Pregnant 35/f, monogamous for 6-7 years, same with hub. Since last partner or any risk behavior, have had four 4th gen HIV tests, all negative. Husband has had a few for work, all negative. No risky behavior since. 

In my recent prenatal screening, I shockingly tested positive for p24 antigen. The confirmatory antibody test and qualitative RNA test were both negative. 

-I am having a difficult time accepting that this was a false positive and my clinicians are not answering me. I have read some reports of RNA undetectable (qual) individuals still having HIV, and have read about elite controllers etc. 

-question 1: what are the chances that I am among this RNA undetected, neg antibodies, but HIV positive cohort with 0 risk factors for 6-7 years? 

-2: can I stop testing? 

-3: this has happened multiple times at my women’s clinic this month- 4 false positives amongst other patients. False positives are associated with a number of frightening conditions, but no one wants to test for any because this seems like a lab error. What would you do if this happened to your wife or daughter? 

I apologize for follow-up questions. No one from my obgyn can be reached or has called me to talk about the results and I’m alone in dealing with this. I literally found out from my email at midnight

1.  Possibility that you have undetectable HIV RNA, Undetectable HIV antibodies and still have HIV is zero.  Elite controllers still have positive test for HIV. The HIVRNA PCR test is the gold standard for detection of HIV. You are low risk for infection, you have tested negative, and need to except that you are not infected. I realize that you were concerned, not only for yourself for your unborn child, but I can assure you that you do not have HIV. 

2.  At this point, there is no medical or scientific reasoning reason for continuing to test.

3.  While  there are a long list of conditions associated with falsely positive HIV and other blood tests, most people with false positive tests, do not have other diagnoses which explain them. Unless there is another illness or clues to suggest another diagnosis I would not encourage you to pursue additional testing for other diseases. Further laboratory testing will only lead to more condition and sustain your anxiety.

Please don’t worry.  Accept that you had bad luck and a falsely positive test and work to move forward.  EWH 

I cannot think if any interfering diseases, but read that liver disease may cause interference. 12 years ago I had a grade 4 liver laceration which healed completely though angioembolization. I was an alcoholic around this time, but stopped drinking etc many, many years ago and my LFTs are incredibly good, some of the damage markers even low-normal. My family doctor is unconcerned and maintains I would have elevated LFTs if something was wrong, and suggested I stop testing LFTs or do so less often. I do have fleeting RUQ pain which he attributes to gallbladder sludge. Otherwise, I cannot think of any interfering factors. Unless you state otherwise, I will not investigate any causes as it is bad for my mental state. 

Thank you for helping me out of this. It’s such bad luck, I think this must be a test to help me overcome my health anxiety. 

I hope my comments are helpful

EWH

Hbsag negative, Hbsag quant .3

1) petrified I received a blood transfusion after my car accident 12 years ago, but have been told by family I did not. Does this change your assessment of my HIV risk? I would have had 5+ negative HIV tests since

2) also afraid that I got HBIG after a potential sexual assault in 2011. I didn't see it on the ER paperwork & it's not policy to administer HBIG in this situation, so this is likely OCD. Does this change your assessment of my HIV risk? 

3) Could receipt of HBIG or a blood transfusion cause a false p24 12 years later? (had 5+ negative HIV tests in interim)

4) This was on my prenatal lab as well: 

Hbsag negative, Hbsag quant .3

With normal lab tests, you can be confident that your liver has recovered.  The body and the liver in particular, has remarkable recovery properties. 

Regarding your specific questions:

 1) petrified I received a blood transfusion after my car accident 12 years ago, but have been told by family I did not. Does this change your assessment of my HIV risk? I would have had 5+ negative HIV tests since

Even if you did get a transfusion and if it's not in your medical record you can be confident you did not, the blood supply is safe and it has been decades since somepone got HIV or hepatitis B from a blood transfusion.  I suspect that you know intellectually that this is not a realistic concern.