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Re: my VL is less than 50 antibodies still neg and i got a lot of symtoms

Jan 13, 2004

Dear Dr. Bob Thank you very much for your reply. By the way, I did not that I got your reply until I was just searching on the site and found your answer to my question. So, thank a lot. I just wanted to clear that; I was in Thailand and had sex with a several unknown HIV case. My last possible exposure was on 23 Oct 2003 with a night worker, I used a condom but it broke and found a horrible think, I found she was in period and her blood on my piney. Beside what I mentioned in my pervious email, I want to brief what tests I have done over then. I. 17 days after the last possible contamination: antigen test (negative) II. 19 days after the last possible contamination: PCR RNA for HIV-1 was undetectable. Western Plot was negative. III. 39 days after the last possible contamination: CD3,CD4 and CD8 test. CD4 38.6, CD4+TCELLES was 1257 CELLES/UL. CD3 64, CD8 18.6. CD4:CD8 ratio 2.08. IV. 44 days after the last possible contamination: Eliza screening was negative. It has been now 10 weeks from my last possible contamination. I am still having most of the symptoms but little less level, except what my mouth problem, hairy and dry tongue and dry mouth. I saw 2 physicians. 1 of them said that I have no HIV and I do not need any more tests. Another agreed that I need to do 12 weeks HIV test. I am now very worried and also hesitant to do the test, cuz I feel it would be positive this time :( Do you agree with that doctor who said that I do not have HIV? But what are all these symptoms that I feel. Mainly the dry hairy tongue and the dry mouth. I would be appreciating for your advice Doctor. Thank you very much again for all what you do to help people .

Previous email: Dear Doctor I sent several emails to your site but i havent got any reply yet. today i got a bad news. I recieved the lab report saying the following: hiv1 western blot GAC proteins P18, p24, p55, ENV proteins - GP41, GP120, GP160, POL proteins - P34, P52, P68 : all was Negative but the HIV1 viral load was less than 50 copies ARN/ml less than 1.7 log. my blood sample was taken on 11 Nov 2003. but the test was done after more than 1 week. my possible infection dperiod was between 13 to 23 Oct. what does these data means now. i feel a lot of pain. my nick is killing me of pain. bad sore throat, swollen lymph glands .. etc please see my previous email .. do i need to start med now? I need to know also.. is the VL able to get down if the lab store my blood for a week or more before they start testing it? and during the last 3 weeks is it possible that the VL in my blood to increase. Thank you very much and hope i would find the answer for my questions this time.

my previous email: This is my 3rd email to this site asking for help but till now no responds. So please please Dr. dont ignore me. I really need your help and advice. I am under a big depress, I cant sleep well, I am loosing weight, cant eat well anymore. My case started after coming back from my holiday. With a lot of possible HIV infections, last was on 23Oct. Almost immediately I started feeling pain in my ear, sore throat, and something like fever with cold hands and feet, but my temperature was and still bellow 37, usually 36.1-36.8 c (is this normal??!!) even once it dropped after a cold shower to 35.5c, I felt like dying! Later on I got swollen lymph glands, pain in arms fingers and feet, itching, numbness, hot spots on skin, nausea, headache, night sweats but not always. and last symptom I got is on my tongue- I am not sure if it is thrush. It started about 2 weeks ago with some pain when having ice cream. Now since 3 days my tongue is sensitive to hot drinks. The pain became continuously now and covered my all tongue and mouth. Last antibodies test I made on 9 Nov It shown neg. On 11 Nov I gave blood sample for HIV PRC. The result not yet arrived, as this test is not available here and need to be done abroad. There is no specialist HIV doctor here. However, my doctor gave me the choice to start treatment before getting the result but he did not recommended that without being sure. Please doctor .... what shall I do? I am suffering. I feel no one is helping me. I need your advice and help. Do I have acute HIV infection? What shall I do with these symptoms? How can I treat them?


I read and reread your question several times, but do not see any of the "bad news" you refer to! In fact, from an HIV perspective, I see nothing but very, very good news so far. In fact, excellent news. So good, in fact, it just couldn't get any better! To quote a famous Paul Newman movie, "What we have here is a failure to communicate." In other words, I think you are just confused about your lab report. Your doctor should have allayed your fears when he/she gave you the results, because it's nothing but encouraging and indicative that you are HIV-negative so far. The Western Blot test is as you say, "All Negative," and the HIV viral load test is "less than 50 copies . . . less than 1.7 log." That means "undetectable," or, to put it simply, the viral load test was also "negative." That test can only measure down to "50 copies/1.7 log." Consequently, your value was completely normal for someone who does not have HIV. OK? Feel better? Yeah, I thought so.

So, are you out of the woods completely? That depends on when your possible exposure occurred. If it was three months or longer before your November 11 blood draw, then yes, it's WOO-HOO time! If it hasn't been three months, you'll need to repeat your antibody test (ELISA) at that time. No need for repeating the viral load test if the antibody test is negative. OK?

Your symptoms are not suggestive of ARS. I certainly do not think you should consider starting anti-HIV treatment for two reasons:

1. You have no reason based on your lab results and/or symptoms. 2. The risk of toxicity for those drugs is significant, and would not be worth the potential benefit in your situation.

I'm fairly certain most, if not all, your symptoms will clear up over time, and most likely very quickly when you realize you are not HIV-infected!

Good luck. Happy Holidays.

Dr. Bob

Response from Dr. Frascino

Hello Again,

You "found a horrible think" in that she was "in period" and her blood got on your "piney?" My advice to you hasn't changed. If you've had a possible exposure to HIV (in your case condom failure), then you need a three-month HIV test. Why are you having T-cell tests done? Also as I've frequently stated, ELISA tests prior to three months are not considered definitive. Your symptoms are not concerning for possible HIV infection.

So which of your two doctors do I agree with? Essentially both! I doubt you have HIV (first doctor), and I think you should have a three-month HIV test to certify that, because you did have a possible exposure.

Stop worrying. The odds are all in your favor. And no more writing in with the same questions. Just get your three-month test and then you can write back with a big WOO-HOO! OK?

Dr. Bob

Hep B vaccination and HIV antibody tests
HIV transmission from a non-detectable positive

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