Questions for Teak and other veterans

Hello,

On 12th day post-exposure, I developed 5 mouth ulcers and 2 swollen lymph nodes in neck that would hurt if I touch them
Day 14, mild soar throat which is still there....for the last 7 days. It feels very soar in the morning when i wake up but then...gets better during the day. Dry mouth too
Day 17, flu, running nose. NO fever yet (Thanks you, God!). I feel like sleeping all the time-- no energy, I am really sleeping like 12-15 hours a day and still very tired. No rashes yet. But my skin color is brown-- so its hard to find those. Extreme depression, headache all the time.

I went to GUM clinic on day 12-- the doctor did a blood, swab and urine test. I got  result text message from them today saying: "I am all clear for any STDs"...but 10 days is too early for any HIV diagnosis.

My DNA PCR result should be out tomorrow or saturday. But these symptoms are driving me crazy. I know symptoms are a very lousy indicator of HIV-- but still.....how can it be so co-incidental?
I am gonna have to push my wedding by 2-3 months-- i.e. until I get my 3 months result....and would have to level with my fiance.....who would most likely just call it off. I come from a very very conservative culture and family....and can't imagine disclosing this to my parents. Anyways, I should have thought this before I made that mistake

My questions are:

- In your very honest assessment, do my symptoms match 50% plus people who show HIV? Given that these started exactly in second week?
- How many cases approx. have you seen of people getting HIV from one time oral and vaginal sex with a CSW of unknown status? I know this is irrelevant to the fact that I have it or not-- but still trying to understand how unlucky I would have to be.
- Have you guys seen any false negatives with PCR DNA tests? how many? If cost is not a concern, can I believe that result to be 75%+ accurate at day 14?
- Was the 10 day blood and urine test of any value at all in determining my HIV status?


thank you so much for your help!

[stupid_717]

Apologies for double post-- my browser crashed. Please delete the previous one.

[Vance2335]

Lets start off with a question for you: You posted symptoms and questions and somewhat of your story. But did you have protected or unprotected vaginal sex?

[stupid_717]

Unprotected oral and vaginal...by with female CSW in Moscow....
Not sure if it was unprotected vaginal-- but i was pissed drunk and not erect. Had the condom on when entered her-- but I think it wold have gotten off because of no erection and the quality of condoms...that I saw the next morning.
NO ejeculation, 4-5 thrusts total, until I threw up massively....and she left.

oral started with protected-- then she took condom off-- I told her to put it back on and,...she said "don't worry about it"

Getting married supposedly on march 14th....but have to push now...or call it off.

[stupid_717]

My case details are here: http://www.medhelp.org/posts/show/752458

[Vance2335]

Unprotected oral=no risk
Unprotected vaginal is a risk if you had it. Since you don't know I would test 3 months post exposure.

[stupid_717]

Thanks. My DNA PCR came back....NEGATIVE.

What do you think on chances of false negatives on a 14 day PCR test? Here is the new dilemma now:

- The doctor who did my PCR test said....it has 99% accuracy, and that based on case I don't even need a follow up test
- I went to a different Pvt clinic. They said PCR results MUST always be verified by a 28 day DUO....or if I can wait, then a 12 week antibody test. But they said that the DUO at 28 days is 99.98% accurate.
- Went to GUM clinic in London. They said any test before 3 months would have chances of false negatives and they can't comment on the validity of 14 days PCR
- Called my primary doctor in San Diego (not HIV specialist). He said typically positive HIV results can be picked up in 4-6 weeks.

So, what do I do now? I am NOT looking for 100% result at this stage....anything over 95% would make me less anxious until the 3 month test...

[iamnotalegendatall]

What clinic did you go to for the PCR, and what GUM clinic?

[Vance2335]

I can tell you is a 6 week test is a good indicator but 3 months is conclusive

[stupid_717]

iamnotalegendatall, I got your private msgs too.  I will give you the names later. Let me get a couple of results until my 3 months post-exposure.
I am going through a very difficult time-- and really don't want to get into any private clinic competitive battles at this point. Hope you understand this-- and goodluck with your business, whatever clinic you run/part of.

[stupid_717]

Does the negative PCR on 14 days post-exposure have any value? Have you seen a negative pcr turning positive in any cases before? I totally understand that this is not recommended/approved for HIV diagonsis-- but most of the people say because it has high false poz potential. What about false negatives?

