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Panic
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Panic

Dear Doctor,

Last week I went to the hospital to take an HIV test, which I was hoping would be my last as it has been about 6 months since my last encounter. I should have settled with my negative rapid test at 3 months but my symptoms(coated white tongue, persistent neck aches, chronic cough) never went away and I wanted some final assurance. I posted on your clinic forum some time ago, I'm the fellow with the deep kissing risk. The test was an HIV ag/ab combo(Chemiluminescence) and it came back positive with an index of 2.69. My doctor ran a Western Blot and it came back completely negative, and negative for p24. She thinks it may be a false positive and the lab made a note saying they also think it may be a false positive, but have asked me to return in a week to retest since this is all questionable. I am, obviously, terrified. Prior to this, I had a few negative rapid tests(Determine HIV 1/2) and a single negative Elisa lab test at 8 weeks. The only other potential exposure I can think of would be a visit to an ENT who did a nasal endoscopy on my about 3 months ago, his office was a bit dirty and I don't know how hygienic those camera scopes are. Do you have any idea what is happening? I don't know how to interpret this situation.
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1024580_tn?1331577721
Hello,
Deep throat kissing is not risky from the point of view of HIV.  I very much doubt that you are HIV positive and I would agree with your doctor about the possibility of having had a false positive.  These happen sometimes, especially with the Duo or Combo tests.  In any case your symptoms and their timing do not correlate with HIV sero-conversion symptoms at all whatsoever.  Also I do nto believe that you could get infected through a nasal endoscopy.  As mentioned many times in this forum, the virus does not survive very long outside the body on an inert object.
Best wishes,
Dr José
4 Comments
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Avatar_m_tn
Thank you Doctor Jose. As you can imagine, I have a lot of questions right now, and I can't stop speculating what might happen during my follow test next week. I am very concerned about that number, 2.69, and what it really means. I have read in a few places that there are cases of a weak positive or a strong positive, but I am not sure what the scale is and how this number measures on that. I became even more concerned when I found a report online written by a doctor in NY who questioned the sensitivity of the western blot test and insisted that the chemiluminescence technique is more than accurate enough. Sadly in his report he specifies the exact same two machines which have processed my results, as I have seen on the document my doctor gave me. When I retest next week, if it produces the same results, what options do I have? Should I insist next week that they conduct a PCR/NAT test as well? Have you ever encountered a case like this before?
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Avatar_m_tn
Dear Doctor, the information I am referring to is here:
http://www.hivtestingconference.org/PDF/HIV_Conference_Program.pdf
The section is "poster #16", where they conclude the western blot is basically outdated and not good enough at detecting HIV. If this document didn't exist I might be able to rest a bit easier, but it basically covers the same procedure I have just had...
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Avatar_m_tn
Doctor Jose,

I know you are busy, but I would like to ask one more thing. About the Western Blot test. I have found many scientific articles about the accuracy of the screening tests(Elisa, various rapid tests, etc.), but have found little to no information about the Western Blot test. I have read that it is no longer used in the U.K., but that is as much as I know. So if the Elisa is the more sensitive test and thus will get a false positive on rare occasion(mine HOPEFULLY), the Western Blot is more specific and may be negative on occasion. So if it is very rare for an Elisa to be a false positive, is it also very rare for a Western Blot to be false negative? If my test results come back with the same sequence again, two positive CMIA tests and a negative Western Blot, what should I do? My doctor is trying to reassure me, she insists she had another patient the same day I came in with the same situation. I have read on your other forum that sometimes you mention the Western Blot as outdated as well. What are your thoughts this(and the above if you have time)?
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