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Do I Need Further Testing
Hi Folks,
After a reasonable risky exposure after 24 days, I decided to go in for Ultra Sensitive PCR Test(Roche COBAS Amplicor v1.5) and also antibody test. Both results were NEGATIVE. Do I still need to go and test again in the future???
- Cheers
Andrew
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what does reasonable risky exposure mean?
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Guys here is my story in full. Hopefully my experience will be eye opener to many considering PCR testing.

Episode 1.
I had a risky encounter about 6 weeks ago. I visited a sex worker in a message parlour in Tijuana.
There was no penetration and I was just rubbing my penis against her back when the condom broke. When I looked at my penis after the condom broke it was visibly dry. I quickly took a shower after that.

Episode 2.
24 days back again in a strip club in TJ and had lap dances and touching many girls all over(some finguring with some girls).

Episode 3.
About 4 weeks back, I started  feeling terribly ill. I had low grade fever with on and off pharingitis and severe lower limb muscular(and nueral) pains. I am still suffering from extreme fatigue. The more I read about peripheral neuropathy associated with HIV I was pretty much sure I had it in my body.
So I asked the doctor in San Diego to perform a PCR test.
The test came back positive saying viral load was @ 400 per ml.
This totally freaked me out. But the doctor said since the viral load was in low number it could most likely be a false positive.
I had to change jobs and move to San Jose. The nightmare started from the day I got the PCR results. My entire life skidded to off track. Suddenly my family, friends, relatives everyone came into my mind over the days and I thought I definitely screwed up myself and others who had really lofty expectations from me.

Episode 4.
I just could not control my thoughts. I wanted a confirmatory result if I was HIV +ve. So I scheduled an appointment with a HIV specialist @ Stanford. He went over my symptoms and said I was at low risk. Anyway he ordered Ultra sensitive RNA PCR test(detect as low as 50 copies per ml) and the antibody test and also whole lot of STD tests. All the results came NEGATIVE today.

I just want to put this nightmare to a full stop. I am not sure if I require further testing. I have my next appointment with the doctor on Jan 2nd. I will post what my doc says.

BE SAFE FOLKS ...

Cheers,
Andrew
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so you never actually engaged in any type of sex, correct? If this is the case I think you would be at pretty much zero risk. The doc says that is the reason he does not recommend pcr tests because they deliver false positives on many individuals and then your mind goes haywire thinking about HIV and how scary it is and that you might be infected with it all because it has the tendency to have false positives. He says a single antibody test at 6-8 wks should be fine. Based on the exposure you describe I would not worry...but I do understand how hard it is to not freak yourself out about this stuff too! goodluck and keep us posted!
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172023 tn?1334675884
You didn't need the testing you had.  And that exact PCR nightmare is why Dr. HHH does not recommend them.  Your life was a living hell for that period of time, for NOTHING.

I don't think you need any testing at all, but if it will settle your mind, do it.
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When I got my first PCR done at San Diego neither me nor my physician were aware of the flase +ves with HIV PCR testing(I believe the latest version by Roche COBAS Amplicor v1.5 is quite accurate???).  I was the one who recommended to the doc that I would want a PCR done. But seeing the results my physician immediately told me that PCR count of 400 copies per ml looks like a false +ve, since 2-4 weeks after exposure the viral count is very high(typically >> 10000s). Anyway from my experience it's better to wait for antibody results to be conclusive.

Happy Holidays and Great Health for All.

- Cheers
Andrew
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Well, My penis (probably) rubbed against the vagina of the message parlour girl in TJ for a while after the condom broke. But, there was no penetration. This was my big concern to get  tested. Anyways it definitely is not worth having fun with sex worker considering all the risk you are putting yourself into. I thought I was just having some fun visiting some clubs in TJ before I move away from San Diego to San Jose.

Well out of curiousity I have one lingering question. Why is that the condom is not completely effective against pregnancy(only 90% I believe??) Is it that condom breakage happens quite often? If the condom is only partially effective against pregnancy that same rate of effectiveness should hold for protecting against HIV which to me seems usage of condom really unsafe against HIV.

- Cheers
Andrew
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desert_rider, you could have rubbed your penis all day and night and you still wouldn't have had a risk. I would never suggest anyone have a PCR test.
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172023 tn?1334675884
That's actually an excellent question.  I personally believe that the pregnancy rate with condoms is due to incorrect usage and breakage.  

Although you'll always hear some people swear that they used it correctly blah blah blah and still got pregnant...I don't believe them.  My sister got pregnant with her first and ALWAYS maintained to everyone it was a rare intact condom failure, but recently told me privately that they just didn't use it one night.  And I've heard her SWEAR to everyone else that it was a condom baby.
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Considering your risk factor of having contracted HIV from the events that you described, you basically did not have any risk. People just do not catch it from touching another person's back with their penis and/or fingering. That's not how it works.

As for your PCR test, you are not alone. I spoke to someone here at length about his own false positive PCR test, and it caused him untold anguish and misery for a number of weeks. That is the reason that I do not recommend them. Of course, I am not a doctor, just someone who has seen the havoc a false positive can wreak.

Your doctor is right about the indicated "viral load" being a tell tale sign that you indeed did have a false negative. Anything under, I believe, 1500 (IIRC, but please do not hold me to that) in the primary infection stage is considered fishy.

Of course, your doctor and/or testing company can tell you that, but by the time you get the false negative, the damage is done. You are an illustration of why many doctors won't recommend them, especially given your "risk". They may serve a role in higher risk situations, but clearly a diagnostic test was not warrented in your situation. I'd make the argument that no test was warranted, as you had no real risk.

So, my advice is to relax. Your 24 day test, negative, is great news for you, and should come as a relief. Your doctor, given your false positive, will probably want a confirmatory test at 12 weeks, but that is just a formality.
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Thanls guys for your opinions. I also found a useful link to interpret your PCR results.

http://www.hivmedicine.com/textbook/acuteinf.htm

Cheers
Andrew
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Interesting article - surprised that they don't mention lymph node swelling in there at all as a symptom.
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