hiv testing

[gt1990]

I had a high risk exposure almost 10 weeks ago. I took one 40mg dose of Humira two to three weeks before exposure. 1.Will that one dose of Humira affect or prolong the production of Hiv antibodies or p24 antigen.   2. I've been having symptoms since week 2 and have gotten worse since. It started with a rash on my torso. some of the rashes looked like purple streaks and some looked like pink spots. they weren't that many and they didn't stay long. they would appear and go away in a couple of days. Since week 2 I've lost 12 pounds, I had a sore throat, I've had stomach pain, mostly lower left. I've been having night sweats, muscle pain and muscle weakness and muscle twitching. I feel tired a lot and I have tenderness under my armpits and around groin that comes and goes. Ive had some red spots on my arms and legs  know my neck is starting to feel sore. I do have a cough but its not dry and I do smoke a lot. 3. I do have psoriasis, psoriatic arthritis and gout. 4. Negative antibody test at week 4. Negative Rna Pcr quantative test at week 5. negative antibody at week 5. Negative AG/AB 4th generation at week 7. Negative rapid POC antibody at week 9.   I don't know what to do. With all the symptoms ive been having wouldn't I have tested positive by know if I was infected? My body temps have been all over the place. No high fever but I did have a low grade fever 99.1 to 99.5 for a couple of days but it would come and go, maybe last an hour and would go down if I went into a different room. What do you suggest? Any specific test? ive also noticed a swollen lymph node on the side of me neck and a very tiny one one the back of my neck. Ive been taking Klonopin for 2 months because of the stress and anxiety.

[Edward W Hook, MD]

Not sure where your information is coming from but there are some misconceptions here.  The RNA becomes undetectable when HIV antibodies are present.  One or the other is present at all times after infection is present.  That is the reason that 4th generation tests are conclusive from 4 weeks onward.  

Your doctor is incorrect.  No change in my assessment or advice.  EWH

[gt1990]

why are you not answering questions at this time?

[coolguy1234]

guys I nees your help, how can I post my own question? im new to the website im using the mobile version on iPhone (not the app)

[gt1990]

forgot to mention ive been having alot of muscle twitching or spasms for the last week and they are getting worse as well,

[gt1990]

Hey Doc! Its me again. What's the difference in an Hiv Dna Pcr test and a Hiv Rna Pcr test? I took an Hiv Rna Pcr test at 5 weeks. Also I contacted Humira and they said that one 40mg dose has a half shelf life of 10 to 20 days but that it would be in my system from 50 to 100 days. Im worried Doc, my symptoms are getting worse daily. My muscles ache, I feel weak and tired, Under my arms are achy, same achy feeling on both sides of groin. My neck is starting to bother me and Ive found 3 swollen lymph nodes, 1 on each side of neck and 1 at the back of neck. Ive been running a low grade fever.Its pretty warm where I work. i work a production job. It was about 95 in the plant but when I got off and walked to my truck, i checked my temp and it was 100. Once I got home and inside the house my temp dropped to 98.6.my rash is worse today thsn yesterday. They look like reddish pink spots. Some are flat and some are raised. My stomach hurts, especially lower left side. im worried the humira is throwing off the tests or delaying the production of antigens or antibodies. my headaches are getting worse as well. Something bad is going on. Im still dropping weight and have no appetite. The inside of my anus hurts like there is a sore or something. I look like Ive aged 5 years in 2 months. Please help me Doc. I dont know what to do or what test to take at this point. Thanks for your time.

[Edward W Hook, MD]

You can believe whomever you wish to and test as much as you wish to. The results will not change.  Facts are facts.  The virus has multiple component parts, including the DNA detected by PCR and the p24 antigen.  As I said above, when persons get HIV and are untreated, they will have either the virus (detectable as either DNA or p24 antigen) or antibodies present.  It is the antibodies which cause the decline in virus concentrations.  That's the way the biology of this infection works.  EWH

[gt1990]

i guess what Im getting at is that everything ive read and researched says that a Rna Pcr test is good for the first 2,3 maybe 4 weeks after initial exposure. After that the viral load drops to undetectable numbers because the virus has entered the cells in the body and the viral load is no longer high enough to be detected. I took my Rna Pcr test at 5 weeks and your telling me that my negative result is good, when a Doctor at MUSC told me it means nothing at 5 weeks. Whos right Doc? And your also telling me that my Hiv Ag/Ab 4th generation negative result at 7 weeks is 100% accurate regardless of evrything ive told you about my autoimmune disorders and taking that shot of Humira? I mean no disrespect. Im sure your a brilliant Doc, but one Doc says this and the other says that. I mean who do I believe. How many times have you been wrong about your assessment of people in my situation under my similar circumstances? I think very highly of you Doc cause I use to want to be one myself.

[gt1990]

I thought the Rna Pcr quantative test actually tested for the virus itself, in other words the amount of virus in your blood. Rna and P24 Antigens arent the same thing are they?

[gt1990]

I thought the Rna Pcr tests were only good for 3 to 4 weeks post exposure because the viral load drops dramatically at that stage. Something about the virus entering the cells and not being detectable again until much later. I took my Rna Pcr test at 5 weeks and the results were none detected. What i dont understand is that my doctor tells me that that test result means nothing at that point. I seek your knowledge because of your background with infectious disease. What about the 4th gen test I took at 7 weeks? Would the antigen or antibody levels have been at detectable levels at that point especially with all the symptoms ive been having, even though I took a humira shot 10 weeks prior to the test? what about the rapid POC test I took at 9 weeks? Is that test anygood? Im going for my 3 month test  in almost 3 weeks and Im praying hard. Thanks for your time and patience Doc.

[Edward W Hook, MD]

Welcome to the Forum.  I'll be pleased to comment.  Before I get to your specific questions, let me remind you that even most high risk persons do not have HIV or other STIs and when they do, most exposures do not lead to  infections. With this, let's get to your specific questions:

1.Will that one dose of Humira affect or prolong the production of Hiv antibodies or p24 antigen.
No, the Humira is an immune modulator which sometimes permits existing infections that many people have to re-occur (relapse) and makes recipients more susceptible to certain infections caused by fungus or to tuberculosis-type bacteria.  Theoretically Humira might delay development of antibodies to HIV but there is no data to suggest that it makes persons more susceptible to HIV and there is no theoretical reason that Humira would make p24 antigen harder to detect.  

2.  Your rash sounds nothing like the rash of HIV.  Your other symptoms are non-specific.

3.  Your psoriasis, psoriatic arthritis and gout do not make you more vulnerable to HIV.

4. If your symptoms were due to HIV, your PCR test would have been positive.  The negative test is strong evidence that you did not get HIV form your high risk exposure.  

My advice is to not worry further about HIV form your exposure over two months ago. There is strong evidence that you are not infected.  There may be something else going on and I would suggest that you talk with your doctor for evaluation of what might be going on but I would not be worried about HIV.

I hope this comment is helpful.  EWH