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Unprotected oral exposure - follow up . Have donated 200$
Dec 20, 2010

Thanks Doctor. I have donated 200 $ on your website and the reference # is EXHE6BECXXXXXXXXXXXX.

I got the results of follow up tests today. These were done on the 69th day post exposure. This is almost 10 weeks

1. HIV-1 Antibody, Confirmation Western Blot - Value is < 1.00, Range is <1.00, Result is Negative 2. HIV 1/O/2 Abs, Qual HIV 1/O/2 Abs, Qual - Value is Non Reactive, Range is Non Reactive, Result is Negative 3. HIV-1 DNA by PCR With HIV Antibodies by ICMA - Vaule is Negative, Result is Negative.

Thank God your prediction on PCR came true. These are my questions:

1. I am not able to understand the Western Blot results. Does it mean that there were no reactive bands? Also, do they do WB when 2nd test is negative? I am relieved, but confused on why WB was done.

2. This is almost 10 weeks now and I have negative PCR and negative antibody test. Do I need another test or can I stop testing and move on? My Physician wants to test at the 3 month mark.

3. Not sure if this is the right forum for this question. I was tested for all other STD's on 9th day and everything was negative. I have not had any symptoms on my penis except for a litte burning sensation while urinating / ejaculating on 2 or 3 days over these 2 months. Do I need to be tested further for any other STD's? Please let me know.

I really appreciate all the good work and God Bless you. Merry Christmas to you and your folks

Response from Dr. Frascino

Hi,

Welcome back to the forum and a very sincere thank you for your very generous tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It is very warmly appreciated. Your one gift will touch many lives in desperate need.

I'm delighted my prediction regarding your follow-up tests confirmed my strong suspicion regarding your false-positive test results! (My good-luck karma continues to bat 1,000!)

Regarding your follow-up questions:

1. It's difficult for me to interpret your results without actually seeing what was ordered and the exact report of the results. I would assume that "HIV-1 Antibody, Confirmation Western Blot - Value is <1.00, Range is <1.00, Result is Negative" indicates that an HIV-1 antibody test was ordered and if that result was reactive (positive) a confirmatory Western Blot would be performed. We call this a reflex test. Since your HIV-1 antibody test was negative, Western Blot testing was not done (or warranted!).

2. As I previously mentioned, the guidelines recommend HIV-antibody testing be done at the three-month mark. HIV-antibody tests performed before the three-month mark are not considered to be definitive or conclusive. HIV DNA PCR testing is not FDA approved for HIV diagnosis. Consequently, if you want the complete reassurance of an FDA-approved negative HIV-screening test, you'll need to retest at three months. That said, looking at the entirety of your testing to date, I have absolutely no doubt your first and third tests were false-positive/indeterminate tests and that you are HIV negative.

3. Nine days is adequate for most STDs. However, if you are still experiencing any burning or discharge or if you develop sores, rash, or other suspicious symptoms repeat STD screening would be warranted.

Once again, many thanks for your generous support of The Robert James Frascino AIDS Foundation. I'm redoubling my good-luck/good-health karma and sending it via special delivery.

Happy Healthy Holidays!

Dr. Bob

unprotected oral exposure - please answer - will donate 200$ Dec 18, 2010

Hello Dr.Bob

Hope you are doing well.I had an unprotected oral exposure with an escort on Oct 6. This involved sucking the penis for 10 -15 minutes, kissing and hand job as well. I got worried about HIV and did test for the same.

1. Oct 15 (9th day) reactive ELISA and indeterminate WB with reactive P24 2. Oct 21 ( 15th day) Negative ELISA 3. Nov 29 ( 53th day) - reactive ELISA and indeterminate WB with reactive P24

These are my questions:

1. Is my 3rd test a false positive as the 1st one? Can I be assured and convinced and not worry about this? 2. I read in some websites that most or all cases test completely positive around 7th week. Since this is almost close to 8 weeks, please let me know your take on this. 3. Are there reasons for such false positives? 4. During weeks 2 and 3, I had neck stiffness, neck pain, shoulder and chest area pain. I am not sure if this was due to anxiety, but there were no other symptpoms like fever, fatigue, etc during weeks 2 and 3. Neck pain is on and off and I still have it. I hope these are not ARS symptoms. 5. I did not have any major ARS symptoms later though I had diarrhoea after 6.5 weeks and have little fever now. I assume this time frame is too late for ARS. Please confirm.

Based on my Doctors suggestion, I have given a repeat antibody test and DNA PCR test today.

Thanks for your time and help in this regard.

Response from Dr. Frascino

Hello,

Unprotected insertive oral sex carries only a very low risk of acquiring HIV. Kissing and masturbation are not considered significant HIV-acquisition risks.

It is difficult to evaluate your tests, because HIV-antibody tests taken before the three-month mark are not considered to be definitive.

1. Most likely both your first and third tests are false-positive/indeterminate results. This assumption is based on a very low risk exposure and a negative ELISA between the two indeterminate results. Also, if your first positive/indeterminate test was the result of early seroconversion, complete seroconversion (positive ELISA and WB) would have occurred by day 53.

2. The vast majority (but not all) of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks after primary HIV infection.

3. Yes, there are a number of potential causes of false-positive and/or indeterminate HIV-antibody tests. These include nonspecific cross-reacting antibodies (this can occur during pregnancy, for example), HIV vaccines (clinical trials) and technical or clerical errors. You can read much more about false-positive results in the archives of this forum.

4. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. Your symptoms are not suggestive of or worrisome for HIV acute retroviral syndrome (ARS).

5. Most ARS symptoms manifest two to three weeks after infection.

I would assume you are HIV negative. DNA PCR testing is not FDA approved for HIV-diagnostic testing, but can be helpful in sorting out confusing HIV-antibody test results. I would anticipate the qualitative HIV DNA PCR will be undetectable. I should point out all this confusion and anxiety may have been avoided if you had followed the diagnostic HIV-testing guidelines and waited until the three-month mark for your first HIV-antibody test.

Thank you for your generous tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated during this holiday season of giving. In return I'm sending you my best good-luck/good-health karma that you are now and will forever be HIV free.

Good luck. Happy (and Healthy) Holidays.

Dr. Bob



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