Hey Dr. Bob love the flavor you bring to this site. I've had three test since a very high risk exposure. A little over two weeks later I developed adenopathy (the area of exposure first)and many other ars symptoms (didn't even know about ars at the time). The last test was over 16 months out. I thought I was in the clear and had no reason to stress any longer. But I have a family member who has been HIV+ since the early 90's and every now and then I'll read up on recent advances/future weapons(Like KP1461 excited about that and hope phase II goes well)in this war. I just recently discovered that CVID can cause false negatives. I've read your past post and understand that this condition can be different from person to person. I have CVID and suffer on average 3 to 4 serious infections a year. So now I'm worried all over again.

These are my questions for you dear doctor

1. Which gammaglobuline does the standard EIA detect? I would assume IGg is the major one when we are talking about a blood test.

2. My IGg is at a count of around the lower 300s. I know the lowest normal range is considered 500. Is my IGg count high enough to give reliable test results using a Elisa?

3. Would a IGg subset deficiency play a role in testing?

I've been stressing about this since I found out. My wife gave birth to a beautiful baby boy about 7 months ago. She didn't get tested during pregnancy. She consented but the Dr. forgot to order the test. Didn't find that out until after my son was born and saw his paperwork. Now he's having a lot of infections and a cough that has gotten worse since 4 months old. We've tried allergy medicine and even a inhaler, nothing helps it just keeps getting worse. I'm so worried, he's my world. Thank you for your time Dr. Bob

Hi,

Yes, CVID can vary considerably from one person to another. That's why it's called "common variable immunodeficiency disease." Clever, eh? In folks with significantly altered immunoglobulin production, I would recommend a non-antibody-dependent HIV test, such as a qualitative HIV PCR DNA, for HIV screening.

To specifically address your questions:

1. Yes, primarily IgG.

2. Actually, this would depend on the sensitivity of the assay used. Consequently I would suggest you utilize an HIV-screening test that is not dependent on anti-HIV antibodies, such as an HIV PCR DNA qualitative test.

3. This would depend on the severity of the deficiency and which subsets were affected.

Regarding your son, his pediatrician should monitor him for problems with immunoglobulin production as well.

Good luck.

Dr. Bob