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Am I Positive or Negative?
Jan 29, 2009

I have looked all over the internet for an answer to my question, but so far have not been able to find anything conclusive.

In May of 2008, I had a rapid HIV test done at a free clinic. The results came back positive, blood was drawn and sent off to the department of health. Both my ELISA and WB were positive. I went into a deep depression and did not seek further medical attention until January of 2009 (8 months later).

My doctor ordered a round of blood tests (Metabolic Panel, CD4/CD8, Hemogram, Lipid Panel, HIV-1 RNA, HIV1 Virtual Genotype).

Two weeks later, I returned to his office for my results, only to find out that my viral load was zero. He said he was unable to get the genotype results back as well because there was no detectable HIV to culture. My T cell count was 850. He then sent me for another HIV-1 and HIV-2 test (the same as was done by the health department). While waiting for those results to come back, I decided to take it upon myself to have another rapid test done. This test came back negative.

I have never been on medication. My last negative HIV test was in October of 2007.

My question(s) are: Can the body suppress viral loads without medication to the point of being undetectable? Is this common? Also, would my age (24) perhaps play a factor.

I do not think that I am HIV negative. In fact, I've resigned myself that I am positive until told otherwise.

Response from Dr. Frascino

Hello,

There are only two possibilities here:

1. Your May 2008 positive results were wrong (false positive or technical/clerical error) or

2. Your January 2009 negative test results are wrong (false negative).

The false-negative scenario is unlikely, as you had not only a negative HIV-antibody test, but also a normal CD4 cell count and undetectable plasma RNA viral load! In addition you had a second antibody test (rapid test), which was also negative. At this point the weight of evidence suggests you are indeed HIV negative and had a "false positive" initial test in May 2008!

To specifically answer your questions, yes, it is possible to suppress viral loads without medications. However, this occurs extremely rarely. Folks who have immune systems that can do this are called "elite controllers." You can read more about elite controllers in the archives. But please note the elite controllers, while having undetectable or extremely low viral loads, still test HIV-antibody positive! Therefore you don't qualify! As for your age, no, that would not be a factor.

If you've resigned yourself to believe you are HIV positive, you've come to the wrong conclusion! Write back when you get your HIV-1/2 results and we'll WOO-HOO together, OK? Also, your testimonial points out a very important lesson. You did not seek further medical attention for a full eight months after your initial positive test! As you can see, this was not a wise decision! Hopefully others will learn from your unfortunate experience.

Dr. Bob



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