Feb 4, 2009
Dear Dr. Bob,
I am disappointed you were not able to respond to my earlier question regarding the positive PCR RNA and negative antibody.
I dont know if it is because you are fearful of posting a reply due to adverse reaction of readers or because you dont believe me.
I have not slept or eaten for 24 hours. But the situation looks grim. All I wanted was your opinion and support in the matter.
Response from Dr. Frascino
Why would I be "fearful of posting a reply due to the adverse reaction of readers . . . ."???? Don't be ridiculous. I'm here to provide information and offer sound science-based medical advice. What readers do with that information and advice is up to them.
Next, your initial question was posted less than 24 hours ago! I have answered it (see below). Your expectation that I can respond within nanoseconds to every question that crams its way into my inbox is unrealistic. There is only one of me and gazillions of "yous." I get literally thousands of questions from throughout the cyber-universe on a daily basis. I can assure you the vast majority are also written by folks who are equally scared as you.
Your anxiety, not sleeping, not eating and unreasonable expectations of this forum are not going to change the results of your HIV status. I suggest you calm down and follow the advice I've already provided.
So Scared..... Feb 4, 2009
I was just informed that my qualitative HIV PCR RNA test was positive and my antibody was negative. They said they saw signifcant level of HIV.
My only exposures were Jan 1 and Jan 18. The former where I received multiple unprotected blowjobs and the latter the same, but I als engaged in deep kissing with cuts in my mouth and some rubbing. She did play with her vagina so perhaps she also had some fluids on her hands. I dont know but I thought the risk for this was non-existant. I did also use a clotrimazole and steroid cream on my penis for 4 days before the second episode due to a fungal infection so maybe the skin was compromised. And she did use cocaine on her tongue. So many variables, so I dont know what the risky part was.
Bottom line is that my hopes are now pinned on the PCR result being a false positive. What are the chances in your opinion?
3 days after the second episode I did experience ARS symptoms like nausea, pain in the groin/armpit/neck, feeling unwell, and stomach pain the first day. I also think I lost weight cause I was eating so much junk and losing weight. I attributed this to a reaction with the doxy and cefixime I was taking at the time.
I thought the risk was very low and the ARS symptoms started too early. But it looks like I was wrong?
Response from Dr. Frascino
Despite your many variables, your HIV-acquisition risk would still be considered low. Why was an HIV PCR RNA test ordered? It's not recommended for routine HIV screening. (It can be helpful in selected cases where there is strong clinical suspicion of active seroconversion. In this case the HIV-antibody test could still be negative.)
Regarding HIV RNA PCR tests in general, false-positive tests occurred in 2% to 9% in some studies. False positives are most commonly seen at low viral load titers (less than 10,000 copies per milliliter). The sensitivity of RNA PCR approaches 100% in confirmed cases of acute HIV infection. The specificity of the test is 97% but improves to nearly 100% when the viral load is greater than 10,000 copies per milliliter.
If you're freaking out about your results, see an HIV specialist physician. He should be able to sort out the confusion most efficiently. Write back and let us know how this turns out. And please include the results of your follow-up tests.
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