I'm really worried

[abadtime]

Dear Doctors, Please read my story and tell me what you think.  I am a 35 year old male with children and married.  For several years I have made some VERY poor choices.  Up until mid 2009 I was unfaithful to my wife--and last exposure was mid 2009.  I had episodes with CSW which some were unprotected oral/vaginal.  In mid 2008 I had an HIV test for insurance which was negative I assume because I never heard anything else. In late 2009 I started having: white tongue, vision changes, weight loss of around 25 lbs without explanation, easy bruising, muscle twitting, and chronic sore throat(which I have til this day).  I have gained the weight back but still have all the other stuff.  I have had MANY hiv tests since late 2009!!  My last few have included;  100 week oraquick, 100 week HIV-1 RNA as well as proviral DNA, 102 week antibody HIV 1/2 from Quest diag and 2 year HIV ab/ag duo test.  All other labs have came back normal as well. My concern is that with all these tests, and there were others like these in the past two years(all neg) that somehow these could be false negatives.  1)Can SO MANY tests fail to detect HIV?  2)Can the variety of HIV antibody tests(5 different kinds in all), miss some sort of kind of HIV that these tests are failing to pick up?(My exposures were with women from various nationalities here in the US)  3)Can the RNA/ DNA/ duo tests miss HIV this far out?  4) are there any other tests to do that would CONCLUSIVELY rule out this as a cause to symptoms?  5) Are you aware of any cases out there where someone like myself has tested SO MUCH, but yet has gone on to show HIV by some sort of other testing but missed by all others?  

[Edward W Hook, MD]

You are asking the same question over and over and over.  This is what I said in my original answer- "Bottom line- you can be certain that you do not have HIV. Further testing is a waste of time and money."  It is still true.

This thread is over.  With further repetitive questions the entire thread will be deleted. EWH

[abadtime]

Dr Hook, this will be it for questions.
1)with testing this day and age and in the united states, can a person, without subsequent exposures, be missed or have false negatives after two years since last exposure of risk?
2)with candida or other "classic" symptoms, can you CONCLUSIVELY rule out HIV as cause?
3)are there any better or more specialized tests that would find?
4)Last, do you think that my results would ever change in absence of future exposures but ongoing medical issues?

Thanks so much.

[Edward W Hook, MD]

This is a repetitive question.  These answers will be brief and there will be no further repetitive answers.  

1.  No
2.  No
3.  C4 can be highly variable in HIV over the course of infection.
4.  Correct.
5.  It is time for you to stop testing.  

EWH

[abadtime]

From all that I gather, it would be nearly impossible to have HIV. Could you please address these:
1)can a person go two years and still have negative tests on DNA,RNA,antibody, antibody duo?
2) are you aware of any cases that have been missed by all this testing!
3)would you expect a person with HIV to have a cd4% of 50%?
4)even rare/uncommon strains would be found!
5)ABSOLUTELY stop testing for HIV?
Thank you for all your time.

[Edward W Hook, MD]

Like your symptoms, the CD4 ratio is also a non-specific test.  Thus, this additional information does not change my impression or suggestions.  You do not have HIV and shoul look elsewhere for the origin of your symptoms.  EWH

[abadtime]

Thank you for your reply. In addition to those symptoms, I also have bad joint aches/muscle pain. These symptoms are indeed real, but nobody has been able to figure out. I also had cd4/cd8 count. Percentage of cd4 was 49% and ratio was 1.96. Could you please address the cd4 numbers as well as prior questions?  Something just doesn't add up to my health. Thank you

[Edward W Hook, MD]

Welcome to our Forum.  I will try to help.  The best thing that I can do for you is to convince you that you do not have HIV.  I would urge you to understand that the symptoms that you are experiencing are not due to HIV - based on your history of no extramarital exposures for two years and a variety of negative HIV tests, there is simply no way at all that you have HIV.

The symptoms  you describe are non-specific and could be due to another illness.  If this is the case, continuing to focus on HIV can be potentially harmful to you by delaying the diagnosis of what is really going on.

Bottom line- you can be certain that you do not have HIV. Further testing is a waste of time and money.  I would urge you to seek a systematic evaluation of the concerns you have, probably starting with an evaluation by an Internal Medicine specialist. EWH