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Should I be worried about HIV 2? - resubmitted form the Fatigue and Anemia Forum.
Mar 10, 2011

Dear Dr. Bob,

I had protected sex with a sex worker (got carried away - which I regret now). After the act, the condom didn't appear broken, although I didn't check thoroughly.

In the fourth week I had a bad sore throat and fever (lasted @4 days), which on one day touched 101.6F and remained about 99-100F on the other days. The sore throat lasted about 3 weeks. I took antibiotic medication to try to curb my sore throat and sinuses. (I had leftover medication at home and did not want to visit my family doc.). I got what seemed like fungal infection on my genitals.

I had anonymous HIV Antibody and DNA test done through Labcorp on day 30 post exposure. Following were the results: HIV-1 Antibody, Confirmation Western Blot Value: <1.00 Range: <1.00 Result: Negative

HIV 1/O/2 Abs, Qual Value: Non Reactive Range: Non Reactive Result:Negative

HIV-1 DNA by PCR With HIV Antibodies by ICMA Value:Negative Range: - Result: Negative

I was puzzled by the results. Why perform a Western blot if ICMA test was negative? If the ICMA test was preliminary positive, then why does the Value in the test indicate "Non Reactive"? Will the lab report non-reactive, even if the result was actually positive as long as Western blot turns out Negative?

At the end of week 7 post exposure, I conducted another anonymous Antibody test. This time the results were as below (they didn't exactly call the second test Western blot).

HIV-1 Antibody Test with Reflex to Western Blot Confirmation Value: <1.00 Range: <1.00 Result: Negative

HIV 1/O/2 Abs, Qual Value: Non Reactive Range: Non Reactive Result: Negative

Again, they seemed to conduct two tests instead of just one.

Although the DNA test seems to rule out HIV-1, I am still worried about the possibility of HIV 2.

Response from Dr. Frascino

Hi,

You are correct: an HIV Western Blot should only be run to confirm a repeatedly reactive/positive screening HIV-antibody test (ELISA, EIA, ICMA, rapid test, etc.). Either the lab ran it by mistake or your doctor/clinic ordered the test improperly. In your case it doesn't really matter, as everything is negative.

DNA PCR testing is not FDA approved as a diagnostic test for HIV. However, it does add evidence that you are not HIV infected at this time. Regarding HIV-2, you were already screened for that with your antibody tests. The 1/O/2 stands for HIV-1, HIV-2 and Type O.

Since your walk on the wild side with your sex worker was "protected," we would expect you to be HIV negative, assuming the latex condom was used properly and did not fail.

One final point about HIV-antibody testing: HIV-antibody testing taken prior to the three-month mark is not considered definitive.

Dr. Bob



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