6 Weeks Neg. Elevated Monoclan Protein

Hello,

Please help me.
I am 27. 1 year ago, I had protected had sex with african american CSW in Chicago.
Condom broke for an for about 1 minute it was unprotected. I pulled out and stopped.
CSW asked if I had condoms and got upset when condom broke, wouldn't have sex without them, she looked like she might have been a drug user, but pure assumption.
About 5 weeks later I came down with sore throat, lymph nodes and fever.

EXACTLYT 6 weeks after I went to my physician and got tested for HIV with blood test. The result was negative...but I went for follow up blood work a year later and my Monoclan (SP) protein was elevated one point.
Doctor said don't worry you have no HIV, but I read that protein could mean HIV and I am scared sick to get retested since I have extremely high anxiety and panic attacks.

My whole blood count, lycocites, white blood cells, haven't changed at all in year since possible to exposure.
Doctor said I have no HIV.

I had unprotected sex with my girlfriend lately and right after we did it for the first few times she came down with sore throat and lymph nodes in 3 weeks.

PLEASE HELP ME.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

Your doctor is correct:  your negative HIV test shows you didn't have it at the time you were tested.  You were tested slightly early, but a negative result is almost always reliable at 6 weeks (see the thread linked below).

http://www.medhelp.org/posts/show/1704700.

I'm not sure what you mean by "monoclan antibody".  Maybe "monoclonal"?  If you had a test called protein electrophoresis, it is possible a monoclonal antibody was found in your blood.  If so, you need to have another discussion with your doctor to fully understand what is going on and what it means.  However, HIV does not cause this; and it would not interfere in any way with your HIV test.  Your other blood test results were normal don't mean anything one way or the other in regard to HIV.

On top of all that, it sounds like you had a low risk sexual exposure. Most people (including CSWs) don't lie about HIV status when asked directly; and the fact that your partner was upset over the broken condom also suggests she knows she isn't infected and intends to stay that way.  After all, CSWs are at higher risk for HIV from their male clients than the clients are from them.

If you remain concerned, I suggest you return to your doctor and follow his or her advice.  Since you were tested slightly early, perhaps s/he will recommend another HIV test.  (If so, and if you haven't had any more risky exposures since last year, you can expect it to remain negative.)  In addition, s/he may want to recheck your "monoclan" (monoclonal?) antibody.

Best wishes--  HHH, MD

[plzhelpchi85]

to add....im uncircumcised. i asked the girl if she was sick many times but she said no, are you. but she looked like a girl that wouldn't be testing.
my doctor said according to the way my immunity looks I am ok, and my test was ok and that if there was desease they would see it.

[H. Hunter Handsfield, M.D.]

This information doesn't change my opinion or advice.

[plzhelpchi85]

He said that I had monoclonal protein elevated and that usually that is the cause of bone marrow cancer. They did additional testing and I am clean on bone marrow, but he was in a hurry and I am really scared.

I read more and many times it said that elevated Monoclonal protein could mean HIV infection and that young people with that should be screened.

How reliable is my test? Since I was tested right when I had "symptoms" would it mean that it should be detectable if I was sick.

Please doctor help me with another answer, I tried to page my doctor but he is gone until Monday and I am extremely upset.

[H. Hunter Handsfield, M.D.]

Thanks for the additional information.

This is not something to be "extremely upset" about.  Monoclonal proteins are sometimes associated with multiple myeloma, a kind of bone marrow cancer.  They are the result of multiple myeloma, not the cause.  However, some cases are entirely benign, causing no harm.  In any case, you need to discuss this with your doctor; my guess is that s/he will want to re-examine and perhaps re-test you from time to time.  (Multiple myeloma is most common in older people.  Few cases occur in people under 60 years old.)

It is true that otherwise unexplained monoclonal proteins are slightly more common in people with HIV, and that young people with it should be screened for HIV.  But only slightly more common; the majority of people with monocloncal antibody do not have HIV.  And anyway, you HAVE been screened for HIV, and your test was negative.  It shows HIV is not the cause in your case.

Continue with your plans to see your doctor for a follow-up visit.  But don't panic. There's no hurry; you can wait until the office is open next week.  In the meantime, I would also advise you to stop searching the web for more information.  Like many anxious persons, it seems you are being drawn to information that inflames your fears and you're missing the reassuring bits.

[plzhelpchi85]

Doctor thank you so much for your response. I really don't like how my doctor handled it, and with my really risky exposure he just brushed it off.

I will ask one more simple questions.
Would you recommend follow up HIV test?

That is all.

[H. Hunter Handsfield, M.D.]

As I said above, I disagree you had a "really risky exposure".  I also would have reassured you about it, as I did above -- but it's possible to do that without seeming like a brush-off.

From a strictly medical standpoint, a repeat HIV test isn't necessary.  But if you read the other thread whose link I provided, you should understand that the official advice is for testing at 3 months.  If it would make you feel more confident to have another HIV test, you should do it.

[plzhelpchi85]

If 99% of tests are positive by 6 weeks and I don't even know that the person was sick and 1 in 500 exposure. I will take those odds and move on.

Thank you!

[plzhelpchi85]

Doctor I please have one more question for you, it is very important to me and it is relevant to my question because of this detail.

When I got tested, at 43 days, it was two days after I came down with sore throat, body ache. When I seen my doctor he said I had inflamed throat and had an upper respiratory infection.

It was the same day that I got tested by a blood test for HIV by my physician.

My question here is....since my test was done then, what are the chances it missed the infection? But then I always read that ARS symptoms don't come so late, so I then the negative test was accurate.

Please explain.

[H. Hunter Handsfield, M.D.]

There are no medical conditions that alter the reliability of HIV testing.  Theoretically advanced illnesses like terminal cancer or other life threatening conditions might do it, but I stress "theoretical".  To my knowledge there are no actual reported cases.

So your negative test result 6 weeks after exposure is entirely reliable, as discussed in the thread whose link I provided in my initial reply.

That should end this thread.  Take care.

[plzhelpchi85]

Doctor, I am afraid you didn't understand my question.

My question was, since I had an upper respiratory infection at 41 days, tested at 43 with it present (let's say ARS symptom right?) and it came on two days to my prior HIV antibody test, could that be a bad sign that I got tested only 2 days after? But I read that ARS symptoms aka sore throat and body aches come no later than 4 weeks.

That is all I wanted to know.

[H. Hunter Handsfield, M.D.]

No, that isn't feasible.

You came here for reassurance.  I have tried my best to do that.  Accept it or not, I don't care, but let's not argue about it.  Read all of my replies, believe the science-based information I have given you, and move on.  I won't have any further comments or advice.