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Could the PCR be that wrong?
Mar 20, 2011

Dear doctor, I'm resorting to asking you this question here because I feel as though I'm running out of places to turn to. I have a very poor rapport with my HIV doctor because he is the only doctor who is specialized in HIV in Lebanon. Now in September 2008, I had unprotected anal sex with another man. In November 2008, I was tested for HIV and my results came back negative. In January 2009, I had sex again but it was with a different partner; however, a condom was used this time. In July 2009, I was diagnosed as HIV +. I was diagnosed + on both the rapid test and the Eliza. In Lebanon there is only 1 type of Eliza test and the Western Blot is not heard of. At that time I was told I was positive on the Eliza over the phone, I've never seen the actual document. The second confirmation test that they have available is the PCR-RNA. Again I was told that I have an initial viral load of 140,000 ml/HIV-1 on my first PCR test. Now, I've only had 2 sexual partners and it was easy for me to pinpoint my HIV to my first sexual encounter - However, the guy I had barebacked with is negative & a condom was used with my second sexual encounter. I'm confused as to how and from where I could have had HIV. My doctor is insisting that it is from my first partner; however, he has several tests showing that he is negative and he is not on HAART medication. Moreover, during my first testing periods (in July 2009), I had scabies and crabs that I had contracted by sharing a friend's towel by mistake who had them. The crabs lasted from (June 2009 all the way to October 2009). My doctor is telling me that I have HIV based solemnly on the PCR results... I want to know... How accurate is the PCR? Also, in less than a year, my doctor said that I need to start taking my meds. He said I'm a rapid progressor...Saying that I'm losing 67 WBC/ml every 2 months. The thing is... I don't even have any symptoms nor do I get or feel sick. When there was a break-out of H1N1 in Lebanon, I was one of the few who was not even showing any flu like symptoms. My viral load was in the normal range, just until the past months. In December 2010, I was still in the 500 WBC; but in February 2011 I went all the way down to 386. When I ask my doctor for a differential diagnosis, he gets all bitchy and says that I have no right to question his diagnosis... But could there be other disorders that cause such a discrepancy in PCR results? When I asked the lab technician what kind of PCR machine they use, she had no idea. Could I have a blood disorder (other than HIV) that is giving me a positive PCR result? My last PCR result said that I have a viral load of 230,000 ml/HIV-1; to which my doctor said: "This is normal because you are in the acute infection phase." Thanks in advance

Response from Dr. Holodniy

You now have two HIV viral load test results over 100,000. I suggest you discuss HIV treatment options with your physician.



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