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False Positive
Sep 28, 2008

Hello. First, I would like to thank you for a great website. Your content, ease of use and dedicated honest questions i'm sure have helped thousands in the understanding of HIV/AIDS.

In February of 2006, I went to a local clinic to get tested for HIV. My HIV occurance happended sometime in the month of January/Early February of 2006. I had flu like systems in February of 2006. On March 9, 2006 the local health department called me to let me know my result was positive. The RNA test had returned positive, while the elisa test returned negative. They immediatley provided care at the doctors office and they began me on Sustiva/Truvuada.

I have now been on Sustiva/Truvada (switching over to Atriplia) from March of 2006 to the present. My cd4 count was 500 with a viral load of 20,000. The following month, of April, 2006, my viral load was undetectible. My viral load has always remained undetectible with a cd4 count averaging 600.

This week, I went and got a oralquick HIV test just (09/23/2008) and the test result was negative. Confused, I was.

To confirm, I went and got another HIV oralquick test on (09/25/2008) which I made they perform two tests on me at the same time. Both of those tests came back Negative.

My question of disarray is i'm positive or negative?

I do not know if the treatment center ever did a confirmation test on me. I always assumed they did.

Additionally, could of the medicine, for lack of better words, "cured" me?

Why was there a viral load in the beginning and a lower than my average of CD4 count?

Thanks for your assistance.

Response from Dr. Frascino

Hello,

A clinic told you that you were HIV positive based on a PCR RNA test that showed a low HIV plasma viral load and a negative ELISA test!!! YIKES!!!! I can only assume that the clinic felt you were undergoing acute retroviral syndrome (ARS) and were still within your window period (defined as the first three months after primary HIV infection). That is the only scenario that could account for their advising you that you are HIV positive despite having a negative ELISA. However, because HIV PCR RNA tests have a significant rate of false-positive test results, especially at low viral loads, they certainly should have followed up with confirmatory HIV-antibody tests once you were out of your window period. That you have now have had three separate negative rapid tests out three years from your "diagnosis" indicates your initial HIV positive diagnosis may have been (and probably was) wrong. I would strongly advise you have an evaluation with a competent HIV specialist to sort this situation out definitively. If you need help locating a certified HIV specialist physician in your area, check the American Academy of HIV Medicine's Web site at aahivm.org. There you will find a roster of certified HIV specialists listed by locale.

Could the medicine have "cured" you? No, unless you believe in miracles. The much more logical explanation is that your initial HIV PCR RNA was a false-positive.

Write back and let us know how this all settles out. It's an excellent lesson for our readers and a clear demonstration why I consistently advise that HIV PCR RNA (or DNA) should not be used for routine diagnostic screening!

Good luck!

Dr. Bob



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