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OCCULT INFECTION
Nov 20, 2006

Hello - you have helped me in the past, but I still have some questions about my test results and I hope you can clear up my worries. My exposure was unprotected sex in Nov. 2004. Since then my symptoms have been RUQ/LUQ pain, dry eyes, dry mouth, white tonguethis list goes on and on!!!! My questions have to do with my test results. Please can you check them out and give me you opinion..

April 05 HCV elisa weakly positive RIBA test negative Sept 05 HCV elisa negative s/co 0.2 range 0.0-0.9 June 06 HCV elisa negative s/co 0.3 range 0.0-0.9 July 06 HCV elisa negative s/co 0.2 range 0.0-0.9 Aug 06 RIBA test negative Aug 06 HCV RNA PCR Qualitative test negative Oct 06 HCA elisa negative s/co 0.2 range 0.0-0.9

Liver function tests (ast/alt) Sept 06 AST=20 ALT=18 June 06 AST=21 ALT=20 July 06 AST=18 ALT=19 Sept 06 AST=20 ALT=17 Oct 06 AST=17 ALT=18

HIV 1 tests all negative out to 2 years (at least 10 tests) HIV 2 test out to 2 years negative (just 1 test)

Here are my questions that I forgot to ask in my last post. I am SOOO afraid that I have HIV/HCV based on my symptoms. I have read about Occult infections where the virus never shows up in your blood but you have it. Do you think that I should worry about that?? What does the s/co ratio mean?? Why is there a number (0.2) if my test is negative??? Shouldnt it just be negative?? Im starting to wonder if I have had this occult infection for years and no tests are picking it up!!! I believe that I may have progressed to cirrhosis now because I have read that AST higher than ALT may indicate cirrhosis. I also have a red spot on my nose which my dermatologist said was spider nevi but that I shouldnt worry about it because normal people get those as well. Dr Bob am I going crazy?? I like my doctors but I think that there missing out on whats going on with me!!! All my doctors say that I am perfectly healthy besides my obsessing about theses diseases. Please help me out, I know you helped me before but I REALLY need you one more time!!!! I do not drink very much at all & I do not do any drugs. I have had ultrasound, endoscopy & colonoscopy which all came back just fine. Do you think that there is any way that I have HIV or HCV???

Please help me one last time!!!! Your friend Jason

Response from Dr. Frascino

Hello Jason,

You "hope" (I) can clear up (your) worries???" I doubt that I can, considering "all (your) doctors say that (you) are perfectly healthy" and I agree with them as far as HIV and HCV are concerned. However, I do not believe you are healthy psychologically. Your fears are totally unwarranted and completely irrational. How many negative tests and how many doctors telling you that you are "perfectly healthy" will it take for you to accept the overwhelming and irrefutable evidence that you do not have HIV or HCV????? No, Jason, I don't believe I can clear up your worries, but a good psychiatrist or psychologist might be able to help. I suggest you seek one out without delay. Bring a copy of this post and my response to your first visit. It will help focus your therapy.

I'll respond only very briefly to your specific questions, as they really have no relevance to your true problem.

1. Should you worry about occult infection? No.

2. S/co ratio is a technical term: "sample to cut off" ratio refers to a technical aspect of how the test assay is performed.

3. Negative is negative! The range of negative results for this test assay includes values up to 0.09.

4. "Shouldn't it just be negative?" It is just negative!!!

Time to get a grip on reality, Jason. You've wasted far too much time, energy, blood and money on a problem that doesn't exist.

Dr. Bob



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