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unsure about starting and confused about testing please help
Aug 25, 2002

Dr. Ben, I am writing because i am quite confused and concerned and i hope you can point me in the right direction. Should i just start medication now? What even made me more anxious is reading the last post with the positive man and his negative wife that tested negative via elisa back in 96 only now to wake up to a rude awakening only near to aids almost. I am quite confused, is it possible that this individual is one of the minority who only develops antibody much later in the progression of the disease and would really have needed to take a dna pcr much earlier? I ask only because i am concerned. I believe your advice for earlier treatment is solid and i wish to pursue that option if i find out need be but i am left in a bit of a pickel. What do you suggest? I had a hollow bore needle accident about 5 months ago with a person of unknown status. I am a lab tech. I sustained a piercing injury with the used needle. I have tested negative at 3 months via EIA for type one and type 2 and also have tested negative for type one via DNA PCR at 40 and 60 days. The problem comes with the fact that i believe i am symptomatic. Following the incident i experienced muscle aches for 2 weeks, my tongue burned so i took zithromax and now i believe i have thrush but i dont know since i am no doctor, i also to this day develop wierd rashes that come and go on my face and body and have these red spots that look weird. These are definitely not familiar to me prior to this incident. Dr. Ben, i really don't know what to do? What would you suggest plus reading about this unfortunate incident with a negative test back in 96 now adds to my dilema. I was planning to test now in September at 6 months Eia type one and two. But since i am symptomatic if and i pray if it comes out negative again, what should i do must i wait another 6 months to clarify testing? How long do i have to test out to? Or can i eliminate this by simply getting another DNA PCR at a certain month? Please advise but i would love to get treatment rather now if i need to rather than waiting. Thank you. You are a caring, good-hearted man!

Juan Carlos Lee

Response from Dr. Young

I'm not sure about what caused the confusion about the previous case; this was a man who apparently contracted HIV at a time after 1996-- six years later has a CD4 count just above 200. This is only slightly faster than the typical rate of CD4 cell decline and may suggest (without data to confirm) that he may have a relatively high viral load. There are confirmed cases of persons who rapidly progess to AIDS after initial infection (some with time lines as rapid as three years)-- this appears to relate to baseline viral load, and for some unfortunate persons, infection with so-called SI-viral strains.

At this point, if you do not have confirmed HIV infection, the risk of medication-related side effects and complications far outweight any potential benefit.

I'd find it extremely unlikely that you've acquired HIV, given the kind of testing that you've undergone; a repeat ELISA at 6 months (or a PCR-based test) would provide sufficient confirmation of this. -BY


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