inconclusive test results

[horst123]

Hello,
First of all: I think you a doing a great job here on your forums.

Since I am terrible afraid I hope someone can find some words of encouragement for me.
I am a heterosexual male. This is my story.

For many years I was alone and felt unloved and went to prostitutes. I always used condoms. I performed cunnilingus on the women. Once the condom broke, but as far a I remember I was not inside the woman. (and it was a least 4 months ago). So I always thought I can not be infected with HIV. And since I always used condoms I believed I would not endanger anyone.

I have no other illnesses I know of so I think my immunesystem should be pretty normal.

A few months ago I met the love of my life and decided this is the time to get tested and put the times of visiting prostitutes behind me. And I wanted to make sure that I am not a risk for her. Up until now except for petting we never had any form of sex without a condom. I wanted to be sure not to endanger her.

So my last contact with a prostitute was somewhere between 9 and 12 weeks before the test and it was vaginal sex with a condom and cunnilingus without any barrier. Everything other contact  was more then 4 months ago, the borken condom even more than 6 months.
So I was quite confident that the test would be negative since many, many sources state cunnilingus as a no risk activity.

What came back from the lab was the following and it was a shocking surprise for me.
Inconclusive in the ELISA
Inconclusive in HIV1 Westernblot
Inconclusive in HIV2 Westernblot
CMIA negative

It scares me a lot.
I think the broken condom incident would have produced a clearer result.
In my opinion the question wether I had a risk it comes down to the contact 9 to 12 weeks befor testing (vaginal sex with condom ans cunnilingus withaout a barrier).Everthing else should have produced clearer results.

The consultant told me that there a some people with no HIV infection who’s test result will always look that way. And theese people will always test in that way, no matter how often they test. But since I was not sure that my last cunnilingus was indeed 12 weeks ago he told me it might be appropriate to test again four weeks later since a beginning serokonversion could look the same way. He believes cunnilingus is an activity with a very small risk but not free of risk.

This retest will occur on Thursday. I am really afraid and have already consulted a psychiatrist about my fear. But she is not an HIV specialist.

What do you make of the results of my first test?
Is it possible that an influenza vaccination I had some 8 weeks prior to the test fooled both ELISA and WB? Or something else in my blood fools both tests?

What do you nice people on this forum think? Do you have an explanation for my test results?

Thank you.

[Andy Velez]

Horst, your flu vaccination would not have affected the test results. Of course it's understandable that you're concerned. Given what you have reported about your experiences and the one possible risk with a broken condom, my expectation is that you will test negative.

Until the condom broke you were protected. HIV is harder to transmit from female to male than the other way around.

Given all the details I'd still say the odds are in your favor that you're going to test negative.

Good luck and keep us posted.

Cheers.

[horst123]

Andy,
Thank you for your kind words. It is some relieve that you seem to believe that under my cirsumstances these results do not really indicate an infection with HIV.

The broken condom was more than 6 months before testing, so I believe if I would have been infectetd on that occassion it would have produced a clear positive (not an inconclusive) in the tests. I hope I do not need to worry about that one.

I will keep you posted.

[Andy Velez]

If that was your only risky possibility, I agree that 6 months would have been more than sufficient time for antibodies to have produced a clear positive result.

Fingers crossed and awaiting good news when you get your test result.

[horst123]

Hello guys

First: Thanks you for your support.
Today I went for the second test and now is the time to wait. They told me that the lab will probably need more than a week, because with a retest such as mine they usually doublecheck everthing.

Today I got a detailed look at my first test results (last time I was too shocked to even look closer)

In the ELISA I had an Indeterminate (I think this is the world used in English) "grenzwertig" is the German word they used, meaning something along the lines of "marginal" or "borderline"
The HIV-I Westernblot was "grenzwertig" because one band showed up.
The HIB-II Westernblot was "grenzwertig" because one different band showed up.
Then they took a CMIA Antibody/Antigene Test showing a clear negative.

The social worker and the physician explained the situation to me.
The told me that it is possible the second test will look exactly the same, proofing that I am negative since I had no risky sexual intercourse in the last 13 weeks and furthermore 4 weeks after the first test I would have seroconverted by now if I were positive. This is the result they expect.

It could come back negative. Everythings fine.

They both do not expect it to come positive, but they do not want to rule out this possibility.
They said it was extremely unlikely that I get a positive.

They explained to me: Since 2 years they are having problems with the HIV-tests producing a a higher amount of indeterminate tests compared to earlier, because the test got more sensitive. They said they have to cope with such an incident often.

They further explained that generally (not only HIV) in blood-serology indeterminate results do happen all the time and are not at all uncommon. But with most infections nobody makes a fuss about them. Just when (among others) HIV is concerned they care for sorting it out with a second test.

What I find interesting: In the health agency I got tested they insist that performing cunnilingus on a woman is a very small risk. A very small one, but a risk.
On the other hand, since more than 2 years the "Bundeszentrale für gesundheitliche Aufklärung", a goverment-agency responsible for HIV/AIDS education here in Germany says that  "the virus load in vaginal secretion is not high enough to get infected by having it in your mouth." (rough translation, sorry) They only state that (menstrual) blood and cum should be avoided.

So I try to choose to trust you on this forum an the government agency.

Okay, of for one or two weeks of waiting.
Thank you for your support.

[RapidRod]

Your ELISA test was indeterminate which mean not positive and not negative.
Your Western Blot tests one band = negative
Your second antibody test was negative.

Conclusion: Your negative.

[Andy Velez]

I agree with Rod. I expect your negative status to be confirmed by your next test results. Good luck.

[horst123]

Thank you for your kind words, RapidRod amd Andy.

Today the results of the second test were not yet back and I still have to wait.
This indeterminate test still scares me a lot.

[Ann]

horst,

Many labs would have already declared you hiv negative based on your ELISA and WB results (as Rodney already told you). You are hiv negative.

Ann

[horst123]

Good Morning Everybody,

I just recieved the results of my second test. They look almost exactly like the first test.
Elisa: Indeterminate
HIV 1 WB: very weak p25
HIV 2 WB: very weak p26 (could be the other way round, I do not remember which band was on which WB)
CMIA ab/ag: negative

The weak bands are a little  different from last time. Last time they were reported as "weak", this time as "very weak"

Since I had no insertive sexual contacts (only kissing, hugging and fingerring;, all no risk) since 13 weeks the social worker told me I am negative and the tests react to something in my blood with no relation to HIV.

Like you all said.

Concerning my mostly irrational fear I have an appointment with a psychiatrist this afternoon. I believe, there are some issues in my mind that need to be talked about.

Thank you all for your great support.

[Andy Velez]

You're welcome. Glad to know you're HIV negative and that you're open to addressing issues about which you need help in the appropriate setting.

Good luck to you.

[Ann]

horst,

Something that is often associated with false positive hiv results and weak indeterminate results is autoimmune disease. You may want to check this out with your doctor to make sure you don't have an underlying autoimmune disease that hasn't made itself known yet.

But you're fine as far as hiv goes - you are hiv negative. Make sure you keep using those condoms and you'll stay that way.

Ann

[horst123]

Thank you Ann, I will keep that in mind.
Thanks again to all of you.
You helped me a lot.