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Need answers before I choose which doctor to go to!!!!
May 17, 2010

Hey Dr Bob, I had an exposure to HIV and test antibody negative on the rapid test at 6 weeks, 3 months and 6 months post PEP. I had a insertive sexual exposure with condom failure not work related. I do not believe in the conclusiveness of my tests due to certain symptoms that concern me. So I have the option to take a PCR and a standard eliza at the university immunodeficiency clinic or an Elisa and a cd4 count to check if I am lymphopenic which that doctor believes would indicate if there was disease or not in his opinion at a different clnic. I don't have the luxury of both tests which one do you think is more sensitive and would give me peace of mind forever hopefully.

Response from Dr. Frascino

Hello,

In the choice between HIV PCR & ELISA and CD4 & ELISA, I would suggest "none of the above" is the correct and most appropriate answer!

Negative six-weeks, three-months and six-months HIV-antibody tests post-PEP are definitive, conclusively WOO-HOO-able and move-on-able! HIV is not your problem. No way. No how. No additional HIV testing is warranted.

PCR testing (aside from APTIMA) is not FDA approved for HIV diagnostic screening, due to the rate of false positives. CD4 counts are nonspecific for HIV disease and can fluctuate for a wide variety of reasons. Ordering such tests without an appropriate reason for doing so can (and often does) lead to additional confusion and stress as one attempts to interpret a test that should never have been run in the first place.

If "peace of mind" is your problem, you need to see a "mind" doctor, not take unwarranted tests. Psychotherapy (counseling) to help you accept the overwhelming and irrefutable evidence that you are HIV negative should be your next step, if for whatever reason you "do not believe in the conclusiveness of (your) tests . . ."!

Dr. Bob



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