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CD4=140, ELISA Negative, why?
Sep 19, 2002

Dear Drs. Pavia, Yong, Wohl,

I am in a strange situation--I had a sexual encounter with a sex worker 1.5 years ago, then developed typical ARS within 2 weeks. Soon my girlfriend started to have similar symptoms. We've been tested negative by ELISA HIV 1/2 and PCR RNA, bDNA, P24 many times over the years and all negative/nondetectible. However, my CD4s keep going down from initially 800+ to 420 to a recent 142 (CD4/CD8=.25) during the 18 months period. Same trend for my girlfriend: CD4 620, 358, and 280 at the last check-up. I've lost more than 35 lbs in a year, and my girlfriend has all sorts of infections she never had before (yeast, skin, eye infections, herpes, medication don't work well). What's going on? Our internal medicine doctor refused to talk about the possibility of HIV due to repeated negative results, but he could find no other causes either. My girlfriend saw one ID doctor early on, but she told her that CD4=620, CD4/CD8=.7 is perfectly normal and refused to take a further look at other possibilities. What should we do? Waiting to die? My health condition is going down quickly. We are hopeless. Please help! Miserable couples

Response from Dr. Wohl

This is very bizarre. In what part of the planet do you live? Where did this encounter with the commerical sex worker happen? DW

PEP missed dose

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