Are my test results conclusively negative

[obsessed80]

Dear Doctor,
Please help me with determining my test results.
I had a low risk exposure and became very concerned 2 weeks post exposure after developing a severe headache for 2 days, followed by a sore throat and swollen lymph nodes in my neck and under arm. I did a qualitative dna pcr with icma antibody at 2 weeks(lab corp) due to great anxiety. To my total shock my antibody came back repeatedly reactive at 2.43 with negative western blot and neg. dna pcr. At 4 and 6  weeks post exposure, I did dna pcr which were neg.but no antibody test. I was too anxious and have autobodies to graves ( being treated with ptu) and also to hashimotos, so I thought this caused my reactivity. But the more I read, the less I believed this to be true. At 8 weeks i did another dna pcr and was negative. Still very concerned, I did a 9 week test at quest using the 1/2 eia ab screen which came back non-reactive, as well as a rna pcr quantitative with neg. result ( <48 copies). My fear remains, as I have had another bout of symptoms, started with a headache, one swollen neck gland and muscle aches and joint pain approximately 10 weeks post exposure. I have psoriasis as well, for 7 years now and it is improving except on my scalp. I have read that cytokine 1 and 2 can play a role in this.  Could I be seroconverting at this point with all the negative dna pcrs? What should I do now? Is the eia 1/2 as accurate as the icma? Do you think I am negative or do I need further testing?
Thank-you very much

















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[Edward W Hook, MD]

You need to believe your test results.  Your experience is a great example of problems which can arise from over testing.  You had a false positive antibody test at two weeks.  We know it was false positive at that time as the Western blot was negative.  Since then your repeated negative antibody and pcr tests prove without a doubt that you did not get HIV from your low risk exposure.  It is time for you to put this aside and move on with your life.

As for your symptoms, they are irrelevant.  When people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.

Hope these comments help. Stop worrying about which test is better, they are all quite good.  You do not have HIV.  EWH

[obsessed80]

Thank-you for your prompt reply. Just to clarify, no need to get 12 week antibody? I am hiv Negative and can move on?. There is so much mis-information out there, even an infectious disease nurse told me to immediately get re-tested with antibody aftter initial reactive antibody test because it may not have had time to show up on the western blot. Hiv is so scarey because you can give it to other people. You are truly a Godsend to me, and your work here is helping so many of us. I am so grateful.

P.S. I will not bother you again, please just answer this last post












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[obsessed80]

The reason I am so concerned is that  I may have gotten blood from an hiv infected person through major lip cut post topical anticancer treatment. And having the icma , which tests for p24 antigen, the western blot may not have detected the antibody as it was not formed at this time. Also, can stress over all this weaken your immune system to the point at which you have delayed antibodies?
Thank-you

[Edward W Hook, MD]

You do not need a 12 week test, The combination of tests that you had had unquivocably rules out the possibility of HIV.  The HIV PCR is more accurate than any p24 antigen test and I know of no expert in the field who has seen anyone take more than 8 weeks to seroconvert unless they have taken antiretroviral therapy as a failed effort at post-exposure prophylaxis.  It is (past) time for you to move on.

This will end this reply and thread.  No further questins will be accepted until May 2010. EWH

[obsessed80]

Thank-you sooooooooooooooooooooooooooooo MUCH!!!!!!
Happy Holidays to you and yours