rarely admit everything to everyone.  Even if he did, it's irrelevant. 

HIV is like a pet.  Accept you can't return it.  You can't put it up for adoption.  You can give it away (although we wish you wouldn't) but you can't get rid of it.  You can ignore it, but it will misbehave and trash the house.  If you take it out for a wild night on the town, it may bring friends back you won't like.  It doesn't always play well with others.  It needs constant visits to the vet and special food to help with it's nasty habits.

Most of all HIV is what you make of it.  Current treatment is very successful and it's possible to live a normal healthy life.  That hasn't always been the case and there is much to be thankful for. 

Lastly, I would encourage you to help your relative find this site. 
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

 


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