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Scared & Concerned.....Next steps?

Aug 31, 1998


After an exposure some 8 months ago, I continue to have very scary symptoms related to HIV. Huge swollen glands, Horrific sore throat that comes and goes, White tongue that makes my mouth taste funny. I have had 7 tests, HIV 1 & 2 Elisa, PCR DNA, PCR RNA all have come back negative. All other basic tests like CBC are fine. Yet these symptoms persist. I went to three different labs to get these tests, Smith Kline, Lab Corporation & Quest Diagnostics just to be sure. My doctor has no Idea what is going on, although he says I should not worry about HIV anymore and he keeps telling me we will find the source of these problems. My question is this: Is HIV type O & A common in the US and should I worry about these subtypes? I have not had sex with anyone from Africa nor have I visited Africa. Also, should I find a doctor willing to do a culture for HIV or a bDNA? Is the HIV Elisa easy for labs to do or are they common tests that they make mistakes on? Should I now just have a Western Blot and forget the Elisa (I hear the Elisa is just as good at catching HIV antibodys). Sorry for all these drawn out questions, but I truly value your opinion and think your are the tops. Would you continue to get tested for HIV or just stop and realize that this is some other thing going on. Every specialist I talk to say that they have never seen a case where someone is actually infected and have not had some results from the above tests that do not indicate that. Thank you and continue your GREAT work. With Appreciation.

Response from Dr. Holodniy

HIV-1 Type O and subtype A are uncommon in the US. Only a handful of sporadic cases have been found. With all the negative tests you have received, I don't think further HIV testing is warranted. ELISA tests are very easy to perform. Many companies produce kits all with standard reagents and extremely reproducible results. The standard testing strategy is to perform an ELISA first. If that test is negative, no further tests are done. If that test is equivocal or positive, the lab will automatically perform a western blot for confirmation. With so many negative ELISA tests, a western blot now would add nothing. In many of these cases, symptoms will go away. If symptoms have persisted for this duration, other diagnoses should be considered. It sounds like you are working with your doctor on this. A lymph node aspiration/biopsy may be in order to rule out other infections or malignancies if the swelling persists. Good Luck.


Have I done enough testing?
help dr please

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