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HIV Prevention (Expert Forum)
Need Conclusion to this HIV testing
Answered by
University of Washington
Seattle - WA
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IMPORTANT
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If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
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Need Conclusion to this HIV testing
by ashamed, Aug 09, 2006 12:00AM
Thank you dr. HH and all.
I had 30min. vag. sex with hiv + woman. No condom. I experienced ARS-like at 2-4weeks after. I had
15lb wt.loss 2nd week, whitish and denuded areas on tongue, 3-4 days of light night sweats around neck/chest area,
several pimple/like eruptions on back for 3-4days, one 2-in. diameter pink blotch on each leg on shin area,
2day type bowel constipation, constant bowel rumbling sounds, eruption of several new black moles on body,
slight nausea and metalic taste on mouth.
I had Elisas done at 1, 2,3,4,5,6,7,8 months Negative. Although 2nd generation by Quest Diagnostics, (Miurex Kit). some Oraquicks. Odered DNA by PCR tests at 3 and 4 months. Negative.
Viral Load test b-DNA 50
Repeated the v.l with bDNA 75reactive, at 6 months. CD4/CD8 ratio is 0.9, (inverted), CD4 abs is 590. CD4 % is 33.
My whitebloodcount is 4.7 in a normal window of 4-10. (I am low which Means my body is fighting a viral infection, right?)
Wife’s Elisas at 1,3,4 and 6 months Negative.
We have both developed several new normal looking black moles.
last 3 motnhs I have been dizzy with lighthead pressure/pain, and she has purple punch like bruises that come and go
In a week or so. I as you can imagine, I am tired, worn-out, and sad. Are we late seroconverters I wander? Or this Elisas outdated? Or what is it?
mY CD-8 cells are high in the 860s and CD4 low 590s is it possible that my:
" HIV-1-specific cytotoxic T-lymphocyte (CTL) responses
have been detected at a low frequency in many HIV-1
exposed, persistently seronegative (HEPS) subjects. "
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=11375420)
Would this mean I am seronegative because I have high hiv-1 specific CTL, eradicating completely the hiv virus?
I had a bDNA v.l. test done <50copies/ml that came at 266, which I repeated with another <75copies/ml that came Undetectable.
Would this mean that my CTLs are keeping the v.l. suppressed and therefore should generate env, nef, and vif proteing, HIV-1
provirus genes, triggering the B-cells to produce antibodies that the Elisa should pick up?
According to USCF primary infection studies:
"A poor CTL response may be associated with a poor antibody response and slow to no control of virological
replication and CD4 destruction." and "Subjects diagnosed with acute HIV infection while ELISA-negative had a
significantly higher VL than those who had already seroconverted"
So what is going on with me, where are my antibodies?
Please give me a scientific explanation why I am not Positive? Everyone seems to take the Elisa Test as a fulproff
gold standard. Won't the mutating virus require a new Elisa to use relevant titers instead.
Is sensitivity between Elisa gen. 2 and gen. 3 the only difference? Thank you
I had 30min. vag. sex with hiv + woman. No condom. I experienced ARS-like at 2-4weeks after. I had
15lb wt.loss 2nd week, whitish and denuded areas on tongue, 3-4 days of light night sweats around neck/chest area,
several pimple/like eruptions on back for 3-4days, one 2-in. diameter pink blotch on each leg on shin area,
2day type bowel constipation, constant bowel rumbling sounds, eruption of several new black moles on body,
slight nausea and metalic taste on mouth.
I had Elisas done at 1, 2,3,4,5,6,7,8 months Negative. Although 2nd generation by Quest Diagnostics, (Miurex Kit). some Oraquicks. Odered DNA by PCR tests at 3 and 4 months. Negative.
Viral Load test b-DNA 50
Repeated the v.l with bDNA 75
My whitebloodcount is 4.7 in a normal window of 4-10. (I am low which Means my body is fighting a viral infection, right?)
Wife’s Elisas at 1,3,4 and 6 months Negative.
We have both developed several new normal looking black moles.
last 3 motnhs I have been dizzy with lighthead pressure/pain, and she has purple punch like bruises that come and go
In a week or so. I as you can imagine, I am tired, worn-out, and sad. Are we late seroconverters I wander? Or this Elisas outdated? Or what is it?
mY CD-8 cells are high in the 860s and CD4 low 590s is it possible that my:
" HIV-1-specific cytotoxic T-lymphocyte (CTL) responses
have been detected at a low frequency in many HIV-1
exposed, persistently seronegative (HEPS) subjects. "
(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=PubMed&list_uids=11375420)
Would this mean I am seronegative because I have high hiv-1 specific CTL, eradicating completely the hiv virus?
I had a bDNA v.l. test done <50copies/ml that came at 266, which I repeated with another <75copies/ml that came Undetectable.
Would this mean that my CTLs are keeping the v.l. suppressed and therefore should generate env, nef, and vif proteing, HIV-1
provirus genes, triggering the B-cells to produce antibodies that the Elisa should pick up?