[stupid_717]

Also, the PCR test only checked for HIV type 1. Given that my exposure was in moscow with a csw-- do I need to be worried about HIV-2 as well? thanks..

[Teak]

PCR-DNA tests are not approved to used for diagnostic use. Not even in the UK. You have been advised several times as to when you can test.

[iamnotalegendatall]

Stupid,

I'm not part of any clinic! I'm just interested having been to a few over the years in London (both Private and NHS), and know that different clinics and Doctors over here say different things. I would help if I could. And I'd be helped by your experience. Sharing experience is what this site is about.

[stupid_717]

Teak, I know I am pushing it- and getting very close to get a warning/banned. But do you guys know WHY PCR is not an approved diagnostic test? Is this because of its cost, false positives or anything else?

thank you!

[Teak]

HIV detection levels, cost, false positives due to cross containation. They are only approved to monitor HIV progression in people with HIV.

[stupid_717]

Thank you!!!
Can you elaborate more on what you mean by "HIV Detection levels" specific to PCR?

Also, do you think I should test for HIV-2 as well?

Best Regards...

[stupid_717]

I guess my real question is-- If someone has HIV, wouldn't the DNA PCR most definitely find it in the blood cells post 2 weeks?
If not, have you heard of any cases where it did NOT?

[Teak]

What part of "not approved" test is it that you don't understand? Use an approved test if you have put yourself at risk.

[stupid_717]

All I am trying to understand is the level of risk? are we talking 1 in 100? 1000 or...1 in 10?

A lot of tests/treatments take a long time to get approved by the conservative bodies like FDA etc, because of the legal reasons etc.

[Teak]

PCR DNA tests have been out for over 20 years and none are approved for diagnostic use. END OF THIS DISCUSSION.

[stupid_717]

Cool, and what do you think about my likelihood of  HIV-2? Should i get tested for that too? thanks.

[iamnotalegendatall]

Any AB test in the UK will test for HIV-2. I doubt you'll find a PCR test (for HIV-2 in the UK) if that's what you are looking for.

[stupid_717]

NO, I am not looking for a HIV-2 PCR...but that I still need to be checked for it
And....general consensus is that HIV-2 is mainly in Africa...and not really prevalent in Eastern Europe and Russia etc?
I am just trying to evaluate where I stand at this point.

[iamnotalegendatall]

HIV-2 is mainly in Africa, or mainly found amongst populations with African immigrants. From what I know of Russia, there is not a significant African population. Therefore, HIV-2 should not really be of concern, and as I said, due to the diverse population demographic in Britain, it is tested as standard.  

[stupid_717]

Cool, thank you!

And in your opinion, does the negative PCR at day 14 mean anything?

[Vance2335]

It means that at 14 days you are negative. It is not conclusive and it is not even an indication.

[stupid_717]

Got it- so basically, i just wasted my money. But it was worth having one normal day. First time in 20 days I felt like a normal person, for few hours atleast.

Next (annoying) question is: what do you guys think about the 28 day DUO test (HIV antibody/p24 antigen)?

I have tested:
- 10 day HIV antibody= NEG
-14 day PCR = NEG

thanks

[Teak]

DUO tests are not negative conclusive until 3 months.

[stupid_717]

Teak, thanks for your replies.

I looked up "conclusive" in the dictionary, it means"putting an end to debate or question especially by reason of irrefutability".
Now just to clarify, I am not looking for an assurance at the level of irrefutability- because I can't have it until 3 months.

There are so many clinics that advertise DUO test at 28 days is 99.8% accurate. To me that's a pretty good detection. Combining it with PCR would give me a good indication of my HIV status.
So, what do you think of the DUOs done at 28 days-- are these really 99.8% (or let's say 99% +) as advertised by the clinics-- or is this a scam?
Have you seen someone turning positive after a 30 day DUO NEG?

thanks man- really appreciate your help

[Teak]

You don't have a choice of waiting. Either you wait for a conclusive test result or you take a chance of being positive and spreading it to others. You won't find in the GUM clinics guidelines that a DUO is conclusive any earlier than 3 months. DUO tests are not approved in the US.

[Teak]

The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.

http://www.bhiva.org/files/file1031097.pdf