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What does unreactive result for HIV 1 and HIV 2 tests mean?

Answered by
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Dr. Sheetal Verma

Infectious Diseases Specialist

Practicing since :2001

Answered : 635 Questions

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Posted on Wed, 28 Oct 2015 in HIV and AIDS
Question: I had a HIV test done recently. HIV 1/o/2 was 3.45 (indexed at 1), HIV 1 and HIV 2 were both unreactive. Nothing specified ELISA or Western Blot. I know HIV 1/o/2 is an ELISA test, so my first question is if the HIV 1 and HIV 2 test are also ELISA (I assume they are). Not sure why nothing was shown for Western Blot if this is the case. I went back in today when they said the results were inconclusive and had more drawn for an RNA test. I was exposed to a needle after an immunization. Just looking on clarity on the results before the RNA results. I know certain other antibodies can be reactive with HIV 1/o/2 and I know if it is reactive and WB is negative it is possible to be in the middle of seroconversion.

Any further explanation is greatly appreciated.
doctor
Answered by Dr. Sheetal Verma 5 hours later
Brief Answer:
PCR test will be conclusive in your case.

Detailed Answer:
Hi
Thanks for your query at HCM.

I understand your concern and situation. As an microbiologist experienced in all infections including HIV, my comments are as below:

As you mentioned test was indexed at 1.0.and your value was 3.45 mean the test is reactive. The ELISA test detects both p24 antigen and antibodies so it identifies a patient both in interval period and beyond. The sensitivity of ELISA test is high but it is the western blot whose helps to differentiate between true positive and true negative. In your case if the western blot tests are non reactive that means they did not find HIV 1 and HIV 2 antibodies. This is poor reporting if they did a EIA assay for these antibodies. If the western blot is inconclusive then it means it could both be positive or negative. In this situation we have to rely on HIV PCR for conclusive evidence. I too would suggest you to get PCR test and this will be the best guide.

You can take a follow up query
Hope I answered your query
Rating and review will be appreciated
Dr Sheetal Verma
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sheetal Verma 3 hours later
Thanks for the reply!

So the HIV 1 and HIV 2 results, were they the Western blot results?
doctor
Answered by Dr. Sheetal Verma 18 minutes later
Brief Answer:
See detailed answer.

Detailed Answer:
Hi

The ELISA test identifies both HIV 1 & 2 and other rare HIV forms. The Western blotting will identify only HIV 1 infection. I suppose they were. It is the lab and the reading doctor who sends the samples to such labs can only read such non standard reporting.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sheetal Verma 3 hours later
Thanks again.

I was exposed only 6 days, 3.45 seems a little strange for so recent. The last time I could have possibly been exposed before that was 11 months ago, I would assume the western blot would have been positive if I was infected that long ago, are those two reasonings accurate?

I feel that my chances of being infected are extremely low given all of that, so would I be correct in assuming I'm not infected... Until the pcr rna results confirm one way or the other?
doctor
Answered by Dr. Sheetal Verma 21 minutes later
Brief Answer:
See detailed answer.

Detailed Answer:
Hi

I would suggest you not to worry so much. When there is descepency between ELISA test and Western blotting test then Western blotting is considered conclusive. But in your case the Western blotting is inconclusive. In this situation we are left with no other option but to depend only on the results of HIV PCR test results. I understand your situation and stress but you have to have patience and get PCR test done soon to clear all the doubts. Till that I would suggest you to exercise, meditate and keep engrossed in routine activities.

Take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sheetal Verma 3 hours later
It was inconclusive? I thought non-reactive meant it was negative?
doctor
Answered by Dr. Sheetal Verma 4 minutes later
Brief Answer:
See detailed.

Detailed Answer:
Hi


You have mentioned yourself that they said results were inconclusive so they drew blood for PCR. So I assumed the same. Non reactive means negative. Kindly upload the reports so that I may give you best advice.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sheetal Verma 14 minutes later
The report was uploaded at the time I asked the first question, the HIV 1/o/2 was repeatedly reactive and the HIV 1 and HIV 2 were non reactive
doctor
Answered by Dr. Sheetal Verma 15 minutes later
Brief Answer:
Go for PCR test.

Detailed Answer:
Hi

See "HIV 1 O 2 abs" means that the test was for antibodies to the common type of HIV (which is called HIV1 group M) and also for two much rarer types of HIV called HIV1 group O and HIV2. Your one antibody based test shows reactive and other shows negative. Seeing the reports it hints towards rare group O positive. But this is very rare and must be confirmed by PCR test. So there is discrepancy between two tests.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sheetal Verma 11 minutes later
Thanks for the info. Is it possible to get a refund for the second $35 charge since the report was already uploaded?
doctor
Answered by Dr. Sheetal Verma 10 hours later
Brief Answer:
See detailed.

Detailed Answer:
Hi

I had seen the ELISA reports but I wanted to see the Western blotting report.


Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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