Occasionally, an HIV test will come back "inconclusive." While this is not necessarily cause for alarm, it is always advisable that an individual with an indeterminate test result follow the appropriate protocol to achieve a conclusive HIV status.
Causes of Inconclusive HIV Tests
An inconclusive result might mean that there was a problem with a blood sample that prevented it from being tested. Alternately, it could also mean that even though the test was completed using the sample, it yielded neither a positive or negative result. If this is the case, an infected individual who is tested could be in the process of what is known as "seroconverting," the time in which one is actively becoming HIV positive. Therefore, achieving an accurate response is not possible. Alternately, an individual might have an underlying viral infection or certain antibodies that cause an inconclusive result.
What to Do When Tests are Inconclusive
Dr. Oliver Bacon of the University of California-San Francisco's Positive Health Program poses that the best thing to do would be to repeat the test (if the individual used a home HIV testing kit). However, if the new test yielded a negative result, there may be confusion as to which test was accurate. Bacon poses that another solution would be to go to a free testing clinic and inform counselors of the indeterminate result. More thorough testing might be required, such as the RNA test or a p24 antigen test.
RNA Testing
RNA testing is done through polymerase chain reaction (PCR) tests and involves assessing a blood sample to determine if genetic material has been produced by the HIV virus. However, these tests may come back false-negative or false-positive if the individual has been infected within five days. RNA testing is typically used to assess the condition of those already infected with HIV.
P24 Antigen Tests
The p24 antigen test is also a more thorough HIV screening and can identify HIV proteins in the blood from one week to four weeks after an individual is infected.
Why Traditional HIV Testing is Thorough
The enzyme-linked immunosorbent assay (ELISA) test is done by drawing a blood sample from a vein. If an initial test comes back with HIV antibodies, the test is repeated. If the second test is positive, the Western blot test is used to confirm findings of HIV protein in the blood. This last measure is extremely necessary as sometimes non-HIV antibodies may yield a false-positive result. Traditional HIV testing takes around two weeks.
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