HIV Testing with Immune Deficiency?
Dec 15, 2007
I wanted to ask a question (I think this is the most relevant forum to ask it in) about HIV Testing. I found a couple of similar questions on this forum, but my situation is a bit different so I thought I would ask again... I am an immune-compromised 20 year-old gay man, and have been living with hypogammaglobulinanemia since I was diagnosed 6 years ago. I get intravenous IGG infusions every 5 weeks and my condition is fairly asymptomatic (and, surprisingly to my immunologists due to the fact that it is quite severe, always has for the most part been so). However, I have made a number of stupid mistakes over the past couple of years, having unprotected receptive and insertive anal sex with a number of partners. My immunologist told me that due to my condition, the antibody test would most likely not be effective as I do not naturally produce enough antibodies for it to be accurate.
My question is this: I have seen a number of answers on this site and also heard a number of answers from different doctors. What test should I get in order to determine my HIV status? Who should I ask to do this test (my immunologist, my physician, my health professional at my college, the county health department, etc.)? What is the likelihood that it would give a false positive or negative?
I have attempted to get a test for the actual RNA multiple times over the past year, but because I wasn't sure specifically what to ask for, half of times I've been given an antibody test anyway, and the other times I wasn't really sure exactly what test I was given. Thus, any insight you could give would be amazing. Thank you so much in advance!
Response from Dr. Frascino
I agree with your immunologist: Tests that rely on production of specific antibodies would not be accurate in someone with hypogammaglobulinemia severe enough to warrant IVIG infusions on a regular basis. I would recommend an "HIV DNA PCR Qualitative Assay." This type of test detects cell-associated proviral DNA. It is not FDA-approved for this use, but in your situation it's probably the best option. HIV RNA PCR tests are quantitative viral load tests. The false-positive rates are between 2% and 9% and occur usually at lower viral titers (less than 10,000 copies per milliliter). As for whom to ask to order this test, I would suggest your immunologist, as he is the most likely to have a good understanding of the tests and their various limitations. You can show him a copy of this post if you feel it would be helpful.
Finally, remember "stupid mistakes" can be easily avoided by a thin piece of latex!
Get Email Notifications When This Forum Updates or Subscribe With RSS
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.