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False Negative Test
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False Negative Test



White Male had 1 time unprotected vaginal sex with CSW in US.  On day 25 white male began working out taking supplements to include "Inosine" and other immune enhancement supplements (Echinechia, Goldenseal, Melatonin, etc.).  White male still continues his supplement regimen.

On Day 17 – STD Test Pannel - Negative
On Day 34 – EIA Antibody Test – Negative
On Day 39 – RT PCR DNA (Proviral) – Negative
Week 8 – EIA Antibody Test – Negative
Week 10 – EIA Antibody Test – Negative
Week 13 – EIA Antibody Test – Negative


Question 1:  Does Inosine have any effect on having False Negative Antibody Test?

http://en.wikipedia.org/wiki/Inosine

http://www.lef.org/Vitamins-Supplements/Item00155/Inosine.html


Question 2:  Does Inosine have any effect on having a False Negative RT PCR DNA (Proviral) Test?

Question 3:  Will a DNA PCR Test show positive even if a person has an Undectable Viral Load?

Question 4:  Will an Antibody Test show positive even if a person has an Undectable Viral Load?

Question 5:  White Male currently has penis discoloration on the head of penis.  It constantly itches/burns (Not during urination or ejaculation) more of a constant uncomfortable feeling.   Could this be a Male Yeast Infection or Vitiligio?  Recommendations???
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239123_tn?1267651214
Welcome to the forum.

As we have said innumerable times, in determining whether or not someone is infected with HIV, the modern HIV tests are far more accurate than symptoms, exposure history, other lab tests (e.g., CD4 lymphocyte counts), or any other factor -- as long as testing is done sufficiently long after the last possible exposure.  That interval is around 2 weeks for the PCR test for HIV DNA and 6-8 weeks for the standard antibody tests (even though many or most official guidance says 3 months).

No medicines are known to have any effect on time to positive results, or to make test result falsely negative.  The only exceptions might be very potent immune suppressive therapy or chemotherapy of the sort used for cancer -- and even these may not have that effect; it's a theoretical consideration with few if any known instances in which it actually happened.  There is no reason to suppose that inosine or the sort of nutritional supplements you take could have any effect -- and even if they did, it could affect only the antibody tests, not the PCR result.

You had a low risk exposure to start, since the vast majority of sex workers in the US don't have HIV, and even when a woman is infected, the average female to male transmission risk is around once for ever 2,000 vaginal sex events.  But regardless of how high or low the risk was, the results of your excessive testing prove that you did not catch HIV.

To your specific questions:  1) No.  2) No.  3) The PCR test IS the viral load test.  Therefore, it is always negative if the viral load is below the limit of detection.  But that never happens in people with untreated early HIV infection, so it's irrelevant to your situation.  4) Yes; infected people with undetectable viral loads always have positive antibody test results.

5) These symptoms are irrelevant.  They do not suggest HIV or any other STD.  However, if they continue or you remain concerned about them, get professionally examined.

Bottom line:  For sure you do not have HIV and do not need further testing.

Regards---  HHH, MD
10 Comments
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Avatar_n_tn

There are two types of PCR Test.....  

1)  HIV-1 DNA, Qualitative PCR  -  “Not detected” HIV-1 DNA results suggest that HIV-1 proviral DNA was not found in the specimen,

2) HIV-1 RNA, Quantitative PCR - • Assess prognosis, • Monitor progression of HIV-1 infection and determine when to initiate therapy, • Monitor effect of antiretroviral drug therapy


Also,

Regarding Questions 5:   Should I see a Urologist and/or Dermatologist?

Can you pleas provide any further insight on why the Head of a Penis would start changing color and actually going down the shaft.

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Avatar_n_tn
Also,

Regarding Questions 5:   Should I see a Urologist and/or Dermatologist?

Can you pleas provide any further insight on why the Head of a Penis would start changing color and actually going down the shaft coincidently after being with a CSW.

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239123_tn?1267651214
No STD causes the sort of penile skin changes you describe, and my guess is that it is unrelated to your CSW exposure.  I have to wonder whether your apparent anxiety about the exposure is leading notice minor variations in skin color that may not be abnormal.  But that's as far as I can go; this forum is limited to STDs, not diagnosis of any and all genital skin conditions.  A dermatologist would be preferable to a urologist to sort this out.

The qualitative vs quantitative HIV PCR are the same test.  Qualitative is generally done first, as it is cheaper; if positive, the quantitative version is then done to determine viral load.

If you like, return with a comment to report what is found by a dermatologist or other provider.  But please accept the solid evidence you don't have HIV; I won't have anything more to say about it.
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Avatar_n_tn
Thanks Dr.

Just to clarify Question 3:

HIV-1 DNA, Qualitative PCR the Test that detects proviral DNA will still show Positive, even though a Persons Viral Load is below the detectable limit?

I will advise upon a dermatogoligist opinion or determination.   Also, I wish it was my mind playing tricks on me, because I would have it play the variation in skin back to normal.

I truly enjoy all your comments and other threads.

Thanks a Million.
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Avatar_n_tn
Also,

You are positive that Inosine has NO Antiviral properties that would give false negative tests?
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239123_tn?1267651214
Thanks for your kind compliment.

Re PCR and inosine:  yes and yes.

You are seriously over-thinking a straightforward, unequivocal, and irrefutable situation.  You're just going to have to accept the apparently difficult truth that you don't have HIV.  I would advise you to stop searching the web or other resources about it.

Let's not have any further discussion until you report the dermatology outcome.
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239123_tn?1267651214
There is a mistake in my last reply.  Re PCR, the answer is no:  if the viral load is below the limit of detection, both the qualitative and quantitative test will be negative.  And of course this is good news for you.  It is not possible to have new HIV with HIV below the limit of detection by PCR.  The only way that happens is in people on anti-HIV treatment, with excellent control of their HIV.  In people not taking anti-HIV therapy, undectable never means there is a little bit of virus present, not detected by the test.  It means there is no HIV, period.

This isn't an invitation to further discussion, except for the result of a dermatology evaluation.
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Avatar_n_tn
I thought the HIV Positive people always test Positive on the HIV-1 DNA, Qualitative PCR regardless of Viral Load Count.  This is the test that detects if proviral hiv dna is present.

Otherwise, people taking Anit-HIV therapy would consider themselves HIV Negative if they were below the detectable limit.

Even though "Inosine" is sold over the counter as a nutrutional supplemnt, are you positive that "Inosine" has NO Anit-HIV properties that would effect the test?

Are my test solid enough to positively say that I am do not have HIV with a Negative Antibody Test at 13 weeks and a Negative HIV-1 DNA, Qualitative PCR at 39 days?


Sorry for wanting the excessive re-assurance.
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239123_tn?1267651214
Oh good grief.  You came here for reassurance.  I gave it, in the strongest possible terms.  Accept it or not, I don't care, but this isn't a debate and I'm not going to argue about it.  These are nonsensical "yes but" or "did you really understand" questions.  I did, and I haven't changed my mind.

You have burned your last bridge; this thread is over.  No more comments permitted, including the dermatology outcome.  This forum has neither patience nor time nfor people who will not or cannot accept strong scientific evidence and reasoned reassurance.
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