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Avatar universal

Are there still possibilities of infection??

Dear Dr, I am a 43 yo male and I'm writing you because of lingering symptoms that will not resolve and others that seem to come out of nowhere.  I have had multiple risky exposures since 1996 with my LAST exposure outside of marriage being in 2009.  I had my first HIV test in 2008 which was negative.  I since have had multiple HIV/STD  tests ALL negative.  with latest being these:  


8/31/12--hiv 1-realtime RNA abbott--RESULTS PENDING--LC
8/31/12-- HIV 1/O/2 ICMA-LC
7/02/12--HIV 1 DNA--LC
6/25/12 HSV 1/2-LC
5/17/12--HIV 1 RNA(COBAS)--LC
9/28/11--HIV DUO TEST--different lab
8/15/11--abbott realtime--viracor lab
7/18/11--hiv 1 Qual pcr--QU
6/23/11--bDNA- QU
3/25/11--hiv 1/2 western blot stand alone
1/06/11-HIV 2 DNA PCR--LC

There were many others of the same repeated since 2009 but these are the latest of each.  I will try and make it short as possible.  I am experiencing some weight loss, bad muscle twitching(first extremities and now on forehead), sore throat, new hypertension, skin changes and i bruise VERY EASY NOW.  My wife also is starting to experience health issues but does not know about my testing history.

1) is there any way that I could still be HIV positive based on all these tests?
2)Is it true that hiv tests will pick up all/any strains of hiv regardless of subtype/strain?
3)Could this be syphillis with all the tests?
4)Would it be wise to advise my wife to test even though I show completely negative?(it would destroy my marriage, but if indicated I would).
5)Is it possible to possibly have waited too long to test and now I do not show antibodies or a detectable viral load?

I just want to get back to a healthier me. Physically/mentally.
7 Responses
239123 tn?1267651214
Welcome to the forum.

A few principles have guided most of the answers you will find going back all the way to the start of this forum ore than 8 years ago:  that the HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition; that strains missed by the standard tests are an urban myth; that the symptoms of HIV are very nonspecific (i.e. the identical ones occur with multiple medical conditions); that almost all exposure risks are far less likely to transmit HIV then they are to transmit it; and, thererore, that as long as testing is done sufficiently long after the last possible exposure, the results always overrule symptoms, exposure history, or any other factor that might lead to concern about HIV.

That statement pretty well covers your specific questions, but to be explicit:

1) Given these test results, it is not possible you have HIV, assuming there hasn't been a new exposure in the past few weeks.

2) Rarely, some tests may miss HIV.  But there is no HIV infection that would be missed by all the tests you had.

3) Your test results also rule out syphilis with 100% certainty.

4) I see no reason for your wife to be tested, assuming she hasn't been at risk other than your mutual sexual activity.

5) There is no such thing as losing both detectable antibody and a detectable viral load.  And if that had happened, you would be deathly ill by now, perhaps dead.

Even without the blood test results, the comination of symptoms you list would not make me suspicious about HIV.

Bottom line:  For sure you don't have HIV and should do your best to stop worrying about it.  I urge you to continue to work with your personal physician about other explanations for your symptoms.  And since you mention "mentally" in addition to physical symptoms, I will point out that much of what you describe -- as well as your apprent fixation on HIV -- are consistent with the physical manifestations of depression, anxiety, or other psychogenic origin.  If your doctor doesn't suggest this possibility on his/her own, you should raise it yourself.

Good luck with it all--  HHH, MD
Avatar universal
Dr. Hansfield, thank you for your insights.  When I mentioned "mentally", it was only because that I or my Doctor cannot find a cause for the very "physical" symptoms that do indeed exist. I am an educated person and do know what is real and what isn't.  I forgot to mention that my symptoms also include a sore throat, whitish tongue, as well as floaters in my vision that look like rods connected with a circle that resembles a nucleus of a cell  I have looked this up and it mostly looks like yeast from the pictures. 
1)I know the window period for "early infection" by CDC is 3 months.  Is it any different if one has possibly been infected for years?  If so,  what are the best tests to do and can you still get a false negative because you tested well beyond infection onset?
2)Once you have a negative antibody test say this far out, could it ever change to a "true positive"  with a more 'specialized" type of AB/PCR test? WIll you ever lose AB/PCR detection potential?
3)In people with "classical types of AIDS defining" illnesses, but ALL negative tests, can one ever be given a diagnosis of HIV/ AIDS?  If so, what type of tests/criteria do they use? Meaning, is it ever a diagnosis of exclusion?
4)now that I have tested this far out, is there any other tests to do that I or my doctor is failing to utilize, that could show differently?  (I am still waiting on ABBOTT REAL-TIME HIV-1).
5)How far do you at the UTMOST LONGEST period of time, have to wait until you can FINALLY AND WITHOUT question disregard any and all symptoms no matter how "classical" they may seem?
6)Should I do any other tests for HIV-1 and or HIV 2

And last, you have said many times(I've searched a lot) that you have never seen a positive individual in this forum.  There may be a day(hope not) when this does occur, but as a STD expert, would you even if you had a hint of suspicion, relay that in the forum? 

I just want to do ALL I CAN, do make sure I am TRULY NEGATIVE.  

Thank you very much for your time and talents.
239123 tn?1267651214
You are seriously over-thinking a simple and straightforward situation.  There is simply no chance you have HIV, and neither these considerations -- nor any others your anxious mind may concoct in the future -- that will change that fact.

"How far do you at the UTMOST LONGEST period of time, have to wait until you can FINALLY AND WITHOUT question disregard any and all symptoms no matter how "classical" they may seem?"  6-12 weeks, depending on the specific tests, or combinations of tests, that are done.  In other words, any and all tests done after that time were "ALL [YOU COULD] do to make sure [you are] TRULY NEGATIVE."

And by the way, I did not say your symptoms aren't real; I know they are.  But HIV isn't the cause, and I still would reiterate my concern about your mental health.  Your thought processes on this are not normal.

That's my last comment or advice on this thread.  Good luck.  
Avatar universal
Dr Hansfield, I wanted to relay to you my news and let you make any final comments on it. I received the results of my Abbott real-time HIV-1 RNA today and it was NEGATIVE down to 40 copies. Also, as mentioned, I got my antibody test and it was negative. Can you answer these please and any other FINAL thoughts?
1)can I be CERTAIN that this is not HIV of ANY kind from an exposure more than three years ago no matter what the symptoms are?
3) is there any other better test to do for HIV/syphillis?
2) and to be clear, there is no way that this could be syphillis with all these tests?

Thank you very much!!
239123 tn?1267651214
No comment.  I'm not going to repeat answers to the same questions using different words.  This is not a hand-holding service for people who will not or cannot accept repeated, reasoned reassurance based on science and logic.
Avatar universal
Dr. Hansfield,
I believe your comments about my hiv status and I thank you. I do have a question regarding syphilis.
If my last exposure was in 2009 or before:
1)is it at all possible to have at 2 1/2 years of that last exposure, a negative rpr, tppa, fta-abs, and TP EIA, and still have syphilis that cannot be detected?
2)can you get to a point where the only way to diagnose syphilis is CSF?  In the setting of all negative tests, or are those enough?

I appreciate it and that will be all I have to comment. I just have systemic thjngs that keep me bothered.

Thank you
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