Dear Bob, I am 28 year old heterosexual male, who has never used drugs, and had the same HIV negative girlfriend for the last year. I have some very conflicting HIV results that I cannot put to rest. A year ago my Kaiser ELISA came back positive, WB indeterminate with weak gp41, and weak p40. Three months later I went to an ID specialist, and he ordered ELISA, PCR, bDNA, P24, HIV-2, T-cell panel tests. ELISA came back reactive, WB indeterminate (weak gp41), bDNA negative, PCR negative, P24 negative, HIV-2 ELISA+WB negative, 729 count and 38% CD4, 1.6 CD4/CD8 ration. Based on this the ID specialist said I was negative, which left me very confused. Two months later I ordered myself Home Access kit, which came back negative, and I paid for Labcorp ELISA test- negative as well. Another month passed, and my Kaiser GP ordered another HIV ELISA with T-cell panel - ELISA was reactive, WB indeterminate with Non-specific viral bands only. My T-cell counts dropped to 680 and 34%, CD4/CD8 ration dropped to 1.3. My GP didnt want to comment my dropping T-cell panel results, he said I was negative according to ID specialist. Apparently he was getting upset me telling him which tests to order I had put HIV testing to rest for five months, which brings a total of one year since my first reactive Elisa. Three days ago, May 2nd, I went to local free STD clinic, and ordered another HIV Elisa test third generation UNI-GOLD blood based rapid test. The UNI-GOLD ELISA came back negative. Here I am a year later, with one repeatedly reactive ELISA kit (Kaiser), and three non-reactive (Home Access, Labcorp, UNI-GOLD rapid), kind of low CD4 counts that got even lower on the second test, negative PCR, bDNA, P24, and indeterminate WB with Non-Specific viral bands only. I feel a bit tired, and sleep quite a bit. My throat has been sore / reddish for a year. I do not feel the same. My questions to you: (1) am I being obsessed with HIV testing? (2) Could I have a rare HIV-1 group O (3) What test should I order to put my mind at rest? I will donate to support HIV research.

Thanks, Very worried individual

Hello Very Worried Individual,

Your extensive (and excessive) HIV tests to date include several reactive (positive) ELISA tests with indeterminate confirmatory Western Blots (WBs), multiple negative HIV-antibody tests, undetectable PCR RNA and bDNA and negative p24 antigen out to one year. I absolutely agree with the infectious diseases physician. You are definitively and conclusively HIV negative. The positive ELISA/indeterminate WB tests are most likely due to nonspecific cross-reacting antibodies.

To specifically address your questions:

1. Your fears are unwarranted and have led to unwarranted HIV tests.

2. No.

3. No additional HIV tests are warranted. You've had way too many already. If you cannot accept the truly wonderful news of your HIV-negative status, you should seek psychological help. Recurrent testing has not put your mind to rest. Consequently, I would advise you address the underlying problem of irrational fear of HIV infection as a cause of your anxiety.

Thank you for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org).

Good luck. Feel better, OK? You should be WOO-HOOing, not worrying!

Dr. Bob