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thankyouthankyouthankyouthankyouthankyouthankyou
Sep 16, 2009

"why do you only answer easy questions" I didn't mean to be rude I just needed and wanted to know so bad and just got frustrated, Im sorry. thank you so much for answering my question, I really apprecaite your response, THANK YOU!!!

Response from Dr. Frascino

Hi,

Apology graciously accepted. You're welcome. Now can we be BFF again and I won't have to defriend you on Facebook.

Be well. Stay well.

Dr. Bob

why do you only answer easy questions Sep 13, 2009

Dr bob, every answer I read is always to an obvious question by some worried well. Can you answer this tough question? High risk unprotected exposure with csw. Exactly two weeks later, rash, mucles aches, joint pain, diarreah, lower back pain, mouth ulcerations, gingivities, nasal polyps, etc but no fever as of yet. Non reactive antibody test 32 days post, undetectable rna by pcr at 37 days post and non reactive antibody at 17 weeks. do I have some weird strain that doesnt show up on tests, are labs messing up my results or are the test tubes not being sealed properly and air is getting in the sample killing the virus before being tested?

Response from Dr. Frascino

Hello,

Why do I only answer easy questions???? Excuse me!?!? Have you perused the extensive archives of this forum? I believe I addressed a wide variety of question types: easy, hard, wacky and really, really wacky! Now I have a question for you. Why is it that folks who don't get a personal response to their question always accuse me of only answering easy questions???

So let's take a look at your question and see how "tough" it really is, shall we? It involves a "high risk exposure with CSW" followed by a bunch of nonspecific "symptoms" a few weeks later, which in turn is followed by a series of negative HIV tests, including two negative HIV-antibody tests out to 17 weeks and an undetectable HIV plasma RNA PCR at day 37. Now let's check the archives with a quick search to see if by some off chance I may have addressed a similar situation in the past. Well, spank my butt and call me a Republican. As it turns out I have! "Quel choc!" (as they would say on the Champs Elysee!). It seems I already responded to exactly a gazillion "tough" questions exactly like yours! By the way, personally I would put your question in the "easy" category! So I'm going to refer you to the archives to review my previous detailed responses to situations like yours and only respond very briefly here, OK? (You're lucky I'm responding at all considering the impolite insinuations contained in the title of your easy question.)

Here are the basic facts:

1. Unprotected high risk sexual activity is a really dumb thing to do. And it places you at some degree of risk for STDs, including HIV.

2. Your repeatedly negative HIV-antibody tests out to 17 are definitive and conclusive. HIV is not your problem. No way. No how. No further HIV testing is warranted.

3. "Symptoms" are notoriously unreliable in predicting who is and is not HIV infected. A negative HIV-antibody test outside the window period trumps symptoms each and every time.

4. Do you have a wired strain that doesn't show up on tests? No, dude, you don't.

5. Are labs messing up your results? The statistical odds of them "messing up" multiple tests taken over a 17-week period nonexistent. What's messed up is you! You are having difficulty accepting overwhelming and irrefutable evidence that you dodged the HIV bullet.

6. Are test tubes not being sealed properly and air getting in the same killing the virus being tested? What??? You need to spend less time criticizing the responses to my "easy" questions and more time actually reading my answers! HIV-antibody tests do not measure live virus. Rather, these tests measure anti-HIV antibodies, which are circulating proteins in your blood made by your immune system in response to HIV infection. Air doesn't hurt them. Your test tub seals are just fine and dandy, OK?

So there you have it! Your personalized response to what you and only you consider to be a tough question. Satisfied?

Dr. Bob



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