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I BEG on my KNEES and ask your help...Will donate $50 and need your opinion on Reliability of Tridot (screen test) done in Mumbai, India. (PCR TESTS SHOULD NOT BE USED FOR ROUTINE HIV SCREENING, 2009
Aug 30, 2009

Dear Doctor, I have already written to you for about 5 times and will keep doing till I get your opinion on my questions please Doc......I am 27 years old guy from India and will definately donate $50...this is the max that I can afford. Comming on to my question....Sir please do reply...

I had unprotected (not such agood thing on my part) sex with a prostitute. Therefore, got tested in the week 14...the test done was Tridot (screen test) and to my great relief the result was negative.

I had fever and diarrhea for a couple of days in the week 15 and in the week 17 I had a few rashes on my back n a few other body parts. On checking with the doctor he advised that it was scabies rashes...I read a few articles over the internet and came to my knowledge that people with scabies have very high percentage of testing positive if they opt for HIV test.

Therefore, I got myself tested again in the 18....the test done was Tridot (screen test) and once again the result was negative. But the doctor who took my blood test advised that Tridot (screen test) are 100% accurate if done after 6 months. ....so based on the above I have a few queries which can only be resolved thru your views....

1) Can I rely on the results of the 2 Tridot (screen test) test that I got done in week 14 and 18.....if yes, this means I am safe.

2)Or should I go by what the doctor advised..and get myself tested again in 2 months.....if yes, is there any specific test that you may advise.

3) Is there any test that I can do right now instead of waiting for another 7 weeks...

4) Also, is there any reason for me to believe that test done in week 18 could be wrong as I started to have flu like symptoms from week 15 (fever and diarrhea.....rashes(still on my back). Could this be bcoz I started to seroconvert from week 15 and hence the test done on week 18 did not come as positive.....

5) Is it normal for a person to seroconvert from week 15 ........

Please do reply to this question as this has been bugging my mind and I seriously need this sorted so that I can start to focus on my life.....

I definately will donate $50 to your charity......please forward me the details to do so and also, I beg on my knees and request you to reply my above queries....

Response from Dr. Frascino

Hello,

1. Yes, I would consider negative HIV-antibody tests at weeks 14 and 18 to be definitive. Certainly if you remain worried, the option for a six-month repeat test is always open to you.

2. See above. HIV-antibody tests remain the best and most reliable tests for routine HIV screening. My colleagues in India advise me the Tridot test is very reliable.

3. Both quantitative RNA PCR and qualitative DNA PCR tests are available and do not have the lengthy window period requirement. However, PCR testing is generally not recommended for routine HIV screening due to the rate of false positives, (There are many examples of this in the archives. I'll post a sample below.), other technical considerations and cost. I'd recommend you stick with HIV-antibody tests (ELISA, EIA, rapid tests).

4. No. "Symptoms" would not affect HIV-antibody test accuracy. It's also worth noting the vast majority of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks after primary HIV infection.

5. No.

Thank you for your desire to make a donation to the Robert James Frascino AIDS Foundation. Donation information for the foundation can be found on the foundation's Web site at www.concertedeffort.org.

Be well. (I'm confident you are.)

Dr. Bob

Western Blot Neg / DNA PCR Detected Yet Inderminant (ANOTHER EXAMPLE WHY PCR SHOULD NOT BE USED FOR ROUTINE HIV SCREENING, 2009) Aug 22, 2009

After having unprotected oral sex only (3 weeks ago, with semen in my mouth) I got a fever, sore throat and my face broke out. I got tested one week ago. The "HIV-1 Antibody, Confirmation Western Blot" was negative. The "HIV 1/O/2 Abs, Qual HIV 1/O/2 Abs, Qual" was non-reactive. But the "HIV-1 DNA by PCR With HIV Antibodies by ICMA HIV-1" result came back with "DNA detected -- Indeterminate". So the big question is... am I positive? Beyond freaking out here. What does it mean for the DNA test to have detected HIV DNA but still be "interterminant". That makes know sense to me. Thank you.

Response from Dr. Frascino

Hello,

Yours is another prime example why PCR testing should not be used for routine HIV screening! Your HIV-acquisition risk is very small (oral sex). Consequently most likely you are not infected. My advice is to get an HIV-antibody test at the three-month mark per the recommended testing guidelines. If it's negative, you're negative. It really is just that straightforward.

