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Is my HIV undetactable

Mar 22, 2008

I have had protective vaginal sex 1 year 9 months back. I had repeated Elisa and Western blot tests after 4 months and 6 months and 11 months. All we negative, but the Elisa value was increasing from 0.23 to 0.45 to 0.7 but all were less than 1 so the report said negative. But the 11th month Western Blot came back positive on P55 and the rest of the bands were negative. So the doctor asked me to go for a DNA PCR for HIV 1 and 2. It came back negative. I was relieved and due to my educational loan I was aksed to take a ELISA again, thank god it came back negative. But throughout these 2 years I had these lessions on my lips and in the inside of the mouth and I also have very tiny warts on the back of my mouth ( which came 2 weeks after exposure and never went away). Recently I started feeling weak ( and having diarreha). I am not able to concentrate on my studies. I am also having small pimple sort of warts all over my upper body. They come and go. I am feeling so sad and down that I feel like I am dying slowly. My dad knows of my condition and he was very supportive but I cant share the new developments with him. Help me :(

Response from Dr. Frascino


Protected (not protective, by the way) vaginal sex is indeed "protected" if the latex condom was used properly and did not fail.

Whoever is ordering your HIV tests isn't doing you any favors!!! Western Blot tests should only be run as confirmatory tests after someone has a repeatedly reactive (positive) ELISA. If the ELISA is negative, a Western Blot should not be done! Period! Your case clearly demonstrates exactly why it should not be done. Western Blots without a positive ELISA can produce indeterminate or false-positive results! That's exactly what happened to you. The next mistake was ordering a PCR test. HIV PCR tests are not recommended for routine HIV screening for a variety of technical reasons and cost.

Taking the total of all your HIV tests, there is absolutely no doubt you are definitively and conclusively HIV negative. No additional HIV tests are recommended or warranted. You've had far too many already. Whatever is causing your symptoms, one thing is absolutely certain: It's not HIV, OK? I'd suggest you show this post and my response to your dad. If you are having problems with warts and other skin problems, see a dermatologist. These issues can be easily treated. I also believe you are clinically depressed. ("I am feeling so sad and down that I feel like I am dying slowly.") Counseling may well help.

Your situation is not unique. Others have also been turned into nervous wrecks by having inappropriate HIV tests ordered and their results misinterpreted. (See below.)

Good luck. Remember, HIV is not your problem. No way. No how.

Dr. Bob

Hello Nervous Wreck,

Agreed: Unprotected sex does place you at some degree of risk for STDs, including HIV. And testing is warranted.

However, your current physician is certainly not doing you any favors and please feel free to let him know I said so. He is ordering improper tests at improper times and not interpreting the results correctly!

First a few facts:

1. The proper test for HIV screening is an HIV-antibody test (ELISA, rapid test or equivalent). If this initial screening test is repeatedly reactive (positive), then and only then should a confirmatory Western Blot test be ordered.

2. HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive.

3. HIV RNA PCR tests are not recommended for routine HIV screening, due to the rate of false-positive results, other technical considerations and cost.

That said, you've had a number of tests run inappropriately. Your two ELISA tests (11 days and 8 weeks) are both negative. This is encouraging, but not definitive. The Western Blot with a single p24 band is not interpretable, because it means nothing without a preceding positive ELISA. The negative RNA PCR is an inappropriate test, but nonetheless is negative.

I see no reason for a lump in the throat or concern based on your laboratory tests to date. What is of concern is your current doctor's competence (or lack thereof) in appropriately screening for HIV disease!

Here's what you need:

1. An ELISA (or rapid test) at the three-month mark. If negative, get a follow-up ELISA (or rapid test) at six months. If that remains negative, you have definitively dodged the HIV bullet.

2. If your three- or six-month ELISA or rapid test is reactive (positive), get a follow-up confirmatory Western Blot.

3. A more competent physician!

Good luck!

Dr. Bob

Doubting Republican still doubting everything.
Abstience vs education and condoms

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