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Questions about Viral RNA tests
Jun 28, 2005

Hi R.J.

I thank you immensely for your input on this website. I have turned to your comments when questioning my HIV status. I had a relatively low risk experience about a year and a half ago. I gave oral sex to a man of unknown status and he then stuck his finger in my anus and gave me oral sex. Im sure he had his own semen on his finger when he did this. By the way, this was in Italy. The following day, my lymph nodes were painful and swollen and in the weeks following, all my axial lymph nodes swelled up and were painful. Since then I have developed recurrent mouth sores, fatigue, occasional fevers, night sweats, diffuculty swallowing, and a white coating on my tongue. I have had four ELISA HIV tests since then, the last at 9 months following the experience. All came back negative. I had blood work done, and I didnt get an lymphocyte subpanel, but my lymphocyte differential % and absolute were all in the normal range. Should I be worried about HIV at this point? Should I get a Viral RNA test to confirm my HIV status? My concern are my symptoms and the fact that I had lymphatic swelling immediately following the experience. Also, the guy wanted to have anal sex without a condom and was a little sleazy (I was young and dumb, I have since learned). Do you think I should be concerned? Does the fact I was in Italy and on a boat to Africa play anything into this? Are HIV antibody tests in the USA accurate for possible African serotypes?

Thank you for your help... also, my life now has dramatically improved from that time and I want to donate to your foundation. Tell me how.

Thanks, C

Response from Dr. Frascino

Hello C,

Lymph node discomfort and swelling the day following a potential HIV exposure would not be due to HIV infection. It just doesn't happen that quickly.

Four negative ELISA tests out to nine months are considered definitive and conclusive. I see no reason for viral PCR RNA testing or any additional HIV testing, for that matter.

That your partner may have been sleazy and willing to bareback isn't all that important. What really counts is how risky your specific sexual activity was. In your case, I agree it was low risk. I can't comment on your question related to serotypes, as I don't know exactly what type of ELISA test you actually had performed. Certainly most FDA-approved antibody tests would provide accurate results for those having Italian fun in a boat en route to Africa. (This sounds like a great vacation trip, by the way!) Consequently, I do not feel your HIV worries are warranted.

Donation information for my foundation is available at the Foundation's Web site at www.concertedeffort.org. Thank you for your willingness to help others struggling with the challenges of HIV/AIDS.

Stay well. Stay safe.

Dr. Bob



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