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D'oh! An HIV Culture test?
Nov 6, 2003

Howdy Dr. Bob,

How are you? Here's an old tale, but with a new question. (At least I think it's a new question).

After a risky exposure and what my HIV specialist thought sounded like ARS (bleeding easily, stiff neck, body aches, fever, night sweats, ear infection, severe upper respiratory infection, coated tongue, folliculitis, subborhic dermatitis,pharangitis, persistent dry cough, strange new "moles" on my skin, etc). He conducted a variety of tests about 10 months after exposure. ELISA, WB, RNA/bDNA Qualitative/Quantitative, HIV antigen test. All these tests came back negative.

So he ordered an HIV culture test, which he said would provide evidence as to whether there was even ONE copy of HIV in me. This culture also came back negative.

My questions: What is an HIV culture? How would an HIV culture test provide evidence as to whether or not there is even ONE virus in me? If an HIV culture is an even a better measure of a patient's possible HIV infection, why not conduct those tests, rather than the PCR's?

My HIV specialist has no explanation as to what happened to me. He said it sounded like HIV infection or the Mediterranian flu. So I'm WHOO HOOING, but I'm still scratching my head.

Muchos Gracias, Dr. Bob!

Response from Dr. Frascino

Dear D'oh!

HIV culture, formally termed peripheral blood mononuclear cell co-culture for HIV-1 isolation, is a very labor-intensive laboratory test that was used initially to establish HIV-1 as the causative agent of AIDS. There are also quantitative cell cultures and quantitative plasma cultures. None of these culture techniques is used very much anymore, as they are expensive, difficult to perform, and labor intensive. Basically, these tests try to measure virus or virally infected cells. The ELISA and Western Blot tests measure antibodies. Antibodies are specific proteins made by the body's immune system that are directed against HIV. Antibody tests and viral load testing by PCR are now the preferred methods for testing for and monitoring HIV infection.

Should you WOO-HOO? Yes. All of your HIV tests are negative. I can't tell you what caused your symptoms, but I can tell you what did not HIV! Stop scratching your head. People will think you have lice!

If your symptoms have all subsided, it's time to "fuhgetaboutit!" If your symptoms are persisting, consider seeing an infection diseases specialist. Yes, it could be a virus or other infectious agent, but it is not HIV!

Dr. Bob



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