Doctor Feinberg,

This question really isn't fitting to this category but I think you are very knowledgable and I think you can answer this question the best. My question is about the very nonspecific test of the ESR. I have read that the ESR is used to gauge inflammatory diseases and possibly chronic infection? Is that true? If it is then why isn't the ESR signfigant to HIV, since it is a chronic infection. Especially if you have had the diease for years. Wouldn't your ESR be high or on the high end? Why can't the ESR exclude Hiv like it does for so many other illnesses? Thank you for your reply.

The sedimentation rate (ESR) is a very nonspecific, general test that is usually elevated in chronic bacterial infections more so than in chronic viral infections. It can also be elevated in inflammatory diseases that are not infections, such as lupus or rheumatoid arthritis. An ESR NEVER excludes a specific diagnosis-- it's too general for that, which is why it cannot be used to diagnose HIV.