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False result
Jul 18, 2006

Recently I tested positive HIV then my CD4 540 31% VL RNA 11000 , But i still do not beleive that i have HIV because I am married since 6 years I have son and daughter will deliver within one week I made the test to my wife she is negative ( Thanks god ). There are two reasons for suspecting my result 1- I do not do any sex outside my marriage and before marriage I was rarely doing sex and all time safe sex 2- My age now 35 and since I was 3 years old until now I got corticosteroide medicine because I have Congental Adernal Hyperplasia , 11 hydroxylase deficiency . my daily prendison is 7.5 mg which is equal to 30mg of hydrocortisone. I have most of corticosteroide side affect due to long term use , my immune system is weak , I have hypertension , my growth was so slow , My height 155 , delay in wound healing , Decrease of immune reaction of body against infections such as throut and flu Please advise me I feel there is a wrong result of HIV infection due to antibodeis contained in my blood caused by stroids . Also I wonder if RNA VL test not accurate and I have to DO PCR DNA test as a final infection confirmation Pleeeeeeese help . My life and my marriage and work will be destroyed as i am living in Saudi Arabia and HIV person is not accepted at all .

Response from Dr. Frascino

Hello,

Although long-term use of immunosuppressive agents, such as corticosteroids, can affect HIV-antibody-test results, this would cause a false-negative result, rather than a false-positive result. The reason for this is that corticosteroids can suppress the body's ability to make antibodies, including anti-HIV antibodies. Consequently, someone who is HIV positive and on significant corticosteroids could test HIV negative (false-negative). Corticosteroids also would not affect HIV PCR RNA viral load test results.

Having said that, is there any way your test result could still be inaccurate? Yes, absolutely. You report that your wife is confirmed to be HIV negative and that you have had essentially no risk exposures monogamous since getting married and minimal sex before marriage, all of which "safe sex." Assuming that you are not an IV drug user who shares syringes and have not received a blood transfusion of HIV-tainted blood, you have essentially no risk. Consequently, your recent positive test is inconsistent with your potential risk. The most likely cause for this is not your congenital adrenal hyperplasia or use of replacement steroids, but rather a technical or clerical error. Someone could have mixed up the samples or your results. I would suggest a repeat ELISA test and, if positive, a confirmatory Western Blot as your next step. If those are again positive, a repeat HIV plasma viral load and visit to an HIV/AIDS specialist should be scheduled. The specialist will review all the lab results, your personal medical history and your current medications. If needed, he will order additional tests to clarify your status.

I'm sending you my very best good-luck/good-health karma that your follow-up tests prove that your initial tests were in error! Keep me posted! I'm here if you need me, OK?

Good luck!

Dr. Bob


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