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I bit a mugger and got blood in my mouth
Aug 17, 2003

Please help. While out with my wife one evening I was attacked by a mugger who looked like a drug user. To make a long story shorter, I bit the attacker to avoid being choked. I got a lot of blood in my mouth. I got a sore throat two days later and a doctor gave me a penicillin injection for laryngitis. I am in fear of the possibility of having contracted HIV. Since then I took five combo tests. The tests consist of both a PCR test and an Elisa test on the same blood draw. The tests were performed at two weeks, four weeks, six weeks, seven weeks and nine weeks after exposure. The PCR DNA QUALITATIVE tests are manufactured by Roche and are supposed to detect as little as ten copies per ml. All results were negative. The first two combo tests were done by LabCorp and the last three combo tests were done by Healthline in Burbank CA. The labs informed me that the tests are extremely sensitive and that my results should be considered conclusive, expecially since I took five PCR DNA qualitative tests and each was combined with an Elisa. Both labs also mentioned that the PCR tests present more of a danger of false positives rather than false negatives, and they are supposed to be conclusive after 28 days. I figured that by repeating the tests, I have minimized the possibility of innaccuracy. I have learned that in rare cases the HIV virus can be undetectable in HIV infected people even without any meds. But in these rare cases, wouldn't these people have had to produce detectable antibodies in order for their bodies to have controlled the virus. So in my case, if I were one of these people who is infected but has an undetectable level of virus because perhaps my body was able to control it, wouldn't I have a detectable amount of antibodies that would show up on an Elisa test? Or is it possible for a person to control the virus down to an undetectable level without the presence of a detectable amount of antibodies? From what I've read, the antibodies are a result of immune response and they would have to be present in sufficient numbers in a person whose body is controlling the virus down to an undetectable level. I also read that the virus takes only a few days to replicate to large numbers. Please help me. My wife and I are terrified. I do plan to retest with the Elisa at the three month window period, but in the meantime I am consumed with fear. Thank you for having this forum!

Response from Dr. Frascino

Hello,

You took 5 PCR's and ELISA's within 9 weeks? Why? Who is ordering all these unnecessary tests? It's a waste of your time, money, and blood! All you needed was a single ELISA at 3 months. The chance of contracting HIV from chomping on the would-be mugger and getting some blood in your mouth is extremely low. No, you are not "one of those people who are infected, but has an undetectable level of virus because perhaps your body was able to control it." What you are apparently unable to control is your overactive imagination.

Yes, I agree that PCR's have a higher rate of false positives than ELISA's do. That is why we don't recommend them for initial screening. They are, however, extremely sensitive and your 5 negative tests are indeed definitive (and excessive).

I'm quite convinced your only problem is being "consumed with fear." I strongly recommend you seek some counseling to help you cope with these fears, as they are totally unwarranted.

Dr. Bob



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