assurance

[sunshine77699]

dear Dr.

I was hoping you could just cofnrim my belief.

I  have a gf for roughly 2 years but have however experimented in the past with men. I have had protected anal sex with 5 men, 4 one off, the other maybe 4 times.

I have also received fellatio unprotected, from the men as well as a couple more guys and I have performed it 2-3 times (I swallowed once).

I have had negative HIV DUO Tests after the most recent expsoure in Nov. 21 Days, 45 days, 60 odd days, 80 days and then at 6 months. All negative. I have also had a series of HIV INSTI tests from 60 days post xposure.

I was worried that I may have an IGG deficiency and would not be able to produce recognsiable anti bodies. But am I right in saying that the p24 tests is separate from anti bodies and so even if I did have an IGG deficicney, p24 part of tests would be reactive.

Also, what people have a IGG deficnecy? Is it immuno suppressed people?

Finally, am I right in sayin that the control spot on the rapid HIV INSTI itests show that the test is operative in the sense that it would show that I do not have an IGG deficinecy?  The INSTI wesbite says the test contains: ;Human IgG-Capture control feature ensures proper sample addition'

Thanks a lot docs.

[Edward W Hook, MD]

I agree.

Once again, worrying about IgG deficiency is a waste fo time. I will not address these sorts of unwarranted questions further. EWH

[sunshine77699]

meant to ask, would someone with an IGG deficiency produce antibodies by 6 months. is that why old literature said some people may sero convert by 6 months?

[sunshine77699]

smashing, well i take it by the fact i am not chronically ill and do not have multiple illnesses and have an immune system that is healthy that I do not have an IGG deficinecy.

Just for good measure, do you agree?

Thanks ever so much, I feel I can put this to rest.

[Edward W Hook, MD]

1.  Correct The antigen is the virus. This is independent of anitbody redponse and would not be impacted by IgG deficiency.
2.  Sorry. Not familiar with precisely what the control is testing for.
3.  Correct.
EWH

[sunshine77699]

Thank you Dr Hook.

I appreciate your comments. I am only anxious as I think of every possibility which is my nature and my job trains me to do that in my working life, so it is difficultt o break away.

a couple of questions just for my own understanding:

1) antigen testing is independent of antibody testing, so even if one were to have IGG deficincy, antigen would appear reactive if one were to have been infected? Correct?

2) Secondly. "The control is not a test for IgG deficiency but it proves that your sample was adequate for detecting infection." :I s it therefore implied that I do not have an IGG deficiency as my sample was adequate for detecting infection.? as if I did have an IGG deficnecy, my sample would not be adequate.

3) I realise that IGG deficiency is rare and that people who have it are chronically ill with multiple illnesses - i guess that is because their body cannot produce anti-bodies. Correct?

thanks a lot doc for the reassurance.

[Edward W Hook, MD]

I see you have returned with more questions about your low risk exposures and are having trouble believing your tests.  From reading your posts, it appears that something has caused you to become quite anxious about the possibility of HIV or other STD. Not sure what that it but my sincere counsel is that your problem is not risk for HIV or other STDs - your negative tests prove with a high degree of medical certainty that you are not infected.  Thus rather than repetitively asking questions which, very roughly can be translated to "Are you sure that, despite low risk an negative tests, that I am not infected...." you need to address your anxiety.  If you cannot accept your test results, then you need professional help dealing with the anxiety as it appears that you are devoting a lot of time to these concerns.  I say this out of concern for you and with great sincerity.  

In answer to your questions:
1.  DUO tests detect both HIV antigen (the virus) AND antibodies to HIV. Because the test really is comprised of two different tests, it provides results faster than antibody only tests and is positive in people who do not have antibodies at the time of testing.  These tests provide definitive answers at 4 weeks after exposure. Your multiple negative tests are proof that you do not have HIV.
2.  The INSTI test confirms that you do not have HIV be yet a third means.
3. IgG deficiency is rare and people who have it are chronically ill with multiple infections.  I would not worry about it.
4.  The control is not a test for IgG deficiency but it proves that your sample was adequate for detecting infection.
5.  If you have (unwarranted I suspect) continuing concerns. about IgG deficiency, you should discuss it with your doctor for separate tests.

Please try to believe you tests an move forward. I will not take part in an exchange about the nuances of test performance.  EWH