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PCP Information and Confusion
Oct 16, 2010

Hello Dr.Bob,

Yesterday I had my yearly physical with my PCP. I am a 28 year old sexually active male, I practice safe sex and just like having my blood taken, BP and cholesterol checked, I have a yearly STD and HIV test done. I am very routine with my physical and tests (little overweight, I like southern food). During the physical he gave me my yearly flu shot and told me that this year the flu shot has both normal flu and N1H1 vaccine together. Once we concluded the physical he gave me the blood work for the lab and I asked about my routine STD and HIV test. He ordered the STD test but said he cant do the HIV test as the N1H1 vaccine has been linked to high false positive HIV tests and needed to wait a minimum of 30 days but recommended to wait 3 months before taking any HIV test. He strongly advised against me going to a clinic (he knows my ocd) and getting a rapid test as they are known for high false positives and negatives to begin with and this would add to the probability of a false positive.

I left and accepted it, however my OCD tendencies started to kick in and I did 6-7 hours of research at work trying to find a source that would validate what he said. To no avail, nothing found. I stopped at a local HIV clinic/support center in Tampa on my way home and they said they have not heard that, but recommended this site as it has tons of information about HIV/AIDS. I searched through thousands (how do you sleep and yes there are way too many fluffernutters out there. You need a fluffernutter vaccine.) of post and found your information regarding the normal flu to be helpful but could not find anything with regards to swine flu (n1hi1).

Is my PCP correct or is he misinformed. Should I wait the 30-90 days he states or am I fine to go test? Is he correct about the rapid test? The clinic I stopped in said they would do the test if I wanted. Is he right about the rapid test? Do I need a new more current PCP?

RY

Response from Dr. Frascino

Hello RY,

You "just like having (your) blood taken"???? Hmm. Perhaps your Mr. (or Ms.) Happily-Ever-After will be a vampire.

Your PCP's advice is only partially correct. It is true flu vaccinations can, in rare cases, cause false-positive HIV-antibody tests due to nonspecific cross-reacting antibody production. H1N1 vaccine was given for the first time last year; consequently, we don't have a lot of detailed information about it's specific effects on HIV testing. It is possible it could act like seasonal flu or other vaccines and cause an occasional false-positive result. However, it takes a number of weeks for specific (or nonspecific) antibodies to be created following vaccination. Consequently, if you just received your H1N1 vaccine within the past couple of days, there is no risk of a vaccine-induced false-positive HIV test. Waiting 30 days after the H1N1 vaccine to get an HIV test doesn't make much sense immunologically and would theoretically increase the risk of potential nonspecific antibody production causing a false-positive test result.

Your HIV-acquisition risk would be extremely low if you practice safer sex consistently.

Regarding rapid tests, the blood tests appear to be a bit more sensitive than the oral fluid tests. A negative rapid test outside the window period is considered a true negative. A positive test needs to be confirmed with a Western Blot test before the patient can be diagnosed HIV positive.

Finally, your idea of a fluffernutter vaccine greatly appeals to me. I'll start working on it right away.

Dr. Bob



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