Concerned about testing results

[golfer1225]

Hello,


I am a 25 year old male who has been constantly and extremely stressed/anxious out for about a month now about possibly having hiv/AIDS.  My only possible exposure would have been almost exactly 2 years ago and it was one-time heterosexual vaginal intercourse with a perrson of unknown status.  I have been having trouble sleeping, as well as sweating sometimes when I sleep.  In the last week or so, I have developed a couple lesions on either side of my tongue that I am worried could be OHL.  I am hoping these lesions can be attributed to my geographic tongue (which I have had for a long time), my acid reflux, or even my extreme stress I've been dealing with.  I've also lost about 15 pounds in the last month, but I havent been eating hardly anything, probably due to my extreme anxiety.  I have lost weight like this before (7 years ago) when I thought I had a heart defect.  I am a hypochondriac and I recently took myself off of zoloft after being on it for a few years, thinking I was ready to deal with things on my own.  Two days ago I tested negative in an hiv antibody test.

My question is this, I realize I am outside the 2-6 month testing window but can I rely on my negative test results since the possible exposure was so long ago?  Since OHL can be a sign of later stage HIV disease, and assuming what I have is OHL, is it possible that the antibodies would'nt show up on my test?  In essence, once your body produces the antibodies, do they ever "go away" or become undetectable?

[golfer1225]

Thank you so much Dr. Hook for your response.  

[Edward W Hook, MD]

Your fear is inappropriate.  You do not have HIV.  Weight loss in and of itself would not invalidate your antibody test- you would have to be protein-calorie malnourished to the point of starvation.   The people in this state typical die due to malnutrition within weeks of reaching the point that antibody tests are no longer useful.   If you are eating and do not have chronic wasting disease your antibody test is an accurate reflection of whether or not you have HIV.  I am completely confident that your antibody test results accurately reflect whether or not you have HIV.  If you really want to waste your money there are any number of labs that will be happy to help you do it with PCR testing.  

I have nothing more to say.  EWH

[golfer1225]

Hello Dr.,

I came across an answer of yours to someone else and it brought up a question.  You're reply was this:

"Again, while a VERY small proportion of persons in the most advanced stages of AIDs who are sick and malnourished rarely have negative antibody tests, the PCR test would still be positive.  it sounds as though you are not severely ill or malnourished and, once again even if you were, the PCR test would be positive."

This is what I'm concerned about.  Do my symptoms such as weight loss, night sweats, tongue lesions (which have seemed to get better in the last few days) indicate a possibility of advanced stage aids with sickness and malnourishment?  I've also felt very weak and tired and nasueous too.  Also last winter i got a cold and a cough followed that lasted all winter long.  My question is should I have a PCR test done? Will that be more definitive?  I am planning on calling my doctor tomorrow and making an appointment to talk to him about all this stuff as well, because I just have not felt right lately.  I just don't have insurance right now because I started a new job and wont have it til i've been there 90 days which is about 45 more days, which is why I'm seeking your advice. I am really scared.

Thanks so much for your help.

[Edward W Hook, MD]

Everyone with AIDS has a positve antibody test, as do many peole who have not progressed to the advanced stage of disease represented by AIDS.  This will be my last answer.  You do not have HIV or AIDS.  EWH

[golfer1225]

Thanks again for your response doctor.  I just have one more question.  I read somewhere that an HIV antibody test cannot tell if you have AIDS.  I think that is because it only checks for the virus.  Having said that if I have progressed to AIDS and therefore have a severely compromised immune system, would I still test positive for the HIV antibodies?

Thanks in advance for your response, this will be my last question.

[Edward W Hook, MD]

Yes, absolutely.  EWH

[golfer1225]

Thank you so much doc for your response.  What you do is a great service and I am grateful to this website for the advice and information I have read.  

Just for clarification, even if a person has full blown AIDS they will be antibody positive?

Thanks again!

[Edward W Hook, MD]

Welcome to our Forum..Let's go directly to your questions.  First and foremost you do not have HIV. Believe the tests, not any signs and/or symptoms that you may be experiencing. Tests ALWAYS trump symptoms, and after two years beyond your exposure of concern I cannot say that emphatically enough.

Second, I am surprised at the great proportion of our clients on this site thing they have OHL when they notice an abnormality of their tongues or mouth. It may be that a few people do have OHL but I have to tell you ( and others reading this) that the appearance ot the tongue is highly variable on a day-to-day and person-to-person basis and to assume that whiteness, grayness, or change in texture is OHL is often wrong.  For that small proportion of persons who do actually have OHL, it is important to point out that OHL is seen in many persons who do not have HIV.  A diagnosis of OHL should be made by examination by an expert.  

Finally, persons with HIV do not lose their antibodies to the virus once developed but remain antibody positive for the remainder of their lives.

Thus, bottom line, based on your test results, it is time for you to cease worrying about the exposure you describe and to move forward.  You do not have HIV, there is no reason for further testing and no reason for concern.  

I hope my comments are helpful to you.  EWH