Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date. I am a lesbian who has been in a monogamous relationship with another woman for the last 1 1/2 years. Prior to that, I was married to a man and I was not completely monogamous (had unprotected sex with 1 man - 7 years ago and 2 women, the most recent of which was 4 yrs ago).
My partner and I got tested for all the STD's we could get tested for. My partner is completely negative on all her tests. On my HIV test, I had either an equivocal ELISA or a positive (I'm not sure which), so they did a Western Blot. On my WB, I showed positive for band p31, but no other bands. I am currently waiting on the results of a PCR test.
My questions are these: How concerned should I be with only one positive band? What might make that particular band positive and nothing else? When should I go for follow-up testing (3 mos?...I have had no new risky behavior in the last 18 mos, so I'm not sure what waiting would show). Why would this show up now? My prior HIV tests were 3 yrs ago and 8 yrs ago, both of which were negative. If that one positive band indicates that I may be seroconverting, why would it take so long? If p31 is specific for HIV reverse transcriptase, why would I have that part of HIV in my blood and not the other parts (envelope proteins, group-specific antigens, etc)?
Any information you can send would be very helpful, as my partner and I are very confused. Thanks.
Marty Markowitz, M. D.
Clinical Director
Staff Investigator, Aaron Diamond AIDS Research Center
Associate Professor, Rockefeller University
Antibody tests for HIV generally are done in 2 steps. THe first is an ELISA which looks for the presence of antibodies that react with a pool of proteins derived from the virus. This is a very sensitive test, meaning that it will pick up essentially all infected people but it is not specific...there are many false positives.
The second test is the Western Blot. This is more laborious, expensive and therefore is only used to confirm infection. To confirm infection it must be positive.
Indeterminate tests are detected in people who may be seroconverting, that is very early in the course of infection. They are associated with single bands in the regions of envelope (120 and 41) or gag (55, 24, 17). When both are present the test is considered positive.
There are some people who have cross reacting antibodies with HIV. They may have a postive ELISA and an indeterminate HIV. You may be one of these people.
The best way to determine this is to be retested within weeks of your first test. Failure to develop more bands would indicate you are not infected. You can also ask your MD to do a viral load test...this should be non-reactive.
Sometimes people infected with HIV-2 will have an indeterminate test...this is unlikely given your history. However you can ask your doctor to make certain that you are tested for HIV-2 specifically.
From the information you have given, it is likely that you have a cross reacting antibody...this can occur after a viral illness or can be associated with other medical conditions. Consult your physician for more information.
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