Question: Are the HIV antibody tests conclusive? The western blots were negative. We got HIV tests done for my child in 2011 at 5 months and 13 months after a blood contamination incident. She was 3 years at that time. At that time they ordered a HIV Antibody test and a PCR Quant for HIV1. Both the times the EIA came reactive and the Western blots came negative. The PCR Quant was negative. Assuming an autoimmune condition if the EIA came reactive then is the Western Blot test accurate? Can we trust the Western blot test result as a true negative, because of any autoimmune disease? and not a false negative. Please help. I am reading that there could be many reasons for a false positive EIA. Out of which some autoimmune condition can cause a false reactive EIA. But does the same autoimmune condition can it cause a false negative Western Blot? or can i trust the Western Blot as a true real negative.

Thank you
When i search online if western blot can cause a false negative result if there is any autoimmune disease.
It says, that False reactivity on the EIA or Western Blot assays can be due to HLA antibody, autoimmune diseases (such as lupus), cross reactivity to yeast, or to other contaminating antigens used to prepare the HIV antigens. When they say cross reactivity, what does it mean? does it means false positive? Can a cross reactivity mean a false negative or a false positive?
After looking at this i got worried, i am not even sure if i understanding it correctly.
Can we trust the Western blot test result as a true negative, because of any autoimmune disease? and not a false negative.
Plus if HIV was present shouldn't the Western blot for HIV test should pick up the infection irrespective of if there is any autoimmune condition?
Can i assume it as Western Blot for hiv to be definitive? and move on?

Thank you very much Dr XXXXXXX
We got HIV tests done for my child in 2011 at even 6 weeks(eia non reactive) 5 months(eia reactive, western blot negative) and 13 months (eia reactive, western blot negative) after a blood contamination incident.

After the exposure she had a like a tiny white dot on her finger about 5 months later, the dermatologist did a visual inspection and told that it is vitiligo. He gave some cream and it went off in a few days. After that (11 years after the incident) she is right now 14 years no white patch or nothing. There was also one time where in the knee fluid popped up inside the knee kind of like leak inside the knee (11 months after the exposure). and they told that if it happens again we need to test for autoimmune conditions like Rheumatoid Arthritis. By the time we went to doctor office after 2 days the leak inside the knee was gone. And the leak of the fluid inside the knee never came back again. So they never tested for any autoimmunity. So can i take the Western Blots to be considered accurate and truly negative in this situation?
Since we were so worried After 9 years we requested these tests just to be certain.
HIV1 DNA PCR, QUALITATIVE Not detected.
HIV 2 DNA/RNA QUALITATIVE REAL TIME PCR. Not detected. But then i read about the Elite Controllers?
If it is an elite controller Dr. then will they show up or be detected on the HIV PCR Qualitative? and Can i please put this beyond me?
Right now Dr. she is 14 years old, the contamination incident happened when she was 3 years old. After the incident we never thought we will get tested, but she started falling sick within a day with allergies, then some times fever and cough. The first year after the exposure it was rough, she was falling sick a lot with allergies, then few times fever. This is the reason we got her tested in the first place.

After 1 year, she has improved a lot(no fever, no cough after that), she is growing good, except that she still has the pollen allergies are still there even after 11 years after the incident.
Please advise.

Dr. XXXXXXX
Thank you very much for your expertise here.
We got HIV tests done for my child in 2011 at 6 weeks(EIA non reactive then at 5 months(eia reactive, western blot negative) and 13 months(eia reactive and western blot negative) after a blood contamination incident. She was 3 years at that time. Both the times the EIA came reactive and the Western blots came negative. We were worried since she was falling sick a day after the exposure and also the fact that the EIA changed from non reactive to reactive.
This is the reason i asked you Dr. XXXXXXX
I will take your advice/expertise here and move on if the multiple western blots can be considered definitive.
Thank you very much again.

My apologies here. Dr. XXXXXXX We did not have any antigen tests that you were mentioning in your answer.

Dr. XXXXXXX
My apologies here Doc, i did not knew that the PCR's are also called antigen tests. Yes doctor we got the PCR qualitative tests done after 8 to 9 years after the incident. I took solace after the test results and then i do not know why i read about this elite controllers.
One thing you were also mentioning in your previous answer was about the Quantitative Antibody. Did you mean that they use a PCR Quantitative to monitor the viral load in an elite controller?
Dr. are these HIV PCR Qualitative tests conclusive in my child's case? assuming even if she is an elite controller?
Thank you very much.

Dr. XXXXXXX
    One last time, please do not think otherwise. Can I have your expert opinion please? You are my God now. We went through a lot these past 11 years.  There are 3 questions i have penned down in the bottom. A yes no or any other detail would suffice doctor and thank you once again for your precious time.
 I want to reiterate that the EIA changed from non reactive to reactive. We got even worried and not sure as to why the EIA changed from non reactive to reactive. 
My daughter was 3 years old when she had the contamination incident.
at 6 weeks after the incident her EIA hiv result came non reactive, then second time at 5 month, 20 days after the incident, her EIA came reactive and WB came negative and at 13 months after the incident her EIA came reactive and WB came negative.

As I told you earlier, my daughter had caught allergies within a day after the contamination incident, the first few years after the exposure were very rough, too many allergies. She also used to get a lot of colds/coughs and fall sick sometimes (maybe 3 to 4 times) with fever in the first year. Before the incident, she was a very healthy child. After 1 year after the incident no more fevers or anything else except the allergies. Now after 11 years she is doing fine except the pollen and rhinitic allergies are still there.
Later about 8 years later we requested our pediatrician for reassurance and requested the  hiv 1 dna pcr qualitative and hiv 2 dna/rna pcr qual realtime.

Do you advise any other tests for hiv the EIA becoming reactive and staying reactive from non reactive? The EIA was negative and then changed to positive the second time and remained positive the third time. I hope those qualitative tests I asked for are good ones. They are the qualitative tests from Quest Diagnostics.

1) Dr. Are these HIV PCR Qualitative tests conclusive in my child's case? assuming even if she is an elite controller?  

2) Can I take these 2 western blots negative done in the first 13 months as definitive and move on? Since the EIA changed from non reactive (at 6 weeks after exposure) to reactive at 5 months and at 13 months after exposure. But the western blots were negative. I am not sure why the EIA changed from non reactive to reactive due to which we got even worried. 

3) Are you suspecting any other disease or conditions since the EIA changed from non reactive to reactive? Do you recommend me to ask for any other tests other than hiv since the EIA changed from non reactive to reactive plus the fact that she was falling sick after the exposure?

To also let you know that they did a Hepatitis B, C test at 5 months 20 days after exposure and the results were negative.