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Please help me understand
Jul 25, 2002

Hi. I actually just began reading your forum and was hoping you could help me. Actually this was the first time someone made me smile in months. I have posted numerous times to the safe sex forum and the understanding labs but to no avail. I look at the body too many times a day hoping for a response but it hasn't come. In May 2001 I had unprotected anal sex with a stranger. There was no ejaculation and penetration was fairly brief due to pain. At this time I was stupid and uneducated in HIV. In late July I began having aches in my muscles and joints. I had a fungal rash that went away with treatment and ringing ears. Tested HIV- and ANA+ (1:620 speckled). In Sept. HIV-, Dec ANA+ (1:320 speckeld) HIV-, JAN anti-RNP +, MARCH HIV- HIV RNA < 50. May 30th 2002 HIV- HIV DNA-, July ANA+ (1:620 speckeld) anti-RNP +. Here is my concern... The anti-RNP antibody has been know to "cross-react" with HIV. There was an article I read on aegis site that tries to explain this(I don't truly understand though). All of my other test for Lupus, etc. have been - (ds-DNA, Sourjens -, etc.). Could this mean I really am HIV+? or does this mean that the HIV test could be falsely positive with the rnp antibody present. I AM SO CONFUSED and STRESSED :-(

Response from Dr. Frascino


You haven't smiled in months? Well no wonder you're feeling poorly. Come on, show me those pearly whites - bigger, bigger, . . . . bigger . . . . There, that's better, now isn't it?

OK, let's start with the good news. I see nothing in your lab report that indicates you might be HIV-positive. In fact, I see all kinds of evidence to indicate you are NOT HIV-positive. You have negative HIV antibody tests in July, Sept., Dec., March, and May. In addition, you have negative HIV RNA viral load test in March and a negative HIV-PCR-DNA in May. The PCR/viral load tests do not rely on anti-HIV antibodies. Consequently, I can assure you that HIV is not your problem. "Cross reacting" antibodies could on rare occasions account for a false positive test, but not a false negative test. That means an antibody to a specific substance might, on a test, come up positive, not only for that substance, but for something else as well. Cross-reacting antibodies could not, for instance, be anti-HIV antibodies, which only show up as anti-RNP antibodies. So, put all those fears to rest. You are HIV negative.

Now the not-quite-so-good news. What about your speckled positive ANA and anti-RNP antibodies? This does indicate you have an autoimmune condition of some sort. That would also explain your muscle and joint pains. So far, Lupus and Sjogren's Syndrome see to be less likely, but there is a whole host of other autoimmune conditions that could account for your laboratory values. You need the help of a certified immunologist/rheumatologist. These conditions are somewhat rare and an exact diagnosis will require some specialized tests. Ask your doctor for a referral to a Board Certified immunologist/rheumatologist. He or she will be able to order the proper studies and give you the appropriate treatment.

Hopefully, this response will decrease your stress and confusion levels. I'm also hoping the emoticon goes from :-( to :-) !

Good luck.

Dr. Bob

Please help, hiv+ and pregnant. two weeks
Second-guessing Results

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