Need Explanation of HIV Test Results

[mbamike]

I receive my health care through the veterans clinic. I request an HIV test every three month when I am tested for other health issues. I don't think they have done the same test any time I have requested one.

Anyways, I was recently tested for HIV. Here are the results:

Test Name Result Units Range
HIV Viral Load (KNOWN POS) HIV-1 <50 copies/mLRef: None detected


I have never been diagnosed as having HIV. What is the "KNOWN POS" all about?
Since there were no antibodies detected, I would think it is safe to conclude I am still HIV negative. Am I right?

 

[KaraBulut]

Someone ordered the wrong test.

Doing a viral load on someone with a negative antibody test is a waste of money.

Probably the physician wrote for an HIV test and the person who entered the order picked the wrong selection on the order entry screen.

This of course assumes that you have had a negative HIV 1/2 antibody screen.

 

[mbamike]

Do I need to be re-tested?

What test should I request?

 

[KaraBulut]

Think of it this way- if you came in to the doctor's office and asked for a TB test. Instead of giving you a TB skin test (quick and affordable), they gave you an X-ray and a bronchoscopy (expensive). Both tests will tell you that you don't have TB- it's just much simpler and cheaper to do the skin test.

An HIV antibody test probably costs the VA about $20. An HIV viral load probably costs upward of $150. If you were paying for it, I'd tell you to complain and ask for a refund. But since the taxpayers paid for it, you got a very expensive HIV test.

An HIV viral load measures how much viral activity is in your body- how quickly HIV is multiplying and how much it is taxing your immune system. We wouldn't order that test unless we knew you were HIV+. So, if your HIV antibiody screen is negative, there's no reason to know how much HIV is in your body. An HIV- antibody test implies you don't any ANY HIV in your body.

Next time you go for a test, just remind them that you need an HIV antibody test and that the last time, someone accidentally ordered an HIV viral load.

 

[hotatlboi]

Do I need to be re-tested?

I believe the answer here is no though. Even though you got the wrong test, if you had it, then it would have been detected by the viral load test since the viral load would have been high if you were recently infected.

 

[Corny]

So, if your HIV antibiody screen is negative, there's no reason to know how much HIV is in your body. An HIV- antibody test implies you don't any ANY HIV in your body.

maybe I got that wrong, but that sounds as if the HIV antibody test is more sensitive to small viral loads than the viral load test, i.e. the viral load test could come back with a "load" of 0, yet the antibodies could be present in a positive antibody test

 

[KaraBulut]

maybe I got that wrong, but that sounds as if the HIV antibody test is more sensitive to small viral loads than the viral load test, i.e. the viral load test could come back with a "load" of 0, yet the antibodies could be present in a positive antibody test

The HIV antibody test is looking for antibody to the virus. All this indicates is that at some point, there has been an exposure to HIV and the body has produced antibody to that exposure.

Some of the newer HIV screening tests look for antibody and antigen- that is they're looking for that prior exposure that triggered antibodies but it's also looking for proteins called p24 antigen that are unique to the HIV virus. These are usually referred to as Ag/Ab or combo tests. What this particular test does is tries to select out people who have had a recent HIV exposure- so recent that their body has not produced enough antibody to trigger a reactive (positive) HIV antibody test. You'll also here these tests called "qualitative tests" because the result is positive or negative- it's only looking for a yes/no answer to "has the patient been exposed"- not how much HIV is there.

A viral load test has several different versions but it's what most people call a PCR or NAAT test. It's looking for HIV RNA- specifically how much HIV is there. These are quantitative tests.

The only time that you would be HIV+ (antibody) but have a 0 viral load is if you were on very successful antiretroviral therapy. It means that you have had an exposure (qualitative) but there's no virus circulating in the bloodstream (quantitative).

The only way you could have a positive viral load and an HIV- antibody test is if you had such a recent exposure that your body had produced no antibody. But the HIV Ag/Ab test would have probably been as successful at finding this and it would have cost about 1/10 the amount of an HIV viral load.

 

[AdmiraalW238]

Look let me be succinct and to the point ...

They ran the wrong test. End of story. Have them redo the test when you next see the doctor. The test you should ask for is a HIV Antibody test.

But the question that I have (that no one else has asked) is who gave you the test results in the first place and why did you not ask them at the time they gave you the results what it all meant and they would have told you then and there that they had run the wrong test.

 

[Nomenclature]

As far as I understand, a viral load test is ONLY done after a person tests positive for the antibodies, in order to rule out a false positive. They have to notify you and call you in for further testing. . .so yes, they did this completely wrong.


I think you'd be much better off finding an LGBT center, a sexual health clinic or a gay-affirmative doctor that actually KNOWS this, rather than a VA hospital; I wouldn't imagine they're hip to gay sex.

 

[winterknight]

My understanding is that Viral Load will show positive before the ELISA - The window period narrows to about a week, which is why the porn industry uses it instead of the immunoassay.

The only way you can be positive and have an undetectable VL is if you're on HAART and have it well under control. I'd check that they haven't sent you someone else's results by mistake (the "known pos" makes me slightly suspicious there), but if they are genuinely your results there's nothing to worry about, all that's happened is that the VA screwed up and spent some money they didn't need to.

 

[mbamike]

I wouldn't imagine they're hip to gay sex.

They are not. I received a lecture on the dangers of having multiple sex partners by the nurse when I asked for the first test several months ago. Basically, she was preaching abstinence. She would really freak out if she knew I am having gay sex.

Anyways, no one has ever asked if my sex partners were male or female. They only ask if I am "at risk" in which my answer is always yes.

As for as this test, I did not receive a copy of the test results until after I saw the doctor. So, I did not discover the mistake until after I saw the doctor.

The doctor said, You requested an HIV test, nothing was found, then move on to the next issue.

 

[KaraBulut]

They are not. I received a lecture on the dangers of having multiple sex partners by the nurse when I asked for the first test several months ago. Basically, she was preaching abstinence. She would really freak out if she knew I am having gay sex.

*sigh*

In the last administration, there were several funding initiatives that were passed by the Congress and the White House that requires organizations and agencies who receive federal funding to promote abstinence. I could get on my soapbox but leave it to say that the nurse was most likely required by policy to encourage you to refrain from sexual activity.