NAT Test

[whyohwhy602]

I know I have kinda already asked this question but since one part of my question didn't get answered and I am freaking out I thought I would try again.  

Dr. Hook I know you said I shouldn't much worry over this exposure but with all the oral manifestations I am having...white coated tongue (not thrush), cracks in tongue not all the way through, ulcers....I just can't shake this extreme fear.

I called the University of Alabama at Birmingham today and they said they do an early detection test called NAT.  Which from what I have read is the same as the PCR the Jefferson County STD clinic offers just with a faster turn around time.  I am assuming they do the NAT along with the standard antibody test.

I will 5 weeks post exposure on Monday the day I am scheduled to have the test

Here is my question

1)  Do you all recommend the the NAT/PCR test?.....because I can find no where in Mobile or Birmingham, AL that offers the p24 antigen/antibody test.
2)  What is the false positive rate on the NAT/PCR test?.....the girl at UAB said less then 1% is that correct?  Very concerned about the false positive rate.
3)  Dr Hook said before that PCR/antibody test would be conclusive at 4 weeks...so is the true with the NAT as well.

I am sorry to ask again.  I am just highly stressed and I have so much going on in my mouth right now, which sounds weird to say, I am just sure I have contracted the HIV virus.

Thanks for taking the time to answer this question for the girl scared for her life!!!!!

[H. Hunter Handsfield, M.D.]

Welcome back.  I agree with Dr. Hook's reassuring comments last time.  And you have misunderstood information you found about oral symptoms and HIV.  Symptoms like yours are rarely if ever the only manifestations of a new HIV infection.  They can occur with advanced HIV/AIDS, but rarely if ever with a new infection.  To your questions:

1,3)  NAAT and PCR are the same thing.  This test and the p24 antigen test both are ways to test for the presence of HIV in the blood.  Of the two tests, PCR/NAAT is the more accurate one; all by itself, a negative result any time more than about 2 weeks after exposure is virtually 100% proof against HIV -- i.e. I agree with Dr. Hook's statement that negative results with both antibody and PCR at 4 weeks would be definitive.  (NAAT is the test blood banks use on all donated blood to make sure there is no transfusion related HIV in the US -- and there hasn't been a case of HIV in the US following transfusion for many years.)

2) False positive NAAT results can occur, and I guess a 1% chance is about right.  Given your anxieties, you'll just have to decide whether you're willing to take that small risk in order to have the definitive negative result you seek.

So try to ignore your oral symptoms and rely on the test results.  Finally, perhaps it will reassure you to know that in the 7 years of this forum, nobody has ever reported actually catching HIV.  You aren't going to be the first.

Feel free to return to report your test results.  But stay mellow in the meantime.  It will be exceedingly surprising if you test positve for HIV by any test.

Regards--   HHH, MD  

[H. Hunter Handsfield, M.D.]

Don't misinterpret straight talk as short temper.  But thanks for the thanks about the forum.  Glad to have helped.

[whyohwhy602]

Thank you so much for your help and advice. I apologize if I have offended you or gotten on your nerves, please know that was never my intent!

Thank you for this forum and everything you all do. Please know your work is such a blessing!

I just wanted to say thanks!!

[H. Hunter Handsfield, M.D.]

The combination of negative antibody and NAAT tests is 100% proof you don't have HIV.

That will end this thread.  Believe the results and move on.

[whyohwhy602]

Dear doctor,

So I took a rapid oral test on Monday which was negative and I just found out my NAAT test was negative......so can I rest assured at this point I dont have HIV? Or do I still need to go rapid test again at UAB at 12 weeks?

Thank you so very very much for all your help!!!!!!!!!

[H. Hunter Handsfield, M.D.]

OHL is mostly an AIDS symptoms and not common in early HIV infection.

It is very unlikely you will be the first person since this forum started (7 1/2 yr ago) to actually become HIV positive after an exposure that concerned them.  If and when that happens, it probably will be someone with a truly high risk exposure.

[whyohwhy602]

Thank you for your response and I will gladly report the results of my NAAT test. They do a rapid oral antibody test and then do the NAAT test.  I truly feel like I am going to be positive but praying I will be negative.

I just have one quick question is oral hairy leukoplakia seen in early infection?

Thank you for all the help you provide!