Negative tests but BAD symptoms

[whenamiclear]

Dear Doctor, I won't bore you with the details of my symptoms I have been dealing with as you say they are not reliable, but they have been MANY!!  My exposures were high risk about 9 yrs ago as well as my LAST one 3 yrs ago. Around a little over 3 yrs ago I started having all sorts of "come and go" illnesses. I first tested for HIV and other std about 5 yrs ago-all neg. Then also tested 2 yrs ago due to illnesses. Recently(last 4 wks),I have again tested neg by all tests. These recent have been very comprehensive including hiv duo, HIV-1 DNA, hiv-1 realtime by Abbott rna(<20),HIV 1/2 Labcorp antibody, HIV 1/2 clearview complete antibody. They also included two weeks ago a fta-abs, rpr, and a TP antibodies.  I just cannot figure why I keep having all these strange things happening to me. Either can my doctor.  
1)I know you say things aren't typical of acute infection, but could I be in a more advanced stage of hiv?
2)could I be below the detection level of these tests?
3)since my exposures were with ladies from overseas, could I have a group/strain/CRF/subtype/hiv2, that is evading detection?(I see most tests only look for group M)
4)is it possible that I could have neg antibody/RNA/DNA due to some process? (Immune, subtype/etc)
5)could HIV just be smoldering and missing it?
6)what more can I due to rule out CONCLUSIVELY and without harm to others, that this is HIV of ANY kind?
7)are the syphilis tests absolute?
8)do my symptoms matter at all no matter how classic for hiv/syphilis?

--thank you very much. There is no reason found why I keep getting ill.

[Edward W Hook, MD]

Einstein said that one defintion of insanity is to repeatedly ask the same question and expect a different answer.  The complaints you describe are non-specifc and are not highly suggestivefor HIV infection.  Your tests show that you are not infected.  You can re-read my answers. Tehyw ill net change and I willhave nothing more to say.  EWH

[whenamiclear]

Excuse me for returning but I had to finalize this. Since we've talked I've had VERY strange neurological symptoms such as facial twitching, other muscle twitch, and numbness on areas of left side of my body from time to time. Also having swollen armpit glands, BAD joint pain and seems though I am losing muscle but just gaining weight. I recently had another hiv antibody test as well as hiv-2 DNA, hiv-1 RNA, fta-abs and rpr. This as you know is over three years from my last exposure, but there were others over the years preceding.
1)can I without a doubt believe these tests?
2)I've read you can be in advanced stage of hiv where antibody is negative and also pcr. Is that correct?
3)could syphilis be more neurosyphilis and rpr, tppa, and fta-abs fail to find?
4)any reservations I should have for my wife/family's sale?
Something is very wrong and it's not anxiety but real processes that need to be found out.
Thank you

[Edward W Hook, MD]

Each of your quesstions essentially repeats your earlier questions.  Repeating the questions will not change the answer.  YOU DO NOT HAVE HIV FROM THE EXPOSURE YOU DESCRIBE!!!!

There is no need for further concern nor any need for further testing.  

I'll have nothing more to say.  EWH

[whenamiclear]

Good morning Dr. Hook,
Thank you very much for your responses. I did want to clarify that yes, my LAST exposure was in 2009. NEVER TO HAPPEN AGAIN.   Since 2009(and after 3 month window period) I have taken multiple different antibody(x18), hiv-1 RNA x 4, hiv-1 bdna x2,  hiv-1 DNA x 2, HIV-2 DNA x1.
1)is there no way that an infection could evade detection even if say my infection was on my first risky exposure 9 years ago, and I could have lost antibody response and in more of an advanced state but showing no viral load? (Strain/subtype)?
2)if I was infected, would one of these tests have to be positive?
3)is it possible to show ALL negative on ALL these tests and still be infected with some sort of HIV?
***4)if in fact it was a rare type/subtype how could it be diagnosed as the tests are not designed to detect odd groups.
5)have I done enough or is there anything else to do to make sure I'm not one of those weird cases that HIV gets missed and therefore I am putting other loved ones in harms way?
6)can a fta-abs, rpr, and tppa be negative this far out and have syphilis or not possible?

I am just trying by best to be sure I'm the safest possible. I also want to rid myself of whatever is causing this!

Thank you very much for your time. I will not respond with what ifs, etc. I just wanted to clarify my questions as I'm nervous about my health.
Take care and have a good day.

[Edward W Hook, MD]

Welcome to the Forum.  I'll accept your statement that your last exposure to put you at risk for STDs was three years ago and that you have since been tested on more than one occasion, more recently about 4 weeks ago.  Based on this, I must tell you that you need to believe your tests.  Modern medical tests for STDs and particularly for HIV are excellent and if you have negative tests, you should believe them.  The reason for tests is to narrow down possible causes of symptoms as symptoms can be caused by so very many different processes.  My sincere advice is for you to believe your tests and then work with your doctors to determine what, other than STDs including HIV, might be causing them.  I cannot tell you how many times I have seen patients who have wasted much time, emotional energy, and money repeating tests which were conclusively negative.  For some, complex medical problems, the best approach is to work with a well-trained health care provider who will thoroughly evaluate you and your symptoms.  In such instances it may also be important to watch those symptoms over time.  

With respect to your specific questions:

1)I know you say things aren't typical of acute infection, but could I be in a more advanced stage of hiv?
No, not with the negative tests you have.

2)could I be below the detection level of these tests?
No.

3)since my exposures were with ladies from overseas, could I have a group/strain/CRF/subtype/hiv2, that is evading detection?(I see most tests only look for group M)
No, given the tests you describe, your tests should be believed.

4)is it possible that I could have neg antibody/RNA/DNA due to some process? (Immune, subtype/etc)
No.  You've been tested several different ways.  They are all negative.

5)could HIV just be smoldering and missing it?
NO!!!!

6)what more can I due to rule out CONCLUSIVELY and without harm to others, that this is HIV of ANY kind?
Nothing.  further testing is a waste of time and effort.

7)are the syphilis tests absolute?
At this time, yes.

8)do my symptoms matter at all no matter how classic for hiv/syphilis?
Correct.  Even "classic symptoms" can be mimicked by many other processes.

Your questions ask the same question again and again.  Please believe your tests and look for other, non-STD causes of your symptoms.  EWH