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Indeterminate HIV results on PrEP


RawSex28

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How common are indeterminate results while on PrEP? That was the result of my last blood test (mail in dried blood spot card) so I'm not exactly sure which tests were run (other than it being a 4th gen) or where the discrepancy occurred, but I have to go to a lab next week to retest with a blood draw.

I'm not sure how concerned I should be? This brings back all the worry PrEP was meant to reduce.

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My local clinic seems to get this fairly frequently. I've had several tests that were indeterminate. My understanding is they look for all four markers to get a positive result. If you have no markers then it's negative. If you have some markers then they need to retest. Once I had three retests in a row before they sent the sample out to an external reference lab for confirmation. The nurse admitted it had been happening quite a lot that month and it seems to go through phases. On talking to the consultant at the clinic, she thought that since I had been unwell with something unrelated,  this may have triggered one of the markers. I'm no expert, so it's always best to get advice from your doctor, but if you're on Prep and adhering to the regime, hang in there as the odds are in your favour. 

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19 hours ago, RawSex28 said:

How common are indeterminate results while on PrEP? That was the result of my last blood test (mail in dried blood spot card) so I'm not exactly sure which tests were run (other than it being a 4th gen) or where the discrepancy occurred, but I have to go to a lab next week to retest with a blood draw.

I'm not sure how concerned I should be? This brings back all the worry PrEP was meant to reduce.

Where are you located ? I heard that there are some PrEP-resistant strains that circulating in certain areas.

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2 hours ago, SubHornyBottom said:

Where are you located ? I heard that there are some PrEP-resistant strains that circulating in certain areas.

Philly Area, for what it's worth the lab results don't actually tell me much. It's pretty ambiguous:

Indeterminate: Repeat testing has yielded inconclusive results. This could be due to pretreatment by antibiotics or other medications,
inadequate specimen collection, a slightly increased “false positive” signal, or the presence of infectious organism or antibody at a
concentration below the detection capability of this assay. A result of “Indeterminate” does not imply a positive result or conclusive
identification of any infectious organism or antibody. Molecular suggests consulting with your medical provider regarding further confirmatory
testing for this organism.

So, for all I know, the whole paper could have turned rainbow color due to lab error and that would fit into the above description. I don't actually know what or if anything triggered an actual indication of reactivity. I was on antibiotics a month before this blood test (So I presume it should have cleared) and only high risk encounter was topping back in June, so I'm hoping this is just contamination, lab error, or poor specimen collection (since it was an at home dried blood spot test) but none the less, it's always concerning not knowing. You take PrEP to minimize the worry, ya know? and it's back again. 

Edited by RawSex28
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I know the feeling. I think we’ve all been there and had the worry, at least before the pre-Prep days.

Understandably, you’re anxious for a definitive result for your test. If you can stomach it, why not go to a CVS or Rite Aid near you and buy the OraQuick home rapid test? That will give you an answer right away so that you don’t have the anxiety hanging over your head until you can get re-tested at the clinic. Hopefully (and more likely since you’re on Prep) the result will be negative. 

Let us know how it goes! We’re rooting for you.

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4 hours ago, RawSex28 said:

Philly Area, for what it's worth the lab results don't actually tell me much. It's pretty ambiguous:

Indeterminate: Repeat testing has yielded inconclusive results. This could be due to pretreatment by antibiotics or other medications,
inadequate specimen collection, a slightly increased “false positive” signal, or the presence of infectious organism or antibody at a
concentration below the detection capability of this assay. A result of “Indeterminate” does not imply a positive result or conclusive
identification of any infectious organism or antibody. Molecular suggests consulting with your medical provider regarding further confirmatory
testing for this organism.

So, for all I know, the whole paper could have turned rainbow color due to lab error and that would fit into the above description. I don't actually know what or if anything triggered an actual indication of reactivity. I was on antibiotics a month before this blood test (So I presume it should have cleared) and only high risk encounter was topping back in June, so I'm hoping this is just contamination, lab error, or poor specimen collection (since it was an at home dried blood spot test) but none the less, it's always concerning not knowing. You take PrEP to minimize the worry, ya know? and it's back again. 

Yeah. Please definitely let us know the updates. We are in this together. Nobody is safe unless everybody is safe.

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On 8/10/2019 at 8:09 AM, RawSex28 said:

Philly Area, for what it's worth the lab results don't actually tell me much. It's pretty ambiguous:

Indeterminate: Repeat testing has yielded inconclusive results. This could be due to pretreatment by antibiotics or other medications,
inadequate specimen collection, a slightly increased “false positive” signal, or the presence of infectious organism or antibody at a
concentration below the detection capability of this assay. A result of “Indeterminate” does not imply a positive result or conclusive
identification of any infectious organism or antibody. Molecular suggests consulting with your medical provider regarding further confirmatory
testing for this organism.

So, for all I know, the whole paper could have turned rainbow color due to lab error and that would fit into the above description. I don't actually know what or if anything triggered an actual indication of reactivity. I was on antibiotics a month before this blood test (So I presume it should have cleared) and only high risk encounter was topping back in June, so I'm hoping this is just contamination, lab error, or poor specimen collection (since it was an at home dried blood spot test) but none the less, it's always concerning not knowing. You take PrEP to minimize the worry, ya know? and it's back again. 

I think it also maybe best to stop the PrEP right now and stop sex for the time being. So the diagnosis could be determined and you aren't building resistance if you do have one.

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3 minutes ago, SubHornyBottom said:

I think it also maybe best to stop the PrEP right now and stop sex for the time being. So the diagnosis could be determined and you aren't building resistance if you do have one.

That is, you take the PrEP till 28 days after your last sex and then stop to let the virus shown. After that, you can get on treatment.

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11 hours ago, SubHornyBottom said:

That is, you take the PrEP till 28 days after your last sex and then stop to let the virus shown. After that, you can get on treatment.

Yes, I actually stopped PrEP a month after my last sex. My first indeterminate HIV result was taken 7 days post PrEP. Today it's 21 days post PrEP and just got my labs drawn to retest and also included RNA/PCR tests to provide a conclusive finding.

My provider has said they've seen 53 seroconversions with people taking PrEP, but adherence wasn't known. Not every indeterminate is a positive. So maybe I'm like 50/50 chance. Will know more by end of week hopefully!

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18 hours ago, RawSex28 said:

Yes, I actually stopped PrEP a month after my last sex. My first indeterminate HIV result was taken 7 days post PrEP. Today it's 21 days post PrEP and just got my labs drawn to retest and also included RNA/PCR tests to provide a conclusive finding.

My provider has said they've seen 53 seroconversions with people taking PrEP, but adherence wasn't known. Not every indeterminate is a positive. So maybe I'm like 50/50 chance. Will know more by end of week hopefully!

Pray for you, and pray for the rest of us !!!

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3 minutes ago, punaman said:

wondering why the 53 seroconversions haven't made the news. Adherence is important obviously, but if it's not working when adhering, it should be let known

Please check my post history... I noted this problem in my earlier post but it didn't seem to gain traction.

Edited by SubHornyBottom
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