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false negatives??
Nov 12, 2003

Hello Dr.

My ex-boyfriend is lying in a hospital with pneumocystis and has been placed in an artificial coma...Evidently he has AIDS. It is very tragic. I have two questions. He got tested every year and the results were negative every year, including last January. Is it really possible that he could have been infected within the last 10 months and that it progressed to AIDS so rapidly? (I should add that he was suffering from serious depression and claimed he had more or less no slept since May)...my second question is probably ridiculous concern for myself: I haven't been together with him for five years and I was tested again nearly two years ago (thus three years after our last physical contact) and the test was negative...But given the fact that he tested negatively too and now has AIDS, it has me a bit paranoid about the accuracy of these tests (the tests were the ELISA variety, sent away to labs and one had to await the results for a few weeks). My test was conducted at a different lab than his....and finally for all of those reading this, please say a prayer or guide your spirituality toward Thomas who is really in need right now..Many thanks

Response from Dr. Frascino

Hello,

This is a difficult question to answer without having much more information. Is it possible to contract a very aggressive strain of HIV and rapidly deteriorate to full-blown AIDS with an opportunistic infection, such as PCP (pneumocystis carinii pneumonia)? Yes, it's possible, but extremely unlikely, unless he had other concurrent problems leading to immunosuppression or immune-deficiency. Depression or lack of sleep alone would not cause this. Second, it's important to point out that pneumocystis carinii pneumonia is not limited to HIV/AIDS. It can occur in any condition that causes profound immunosuppression or deficiency.

Next, what about the negative HIV tests? Are you sure they were really negative. Perhaps he was not being completely honest with you about his results. Yes, a false-negative test is always a possibility, but multiple false negative tests are essentially impossible.

So what really happened to Thomas? I really can't tell you from the limited information I have. The answer would be found in his old medical records, his past laboratory tests, and evaluation of his current viral strain (if he is indeed HIV-positive).

Regarding your second question, you tested HIV-negative 3 years after your last physical contact with Thomas. That result is considered definitive. If you are concerned about unusual circumstances, you can talk to Thomas's HIV specialist. Without breaking any patient-physician confidences, he will be able to tell you if you need any further testing or evaluation. This, by the way, would be extremely unlikely.

Our thoughts are with Thomas and everyone struggling with this scourge. Give him a hug from us all.

Dr. Bob



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