Aug 25, 2002
Dr.Bob, please help and advise me with your professional opinions on my situation. Your answer to me will be greatly greatly appreciated.
To make a long story short, I went for an HIV antibody test approximately 3.5 months after a possible exposure (body contact, open mouth kissing with one lesion inside mouth), and the result came back as screening elisa for hiv1&2 - reactive, western blot - nonreactive, supplemental elisa for hiv 1&2 - non-reactive and p24 antigen - non-reactive. Then approximately 3 weeks later, I went to take another antibody test, and I received the exact same results as the last one. Then about 5 months later (8 to 9 months after possible exposure) I went to get another antibody test again, and this time, the screening elisa for hiv1 & 2 came back as - non-reactive. A pcr dna test has also been done at this time, and the result came back as negative. After that, I was refereed to a infectious disease specialist/doctor, he ordered a pcr rna ultrasensitive assay, cd4 count, cd8 count and a bunch of other tests for me, the pcr rna came back as undetectable or lower than 50 copies, the cd4 count is 800 and the cd8 count as 360. The infectious disease doctor told me that I'm fine, that I do not have hiv and I do not need further testing. Would you agree with him based on the above tests results??
I am apparently healthy, I am not on any regular medication regime, I've been celibate for the past 9 months, I do not notice any special medical symptoms happen to my body and I live in Canada. Do you think I can stop worrying about the 2 positive elisa tests happen to me about 6 months ago?? What should I do or what test/s should I take now to ensure that I do not have hiv? Will I have to test forever and never know for sure that I am negative?? Is there an end to this?? You are a very nice guy Dr. Bob, please help and answer my questions. Thanks a lot.
gayboy all alone
Response from Dr. Frascino
Hello Gayboy all alone,
Your risk of contracting HIV is extremely low. I'm sure the 2 positive ELISA screening tests were extremely frightening for you. However, remember there is a reason we have a 2-stage screening process. It's exactly for cases like yours. The ELISA is an extremely "sensitive" test. It's designed to find any chance of someone being HIV-positive. If that test is negative, then great, you don't need additional tests. If, however, as in cases like yours, the screening ELISA is positive, then a more "specific" test is done - the Western Blot. The Western Blot test determines which positive ELISA tests are really positive and which are "falsely" positive. Without a confirmatory positive Western Blot, the ELISA test cannot determine for sure if someone is really HIV-positive or not. You have had subsequent antibody, p-24 antigen, and PCR (both DNA and RNA) tests, all of which were absolutely negative. Your CD4 and CD8 counts are absolutely normal, and I can tell you with 100 percent confidence that you are absolutely HIV-negative! You do not have HIV disease. You had 2 "false" positive screening ELISA tests after a low-risk exposure that were subsequently confirmed to be "false" by repeated more sensitive tests. Gayboy, don't feel alone. This actually happens quite frequently and can be scarier than seeing Cher without her wig and makeup. But, please believe me that you are not HIV-positive. The tests are absolutely conclusive. You are fine.
Canada is a wonderful place. I was in Vancouver and Victoria last week and met some marvelous folks, including some handsome and single gay guys. So don't be alone. Get out there and find Mr. Right.
I wish you continued excellent health.
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