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pcr necessary?

Mar 5, 2008

Doctor I know it sounds weird but I have to make it clearer. In 1998 I had a boyfriend who found out to be HIV positive. I had unsafe sex with him for quite some time. I was the top always. Anyway, I had ELISAS after 2nd, 3rd and 6th months after last risky sex. All negative. At the 6 months mark the blood checking took 1 day longer to be done and I asked a friend who worked at the laboratory and he said that one of my ELISAs was indeterminate (gray zone) and the other one was negative so they did it again in duplicate and both ELISAs came back negative - thats why my results were finally negative. I would never known this fact if I did not have a friend working at the place. OK, for all these past 9 years Ive been taking tons of ELISAs and even a WB, all negative. The last one was 4 days ago. Negative again. BUT, my blood count always shows some lymphocytosis which is getting some worse each time I take it. Right now I have 7600 leucocytes with 59% of lymphocytes. I have genital herpes outbreaks rarely which I manage with acyclovir just fine. I keep thinking that this lymphocytosis is a sign of body fighting against some virus. Odd things: my herpes serology is negative either IgM and IgG. Lymphocytes Immunophenotyping shows total lymphocytes of 4552 with 55.2% of CD3 (2513), 37.7% CD4 (1716), CD8 14.9% (678) BUT CD19 39.7% (1807). So, my lymphocytosis is due to high B cells count. PLEASE, would it be a reason to worry about HIV? My thought is: if I have herpes and dont produce antibodies for that plus high B cells count - would my body be fighting against hiv and not producing specific antibodies related to hiv? I have antibodies (IgG) to other infections I had in the past like Hepatits A and my body produced anti HBsAg after Hepatitis B vaccination normally. I also have Epstein Barr IgG positive and Toxoplasmosis IgG positive (so my body works fine for these patogens).Im so worried doctor. I dont want to take HIV pcr due to possible false positives which could drive me crazy. I need your help as an immunologist. Thank you so much and sorry for such a long question.You help people so much. I have donated although it has nothing to do with answering or not. God bless you.

Response from Dr. Frascino


To answer your primary question is a pcr necessary? No!!! Absolutely not!!!

How unfortunate that you had a friend who worked in the laboratory where your ELISAs were performed! That circumstance and your misunderstanding of HIV testing assays has led to nine years of completely unnecessary worry and "tons" of unwarranted HIV tests!

Let's start at the beginning. Your negative HIV tests out to six months after your last possible exposure are definitive and conclusive. HIV is not your problem. No way. No how.

An indeterminate ELISA followed by a negative ELISA indicates a definitive negative result! I can't say it any plainer than that. That you worried about what amounts to nothing more than a technical glitch in the testing assay and that no one explained this to you is indeed unfortunate. That you then spent nine years testing with countless unwarranted HIV tests and multiple inappropriate immunological studies attempting to draw conclusions to explain your technical glitch is tragic! I urge you to stop testing and stop perseverating on a disease you could not possibly have. Your immune system is functioning totally normally. Your current problem is psychological/psychiatric. I urge you to seek counseling with a qualified psychologist or psychiatrist to help you confront your totally irrational HIV fears. Bring a copy of your question and my response to your first visit and show it to your therapist. It will help focus your treatment. You are HIV negative. This is wonderful news. How you choose to live with this reality is up to you. You've wasted nine years, not to mention blood, money, time and countless anxious hours worrying about a nonexistent problem. I urge you to get the help you need, not more unwarranted tests that you absolutely do not need.

Good luck.

Dr. Bob

Myelodysplastic/stem cell transfusion
should i get retested?

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