According to USCF primary infection studies:
"A poor CTL response may be associated with a poor antibody response and slow to no control of virological
replication and CD4 destruction." and "Subjects diagnosed with acute HIV infection while ELISA-negative had a
significantly higher VL than those who had already seroconverted"
So what is going on with me, where are my antibodies?
Please give me a scientific explanation why I am not Positive? Everyone seems to take the Elisa Test as a fulproff
gold standard. Won't the mutating virus require a new Elisa to use relevant titers instead.
Is sensitivity between Elisa gen. 2 and gen. 3 the only difference? Thank you
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 10, 2006 12:00AM
, Aug 10, 2006 12:00AM
You ask the key question toward the end: "Please give me a scientific explanation why I am not Positive?" Because your blood tests are negative. That evidence outweighs all the other things you say, hands down. You don't have HIV.
It is true that some research suggests that some people can be exposed to HIV, develop an immune reaction to it of the sort you describe, yet are not infected. That's NOT INFECTED.
You have been grossly overtested. I believe you are depressed, probably rather seriously. (I could show your thread to medical students to teach them many of the classical manifestations of that disease.) Whatever else, you do not have HIV. The first thing you should do is stop searching the web or elsewhere for arcane immunologic interpretations of your test results and symptoms. The second thing is to seek mental health counseling. I suggest it out of compassion, not criticism.
Regards-- HHH, MD
It is true that some research suggests that some people can be exposed to HIV, develop an immune reaction to it of the sort you describe, yet are not infected. That's NOT INFECTED.
You have been grossly overtested. I believe you are depressed, probably rather seriously. (I could show your thread to medical students to teach them many of the classical manifestations of that disease.) Whatever else, you do not have HIV. The first thing you should do is stop searching the web or elsewhere for arcane immunologic interpretations of your test results and symptoms. The second thing is to seek mental health counseling. I suggest it out of compassion, not criticism.
Regards-- HHH, MD
Good luck to you
Maybe you caught a wierd strain not picked up by antibody tests? Not possible, especially if the woman you got it from has tested positive using the standard antibody test.
As for generation of tests, no matter. All become positive in over 99 percent of the population after 3 months.
What is the difference between someone with PEP/haart keeping the v.l. undetectable
and causing a late seroconversion, and an untreated individual with a suppressed
v.l/undetectable v.l. that keeps testing seronegative up to 9 months?
Why one under haart will cause late seroconversion?? Would I also be a late seroconverter?
If I did not have this current dizzy slight pressure/headache with slight pain in
my eyes and what appears like clinical candidiasis on tongue I would take the negative status
without questions. Unfortunately I am a an analytical type person that tends to rationalize
everything. I have always been king of this way.
There are cases where the CD4 gets depleted to the point of aids yet the person is seronegative and
for this they've come with a name of cd4 lymphod.. deficient of some sort, this proves that the hiv tests are not
always conclusive.
The stress of thinking that one may have infected ones children and wife is terribly overwhelming.
Reaching out to educated individuals who have experience with hiv tests/results/window/probabilities/statistics
and its viral behaviour is the best therapy I can get. Therefore I seek your counsel Dr. HHH and comrades
willing to stretch out their hand to dig me out of this quicksand. This experience has made me a much better
person morally and spiritually, for I have come closer to Him, Jesus Christ.
Any more information is certainly appreciated. How is Johnnyv? Thank you all.
OK, question 1.
Individuals taking HAART medication due to HIV infection stop HIV from replicating, therefore eventually reaching undectable status,...sometimes. Mutations can delay or halt this process.
Individuals taking PEP for a High risk exposure would theoretically take longer to produce antibodies. If the virus is being supressed or eradicated very early on the body would have no need for a large production of HLA antibodies.
An individual who is infected and keeps the V.L. undectable without treatment (very rare) has built up a strong immune response to the virus. And you can be sure HIV antibodies ARE part of that response. These people DO NOT test antibody Negative. They are indeed infected.
This thread is over; I will delete any further responses.
HHH, MD
Been there man, I know what you are going through. Think logically. Let's say you are that individual who 1. got infected through a one time exposure with an HIV positive person through penile-vaginal sex (.1% chance). 2. continues to test negative after a 6 month test (.001% chance) 3. continues to test negative with viral load and qualitative DNA PCR tests (.00001%). NOW ... how do you explain your wife having "HIV symptoms" and not testing positive also. Dude...NOT POSSIBLE. NO WAY.
The sentence quoted above says it all. Until you forgive yourself and stop the punishing and hating yourself this will hover over you forever. Being a man of Jesus, you should no GOD has no patience for the forgiven not forgiving themselves.
Once you do, you'll be able to live again.
The therapy of looking for conspiracy explanations of HIV boogeymen viremia particles is NOT a good idea.
I'll keep you in my prayers.