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Ive Got A Whopper For You
May 2, 2003

Dr Bob, First let me tell you what some many have said in the past: "you are an amazing person. You impress us everyday with you compassion, passion, knowledge, and of course HUMOR"

NOW FOR THE WHOPPER:

I find the hardest part of your job here is getting people to believe their 3 month tests. Many times people ask questions about symptoms and if these symptoms warrant more test (you know swolen lymohnodes, sore throats, ect). Most the time you say that the three month test is accurate and "that their symptoms dont concern you" (meaning their symptoms arent indicative of HIV ARS) Question: Do people write symptoms such as extreme night sweats, thrush, dry cough, hospitalization weakness, or shingles that you believe would warrant more testing.

The reason I ask this is because I had somewhat of a risky experience and found I truly experienced a mind blowing illness that sent me to the hospital. Ive tested again and again out to 7 months and just wanted to know if you ever do recommend continued testing.

If you answer this WHOPPER many people might say "OH NO ARE YOU SAYING I NEED TO TEST MORE" so I would understand if you let this one go unanswered.

I hate to admit it but I tested PCR DNA -ve as well at 4 months- and was wondering if that would rule out infection as did the 3 month test?

I send you love brother!!!!!

Response from Dr. Frascino

Hello Love Brother,

You've "got a whopper for me"???????.....I bet you say that to all the boys................

Well, you sort of answered your own question. Lots and lots and lots of folks (more than you can ever imagine) write to me daily with lots and lots and lots (more than you can ever imagine) symptoms. My advice remains the same. Your "somewhat of a risky experience" would most likely warrant only a 3-month HIV test. That would absolutely confirm whether or not you contracted the virus. In your case, as in the vast majority of cases, due to overwhelming statistical odds, you were negative. That should have been your WOO-HOO. Additional testing would continue to give negative results, because you dont have HIV. Hence, your testing "again and again" gave you continued negative tests. The PCR-DNA at 4 months is just overkill, and again, reconfirms exactly what we knew with the 3-month antibody test. Some exposures, and Im not speaking of the "somewhat risky" variety, require testing out to 6 months. These would be classified as significant exposures, like mine, for instance sustaining a hollow-bore needle stick and laceration while treating a person with advanced-stage AIDS or receptive anal and/or vaginal unprotected intercourse with a partner known to be HIV-positive.

No, Im not at all worried about frightening folks into thinking they need additional HIV testing. The recommendations have remained the same. What folks do with that information is up to them. Dont you wish you believed your 3-month antibody test? Just think of all the extra anxiety it could have avoided, not to mention the cost and getting stuck for all those unnecessary blood tests. Futilely chasing a nonexistent illness (like HIV) often leads to a delay in diagnosing and treating the real medical problem, whether that is psychological or physical. Luckily, eventually common sense prevails and folks find their way to the obvious truth, hopefully well before they run out of money from excessive and unwarranted testing or before they drive themselves totally "round the bend," (crazy) as they quaintly say in Australia.

Stay well, Dr Bob



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