Can i be 100% sure its not HIV

[naveea]

Hi Doc,Am 27 year old male from India
1st Exposure :Protected vaginal &unprotected oral with CSW in Mar -May 2009 in UK.diagnosed with chronic pharyngitis later
2nd Exposure:Protected oral &vaginal with CSW in India Dec 2009, CONDOM BROKE
Jan 2010:tonsillectomy,septoplasty&sinus surgery
Feb 2010:Fever(100F), Sore throat, palm rashes.CBC:RA +ve ,Elevated ESR-35 &Neutrophils
April 2010:tested HIV -ve(4 months after 2nd Exposure)H.Pyolri was +ve &.RBS was low(50)still had sore throat
3rd Exposure:May 2010:protected oral &vaginal with indian CSW
4th week to 9th week:had tender lymph nodes in neck &armpits, sore throat & fever (99F)
6th week:I tested -ve HIV 1&2 (4th Gen ELISA) &my CBC showed elevated Neutrophils &Eosonophils.ESR normal
11th week:developed a fever (99F), sore throat, tender lymph nodes in armpits &neck.CBC was normal.
12th week:I tested -ve for HIV 1&2 (4th Gen ELISA),HEP B& C ,VDRL,HSV2 but +ve for HSV1.-ve for Malaria &Typhoid.CBC showed Elevated ESR -23 &Neutrophils ,RBS was Normal
13th week:I tested -ve for HIV 1&2  (ELISA- 3rd Gen),TB,LDH,Chest Xray was normal.RBS was Normal.still had sore throat,fever,aching armpits.
18th week:I tested -ve for HIV 1&2  (4th Gen ELISA ),CT scan showed slight sinusitis
19th week- tender Lymph nodes behind knees,Thigh  pain,low grade fever(99F),sore throat,aching armpits.still have all these
21st week(146 days):HIV 1 & 2 4th Generation Chemiluminesense->NON REACTIVE
NUCLEIC ACID TESTING FOR HIV-1(RNA)-->Lower than detectable limits(Analytical sensitivity 53 UI/ml)
1. How conclusive is a -ve HIV 1& 2 4th generation test @ 21 weeks from my last exposure for some one like me who has an undiagnosed condition or a weak immune
2. Does NAT HIV-1 RNA cover all subtypes of HIV-1?
3. Should i go for HIV-2 RNA? Since HIV-2 is prevalent in India unlike US
4. Are my symptoms indicative of HIV infection?
5. Can i be 100% sure that i am clear?am getting married next week so i don’t want to infect my fiancée

[H. Hunter Handsfield, M.D.]

1) HIV is too rare to worry about and in any case most of your tests were valid for HIV-2.

2,4) No medical condition, including CVID, significantly alters the reliability of HIV test results.  The only things that potentially do this are advanced malignancy (terminal) or other overtly life threatening conditions -- and even those aren't proven to cause delayed seroconversion, only theoretical with few if any actual instances reported in the medical literature.

3) I don't know the cause of your symptoms, but clearly not HIV or other STDs.  This forum does not speculate about other causes other than those.

That will be the end of this forum.  Accept the reassurance you have had and move on.  This forum cannot help you further and I will delete any additional comments or questions.  Good bye and good luck.

[naveea]

Thanks for your reply doc

Well my symptoms started with my 1st exposure(Dec 2009) and have gotten worse after my last exposure(march 2010),not a day goes by where i am free of symptoms,that makes it hard to believe my results though i tested -ve @ 21 weeks post my last exposure

Just one more question

1.Am more worried about HIV-2 because the 4th generation antibody test looks for P24 antigen for HIV-1 and antibodies for HIV 1& 2.it does not look for P-24 antigen for HIV-2

2.Assumming if some one has Common Variable Immunodifficiency (CVID),How long will it take for such person to produce antibodies ,will it still be within 3 months ?

3. I have tested -ve for all STD's except for HSV-1,Can HSV-1 cause sore throat,tender lymph nodes in neck,armpit and behind knees and low grade fever.my doc is clueless about whats wrong with me

4.What medical codition can cause delayed seroconversion? What about a person like me who gets recurrent infections every 2 weeks ?

Thanks in advance doc...

Naveea from India

[H. Hunter Handsfield, M.D.]

Welcome to the forum. But I have to say I am rather surprised by your question.  You have been very active on the HIV community forum, having participated in almost 200 threads (maybe a MedHelp record!).  And in the few I examined, you provided apparently knowledgeable supportive comments to other users with HIV related anxieties.  I cannot imagine that you do not know the answers to your own questions.

The bottom line is that test results never lie.  If testing for HIV is done sufficiently long after the last potential exposure to the virus -- i.e. 6 or more weeks after exposure -- then the test results rule.  Symptoms and exposure history no longer matter.  In other words, your multiple negative test results prove you did not catch HIV.  To the specific questions:

1) 100% conclusive.
2) Yes.
3) Do not have any further tests of any kind.
4) Your test results prove your symptoms cannot be caused by HIV.
5) Yes, 100%.  You can safely marry without infecting your wife.

HHH, MD