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Positve PCR at 83 count, and a few symptoms

Mar 27, 2005

My boyfriend is very worried and waiting for a second set of tests to come back. Two weeks after a having a few minutes of unprotected receptive anal sex with someone with no ejaculation, he had a Q-PCR test that came back postive with an count of 83. At the same time and again at 3 weeks he had negative results with ELISA. He has had no fever, but he has said he feels tired, has some headaches, some achy joints, and occasional upset stomach. I have been telling him that it may be a false postive, usually after 2 weeks the viral count should be very high. Now at 5 weeks he has gotten some red spots on his skin on his arms and torso (around 6 or 7 total). What is your assessment of the likelihood it was a false positive at this point? He is convinced he is HIV positive and I told him it is unclear, and could still just be stress. (I have had some of the same symptoms except the spots and am sure I am negative, so I attribute my symptoms to stress) The info I have found on the internet says that false positive PCR tests almost always have a low viral load count, but what about the reverse? How often does a low count mean a false positive? Are there many cases of low counts on PCR, negative Elisa that are true positives?

Response from Dr. Frascino


Your boyfriend's case is an excellent example of why I do not recommend PCRs for routine HIV screening and why I don't recommend testing prior to three months. His ELISA tests are encouraging, but not definitive. His PCR is most likely a false positive. It's important to note that 2% to 9% of people without HIV infection have false-positive results, virtually always with low RNA titers. By jumping the gun here, your boyfriend has increased his stress (and yours) and still has no definitive answer as to whether he's positive or not. He may be "convinced he's positive;" however, the statistical odds would argue against that. Only time and appropriate testing taken at the appropriate time will answer that question.

I wish you both the best of luck and hope our readers will learn from your boyfriend's mistakes unsafe sex is not worth the risk and taking the wrong tests at the wrong time can be far from helpful or comforting. I strongly urge against both practices!

Good luck.

Dr. Bob

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