INDETERMINATE HIV TEST RESULTS
Have you ever heard of an indeterminate test result?
Last week, a friend and I happened to talk about his indeterminate test and it was very casual and the conversation was quick and short. Today however the term came up twice over twitter.
What is an indeterminate result?
Google it up and you can see several explanations.
Causes of Indeterminate results vary
There are some well-known causes of indeterminate HIV-1 antibody Western blot results. I’ve listed them here. Most frequently, we see are due to nonspecific reactions, so there are some proteins or antibodies in the patient serum, particularly those with autoimmune disorders such as SLE rheumatoid arthritis that can cross react with the antigen on the Western blot strips. Another major group that we’ve seen indeterminate Western blot in a false-positive screening antibody test is the pregnant women, because they produce allo-antibodies during pregnancy and these antibodies tend to cross-react with the HIV-1 and -2 antibody screening tests as well as the Western blot results.
What to Do
So the approach with individuals with such indeterminate Western blot results is to repeat antibody testing in 2 to 4 weeks in high-risk individuals. For low-risk individuals, repeat testing is recommended in 3 to 6 months. In pregnant women, they are likely to have a false-positive antibody screening test and indeterminate Western blot results until 1 month after delivery, where the allo-antibodies are cleared from their system. The other possibility, instead of waiting 2 to 4 weeks in high-risk individuals, is to proceed to detection of HIV-1 RNA or proviral DNA using molecular tests.
Funny but true,
At least two cases were reported where: (1) the hygiene clinic said it was their first time to encounter the said results and they did not know what to do and (2) the patient was at a lost since the private clinic was unfriendly and he was handed the confirmatory (indeterminate) results without any explanations.
So did you get the correct response from your clinic?
If not, please report to your local NGO working on HIV/AIDS so proper education and information dissemination can be done. We do not intend to mock these clinics, but we do intend to educate them for possible future cases of Indeterminate results.
Read more about Indeterminate tests:
- Mayo Clinic
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