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A question from the third world ( no hiv couselling available here).
Jul 19, 2009

Dear Dr. Bob, I am from very poor country, Nepal. My 5 antibody hiv1/2 elisa tests were ve out to 22 months (5,15,18,20,22months) after an unprotected sexual exposure. But the dark purple lesion with darker ring around it on my shin bone (left leg) hasnt disappeared since 6 months. Test for Kaposi, and microorganisms were ve (no test was performed for herpes). Chlamydia, hepatitis were also negative. Now I have got small lumps on palm and feet; on and off red rash (bisymmetric) on my chest, indigestion and frequent sweats on the cleft of anus. Due to these worrisome symptoms, I took HIV DNA PCR qualitative on 22nd months- it was negative. My question is, 1. Is it possible that hiv virus can hide into lymph nodes and other organs in the body after 22nd months with the decrease in viral load in blood to such an extent resulting in negative PCR DNA test (without hiv medication)? 2. Also, my lab report says there is no significant change in my differential lymphocyte count CD4/CD8 which was taken at 20 months. Can CD4/CD8 ratio remains normal after that many months post hiv-infection? My doctor told me that there are documented cases of hiv seroconversion after 3 to 12 long years in the past. He was reluctant to advise me for hiv testing for some more months when I said 6 months is the longest window period according to "The body" web-site. He made me really worried. Please help me.

Response from Dr. Frascino

Hello,

Your repeatedly negative HIV-1/2 ELISA tests out to 22 months plus your undetectable HIV DNA PCR qualitative test at 22 months from the time of your potential exposure are definitive and conclusive. HIV is not your problem. No way. No how. Responding to your specific questions:

1. No.

2. Your negative test results are absolutely conclusive. No further HIV testing is warranted. There is also no reason to order a CD4/CD8 ratio! Yours is predictably completely normal because you don't have HIV!

Be well. Stop worrying. Stop testing.

Dr. Bob



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