Fear of HIV

[harinn123456]

I live in New Delhi. I had a low risk exposure (protected sex with SW for about 5 minute using condom and ejaculated inside) on 18 feb could not check the expiry date. But the condom did not break. I was concerned of HIV and went to a doctor who was new to me  He then took a western blot test at 24 days post exposure which came negative. As I heard the test is used as a confirmatory test only, I raised the concern to the doctor. He then took a PCR RNA test along with repeated western blot test at 44 days post exposure.PCR RNA gave positive with 225 copies/ml. and western blot came negative. He took my blood sample on 3rd of April and sent the sample from New Delhi to Mumbai . The Lab in mumbai received the sample on 5th of April 9.00 Am and the result was concluded with 225 copies/ml at 7.00 PM at the same day. Then the doctor told me that this is a weak HIV positive and You have to start ART. He then gave me ART(Treever - mixture of three ART). It was at 46th day post exposure. I took one tab. Then at very next morning I thought that since the western blot antibody test at 44 days came negative I should take a combo test before conclusion and I on my own did the HIV1/2 & P24 Combo test by CMIA from a Reputed Lab of Delhi which came back negative with index value of 0.1. only thing is I took this test after taking one day ART. I took the ART for consecutive three days because of fear of progression of my deasses. After taking three days of ART I gave a Gap of one day and then I took a PCR RNA test from the reputed Lab of New Delhi. The result came negative. Now I got confused and stop the ART.My questions are as follows: 1) Can the first PCR RNA test be false positive looking at so less load (225copies/ml) at 44 days post exposure. 2) Can the 2nd PCR test is false negative as I took three days of ART. 3) what is my probable status. 4) should I continue with the ART. I am going to take another Combo test on sunday which will be 61 days post exposure.
regards

[Edward W Hook, MD]

Final answer.  You can be confident that your results will not change.  you may post other results here but there will be no further replies.  eWH

[harinn123456]

Thanks doctor

Now I am waiting for 90 days post exposure to come and the combo test result of 90 days. I am still scared.

Regards

[Edward W Hook, MD]

Thank you for the follow-up.  This confirms what I told you and proves that you were not infected by HIV.  EWH

[harinn123456]

Hi Doctor
Today I deed HIV AB/AG combo test and it is my 74 days test. It came non-reactive with index value of 0.07.

Started feeling confident.

Regards

[Edward W Hook, MD]

I am confident your further responses will show that you were not infected.  My further responses will be limited.  Take care EWH

[harinn123456]

Hi. Doctor.

Today I received my 61 days HIV 1/2 antibody and P 24 combo test result and it came non-reactive with index value of 0.15. this test is done after 8 days of taking last pill of ART. I took total 5 pill of ART in 7 days (irregularly).

As Advised by You I will again repeat the same test after one month at 90 days mark result of which may considered to be conclusive.

Respected and dearest doctor. I can not explain you how emotional phase I am going through. May be I have been completely misguided by Indian Doctor. So presently I am not able to trust Indian doctor for HIV specialist. I have already spent $1500 (INR-90000) only because of misguidance by Indian doctors.

I am Sorry.

Regards

[Edward W Hook, MD]

I would believe your test results.  I would not restart ART at this time. this will only confuse things.  

As I said before, my advice is that you seek the advice of a physician experienced in management of persons with and at rsik for HIV.  You should not try to manage your situation over the internet.  EWH

[harinn123456]

Respected Doctor,

I had taken a Combo test on 47 days post exposure which came negative and it was taken just after taking one tab of ART at 46th day night. can it be false negative for taking one tab of ART. please also advise me about some of the symptom I wrote in previous question.

Regards

[harinn123456]

Thanx doctor,

I have allready stopped the ART when my 2nd PCR test came negative.

Presently for two days I have got slightly sore throught. this is may be due to sudden cold as there was rain two days ago in the summer in India, which is unusual at this season.

I have also got Rash type of things in Skin on back of right hand not severe. can this be the side effect of taking strong ART or due to I am in severe enxiety these days. I have no fever during this two months.

Please help to guide me doctor.

regards

[Edward W Hook, MD]

Welcome to our Forum.  Your experience is precisely the reason that we do not recommend the PCR test for HIV.  While the PCR test may become positive before the ELISA or Western Blot tests , it also has more false positive results.  When the result is false positive, the numbers of virus detected is typically low, in the hundreds like your result.  When people have HIV their virus concentrations are in the thousands.  It is most likely that your test was false positive.  

Certainly the exposure you describe had no meaningful risk for HIV.  Condom protected sex is safe sex and as long as the condom is worn throughout sex and does not break, there is no risk for HIV.  Your condom did not break- when condoms break, they break wide open.  

As for your specific questions:
1) Can the first PCR RNA test be false positive looking at so less load (225copies/ml) at 44 days post exposure.

Yes, this result is almost certainly a false positive result.

2) Can the 2nd PCR test is false negative as I took three days of ART.

It would be unusual for a PCR test to become negative in a person with HIV after only three days of ART.

3) what is my probable status.
You are probably not infected and had a falsely positive HIV PCR.

4) should I continue with the ART. I am going to take another Combo test on sunday which will be 61 days post exposure.
When the combo test is negative (I am confident it will be) I would stop the ART.  I would then repeat the combo NOT a Western Blot) about a month to verify this result off therapy.

I hope these comments are helpful.  I should also add that the doctor you went to does not sound knowledgeable about HIV.  I would advise finding a doctor more familiar with HIV.  EWH