Dr. Bob

HIV PCR RNA Quantitative Test Positive (ANOTHER EXAMPLE WHY PCR TESTS SHOULD NOT BE USED FOR ROUTINE HIV SCREENING, 2009) Jul 30, 2009

Hello,

I have a protected intercourse and unprotected Oral Sex durimg the months of May and JUNE, and due to my curiosity, I went to the clinic and did a PCR RNA Test which came Positive this was last week, and yesterday I did a spot test which came negitive, I am very nervous, and today I went to the clinic to perform PCR DNA Test and Western Bolt.

What is the accurecy of the PCR RNA Test, I am panic and really thinking of killing myslef.

Response from Dr. Frascino

Hello,

You are thinking of killing yourself because you might be HIV positive. Often I skip over these melodramatic posts, as I think they are highly insensitive to those of us who struggle with the challenges of being "virally enhanced" on a daily basis. I should also point out that if I had jumped off the Golden Gate Bridge when I seroconverted in January 1991 (yes, January 1991!!!), I wouldn't be here today to respond to your histrionic post! That said, I am responding primarily to point out one of the recurring messages I stress in this forum. HIV PCR RNA testing is not recommended for routine HIV screening due to the rate of false positives, other technical considerations and cost. (See below.) Your "positive" HIV RNA PCR is most likely a "false positive!"

The risk of acquiring HIV from oral sex is extremely low. Your negative HIV-antibody test is very encouraging (although not yet definitive because you did not wait the full three months before testing). Your follow-up testing will quickly confirm your HIV status which is most likely negative. So if you haven't committed hari-kari in the interim, I'm confident you'll soon be WOO-HOOing. Write back and let us know the outcome (or where to send the funeral flowers).

Dr. Bob

False Positive PCR (AN EXAMPLE OF WHY PCR TESTS SHOULD NOT BE USED FOR ROUTINE HIV SCREENING) Oct 21, 2008

Dr Bob Actually the Lab called me that they had reconfirmed the test and its negative.I am feeling really good now. Thanks. I will follow your advise and test only after 3 months

Positive HIV DNA PCR Oct 17, 2008

Dr Bob, I just received my HIV DNA PCR Positive. I cannot believe this. I went to local hiv testing center and had negative oraquick after 3 weeks of exposure. I am on Xannax now. How can a handjob from a stripper give me HIV. I am in deep pain and anxiety. I dont want HIV doc but I got it.

hiv through risky handjob Sep 28, 2008

Hi Doc, I went to a dirty strip club where I got a hand job. What if the previous customer's hiv semen came in contact with my urethra through her hand. There was 5mins between me and previous one. I also dont know whether she had sores on her hand or wounds. Please let me know whether I need testing and can I have sex with my wife until 3 months results. I am also promise to send $50 donation for the great work your doing. Thanks

Response from Dr. Frascino

Hello,

Your HIV-acquisition risk is extremely remote. However, if you remain worried, get a single HIV test at the three-month mark. In the interim, you could use latex condoms with your wife. I'd also recommend leveling with her. (It's the right thing to do.)

The statistical odds are astronomically in your favor that you did not contract HIV from your "risky handjob." Handjobs, in general, are not considered to be a risk for HIV.

Thank you for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return, I'm sending you my good-luck karma that your definitive three-month HIV test will be negative. I'm quite confident it indeed will be negative.

Good luck.

Dr. Bob

Response from Dr. Frascino

Hello,

As I have pointed out innumerable times on this site, PCR testing is not recommended for routine HIV diagnostic screening, due to the rate of false positives, other technical concerns and cost. Your HIV-exposure risk was negligible at best and now you have a positive qualitative HIV DNA PCR, which, in turn, has caused you "deep pain and anxiety" to the point you are freaking out and need to take Xanax. I still strongly doubt you are HIV positive based on what you have told me about your potential HIV exposure risk. Your next step should be to see an HIV specialist. He will be able to run the appropriate diagnostic studies to determine your true HIV serostatus. Write back after you've had that determination.

Good luck.

Dr. Bob

Response from Dr. Frascino

Hello,

Excellent news! I'll post your update immediately, as I'm sure your initial post worried some of our chronic worried wells! Like you, they too will be relieved.

WOO-HOO!

Dr. Bob



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