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33rdday Elisa, CD4 and RNA accurate?
Jul 29, 2005

Hey Dr. Bob. I have got to tell you, you are a true inspiration to all. Not just those who are HIV+ but everyone who needs to overcome something trying in there life. I have been sitting here reading you posts for about an hour and then read your Bio. WOW. 1) You are freakin hilarious, and 2) I admire you for your accomlishments in the HIV field. Well anyway here is my question. 3 days after a "technically" low risk activity (recieving oral to ejaculation, and giving for 2-3 sec without)with someone Im pretty sure is HIV+, I developed a eye problem that 2 ER visits and 3 eye doc visits could not figure out (swollen eye with double vision). Well that lasted for about 1 1/2 weeks. After that I had a fever, swollen glands in my neck, rash on my back, SEVERE itching all over my body, 2 nights of night sweats (just head and upper chest though)I had leg pain 1 week and 3 days after exposure so bad it hurt to walk, a cold sore developed (1st one in 2 yrs) and I had an 2 oral ulsures'. I went to see my doc at day 33 after exposure and he did a full work up. Full CBC, STD screen, ELISA (I don't know what gen.) a CD4 count and a viral load test. My CBC came back normal, STD screen (syph, gohn,clam) all came back negitive, ELISA was also negitive. A week later my CD4 and viral load came in. CD4=881 and my viral load was undetectable. That was 3 days ago and Im still having symptoms. Are these tests conclusive? I will go to the local health dept at 13 weeks and get tested but Im still concerned.Have you ever heard of anyone having all these symptoms (confirmed by my doc) and not have a viral load, or lower cd4 count? Thank you for all your advice on this site, you are GREAT!

Response from Dr. Frascino

Hi,

Welcome to the Forum. Sorry it's under such trying circumstances, but hopefully this reply will alleviate any lingering doubts.

Have I ever heard of someone having symptoms like yours plus a negative 33-day ELISA, undetectable viral load, and normal CD4 count, who turned out to be HIV positive? No, I have not!

In general, PCR (viral load) tests are not advocated for routine HIV screening due to a 2-9% rate of false-positive results. These false-positives usually show low-level viral loads (less than 10,000 copies). Consequently, at high viral-load levels, as would be expected with someone experiencing symptoms associated with acute HIV (ARS), this type of testing becomes a more valid indicator of infection. It can be quite useful, therefore, in diagnosing acute HIV when testing symptomatic individuals in the period before detectable levels of anti-HIV antibodies become present, i.e. during the window period. Consequently, I would be very encouraged with your test results to date. Whatever is causing your symptoms, it is not HIV. This would also be expected in light of the fact your HIV-transmission risk was low.

So even if you don't have HIV, you can still visit this Forum for a smile from time to time, OK?

Good luck!

Dr. Bob



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