Dec 12, 2004
In mid-September I became very ill with flu-like symptoms. I immediately went to my doctor. He ordered blood testing and I asked him to include an HIV test in the Lab Order. All tests came back negative including the HIV. After a week in bed, I felt strong enough to return to work for a few days. I relapsed six days later and went back to my physician. He was baffled and sent me to an infectious disease specialist that afternoon. This doc ordered a barrage of blood tests in order to determine what was ailing me. A week later, the specialist confirmed that I was suffering from Chlamydia Pneumonia. Based on my numbers (ICG 1:128 and IGA 1:128) he indicated I probably had the infection for several months before it crippled me. Although I was recently told I was HIV-, my symptoms had similarities to sero conversion. Being in a high-risk group (gay white male in NYC) the specialist had also ordered a test called "HIV 1 RNA QN PCR with Reflex." Although I tested negative for HIV only several weeks earlier, this doctor informed me that I was, in fact, sero converting. He told me my Viral Load was 750,000 and that my HIV RNA PCR, Quant was 5.88. The Lymphocyte Subset Panel 4 indicated I had a t-cell count of 583 (CD3+/CD4+ Helper ABS).
He told me not to worry too much about the initial high viral load because these numbers can be extremely volatile during sero conversion and furthermore, the C-Pneumonia was probably throwing everything out of wack because my immune system is fighting multiple wars.
My questions are: Can this RNA test be innacurate since they are multiplying DNA in order to examine traceable amounts of virus? Also, should I be re-tested for HIV considering every test I have ever had indicated I was negative. And finally, I don't know what to do about starting treatment. I fear the side-effects of the medications and don't know if I can deal with them at this time (mentally and physically). My doc explained there are conflicting reports as to the benefits of starting and delaying initial treatment. I am very interested in anything you can tell me. I am 39 years old. My only other medical condition is that I suffered a heart attack about 14 months ago (Left Anterior Descending - 100%). Had to have a stent implanted in that artery.
Response from Dr. Pierone
The blood testing shows that you recently seroconverted for HIV infection. You should be retested to confirm the results and also to have a genotype done to see if there is any evidence of transmitted viral resistance. We don't have proof that early treatment is better than watchful waiting, but ongoing studies should help answer this question. It sounds like you are not ready to initiate medication now in any case. Good luck to you and let us know how things turn out.
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