Antibody test came back negative and NAAT positive

Hello,
           I am very concerned because I was recently tested  for STD and HIV on April 13th or this year, where I recieved the rapid test and the NAAT test. My rapid test came back negative for  HIV. I was to receive my NAAT test results within 14 days. I was called in unfortunately on April 22 for Chlamydia in my rectum and had to be treated. Upon treatment I was told that my NAAT test came back positive for the HIV Virus.

My question for you is is there a likelihood of my having a false positive HIV NAAT?

I was told that since my Antibody (rapid test) was negative this just means in the past 3 months no antibodies have shown up but that the positve NAAT  result means it was recent exposure.

How recent?

I have gone over any sexual experiences in the past 3 to 4 weeks and honestly dont see where I did anything risky. I was shocked to even find that i had chlamydia in the rectum because I havent had anal sex since the week of March 1st 2011 and I am usually generally safe. I am 36 and have gotten tested regularly since the age of 27.

Could any other medical problems (ie. Herpes) cause NAAT to read wrong? I heard they are extra sensitive tests.

Please help me, Im wondering what I should do. I am trying to take both possibilites in stride and carry on with my life but I am usually well intuned with my body...and more than denial this just doesnt feel like the truth to me. So I am asking is there any hope? What are the odds?

Thank you,
Just hoping

[Dr Sean Cummings]

Hello

Sorry to hear your news - and sorry that we missed you. occasionally if there are lots of questions and repeat questions some may get lost.

it is possible that you have a false positive result using a NAAT so yes, you should have the tests repeated.

Rapid HIV testing - which test, what generation? It is possible to have a false NEGATIVE antibody testing if you were tested before you generated antibodies to HIV (assuming of course that the NAAT was correct). More than 99% of people will form antibodies by 6 weeks after infective exposure - which will be detected by a modern third generation HIV test at between 4 and 6 weeks. If your rapid test was a second generation then the performance of the test will be worse.

Rectal chlamydial infection will result from any anal sexual activity - including penetration and rimming. It does increase the chances of HIV contamination I'm afraid.

So my advice is to source a reliable third generation antibody test or preferably a 4th generation combined antibody/antigen test and see what transpires. Like you, I'll hope that all is negative.

Best regards, Sean

[Justhoping]

I noticed that my post was skipped over and one after mine was answered. Is there any particular reason for this? I paid, and I believe I did everything correctly.

Any advice?

[Justhoping]

Dr. Sean,
                Thank you so much for taking the time to offer your advice to me and all the other worried, confused, or lost individuals (with regard to this subject of HIV) on this site. Your response was informative and gives me some hope that I might actually still be negative. I am moved to tears just to hear from someone of your knowledge who seem to care. Im sure you are aware of the amount of anxiety one goes through when told that they may have HIV. I appreciate your well wishes. No matter the outcome, this has been a life changing experience for me, and for some one like myself with no one to really express my feelings to...you are a true angel. Thank you, Thank you, Thank you.

Sincerely,
Justhoping

[Dr Sean Cummings]

Hello again,

Thanks for your message - very kind and i've never been called an angel!

I do hope that we have a false positive NAAT. But worst case scenario, we'll still be all ok and we'll do our best to support you our end.

best regards, Sean

[Justhoping]

Dr. Sean,
               I have a bit of an update for you. A counselor from the center where I received my rapid and NAAT test called me to check on me, after a few answered questions I decided I wanted to get a confirmatory antibody test (which he said he believed was a 3rd or 4th generation test) He told me that it had been about 2 weeks since i received my Positive NAAT and that the antibodies would surely show up. I took the test and once again it came out NEGATIVE for HIV antibodies. So thats two NEGATIVE antibody tests and one positive NAAT. I am so confused.

He tells me that regardless, I am positive because the NAAT picks up Viral loads and I have it in my body.He also stated that there are NO false positives with the NAAT HIV RNA. I read later in an 2011 Oxford Journal Clinical Infectious Disease article that there are in fact cases of false positives and that if there are no antibodies and there is a NAAT viral load less than 5,000 copies per ML that it may be a possibility of false positive because in the acute HIV stage usually the viral load is between 5,000 to 100,000 copies because there are no antibodies to break them down.

My NAAT Hiv RNA was 3,860 copies per ML and I had no antibodies twice after what would probably have been about 4 to 6 weeks since possible infection.

Needless to say this has all been so confusing and an emotional rollercoaster because I still dont have a definite answer. Even two counselors seemed baffled. As I told you before I still feel that I am negative and am claiming this to be true.

Im curious. What do you make of all of this?

Also, Im not too sure what exactly false positive means because if a NAAT viral load shows up doesnt it mean there is the HIV virus in your system? Or does it mean something else is being picked up. I feel like the center was pushing for me to be positive rather than the possiblity/hope of a false positve.

Just Hoping