Hiv antibodies in person with advanced stage AIDS???

[Nevadan]

Doctor, I'm not sure if you've been asked this before, but is it possible that in a person with Aids or a person with an advanced stage of Aids would stop making hiv antibodies? Do people with hiv show hiv antibodies for the rest of there life, even in the terminal stage of aids? And is it possible that someone could catch the hiv virus and in 3 years develop aids in an advanced stage if that person where unaware that they where hiv possitive and where not receiving treatment for hiv? Or does anyone with hiv always test positive for hiv antibodies even if they had developed an advanced stage of aids? I've seen on the internet that sometimes people with aids test negative for hiv antibodies.

[H. Hunter Handsfield, M.D.]

I don't care what you have read and what sources you have searched.  Those symptoms don't particularly suggest HIV, because uncountable other conditions cause exactly the same things.  (Heavy drinking is an excellent example.)  The blood test results always outweigh symptoms in judging whether or not someone has HIV. Always, as in no exceptions, ever, no way.  Got it?

To your follow-up questions:  

1) My opinion?  Someone who drinks too much and thinks that such symptoms are due to HIV, in the presence of a negative HIV test, reminds me of the guy with a headache after he was clubbed with a baseball bat, wondering whether his headache might be due to a brain tumor.

2) Heavy alcohol use is bad business.  But your question about HIV is irrelevant, because you don't have HIV.

3) No.

4) There is no need for additional testing.

Please see a primary care provider who you trust.  If you don't have one, find one.  An internal medicine doc would be an excellent choice; or a family medicine doc. Then follow his or her advice.  In the meantime, put HIV aside.  It is not your problem.

I won't have any further comments.

[Nevadan]

Doctor the reason i ask these questions is that i am a young hetorosexual male and for the most healthy. I had unprotected vaginal sex with a female 3 years ago and since then have not had anyt other sexual encounters and i dont use drugs. I have been suffering from symptoms that could be related to hiv. Since that encounter a few weeks after that i remember i became very sick from flu like symptoms. Since then i have had bruises appear on my arms with hurting them to this day. Also since that encounter i have had genital sores that come and go and sores in my lips that look like herpes to this day. I have also suffered from a dry cough that lasts from 1 to 2 months on about 4 ocassions since then. In may 2007 i noticed my tongue turned white, i clean it with a tongue cleaner but it remains white. In may 2007 i also developed itchy skin all over my body. Recently my eye lids started to look purple. I also sometimes get small red spots that have a red circle around them that appear on my skin. Right now i have a really bad cough, its a wet cough and ive had it for a week. I tested negative for hiv 1/2 antibodies in april,may,june and september of 2007. Im scared that i might have waited to long to get tested. The first test was 2 years and 4 months after exposure (negative). Also for the last 2 years i have been drinking alcohol heavily. for the last 2 months i have been getting sick on and off frequently and i used to be very healthy.

Doctor what is your opinion on my situation?
Doctor my questions are does alcohol make an hiv + persons body make more virus?
Do you think there is a possibility i could have aids in an advanced stage?
What other test are done to check for hiv other then the hiv antibody tests?
  

[H. Hunter Handsfield, M.D.]

It is true that "sometimes people with aids test negative for hiv antibodies".  But it is exceedingly rare, probably less than 1 in 1,000 infected persons.  And as your question suggests, it is seen primarily in people with advanced AIDS, i.e. sick enough to be near death.  Had those people been tested earlier, most would have had postive blood tests earlier in their illnesses.

It is uncommon for overt AIDS to develop as early as 3 years after infection.  No matter when that happens, it is almost impossible for someone who looks and feels well to have such advance HIV disease.  Anybody with such advanced infection will have had many health problems, which would have led to the diagnosis of AIDS.  In other words, if you feel basically healthy and your HIV test is negative, you can be 100% certain you are not infected.

I hope this helps.  Best wishes--  HHH, MD