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False PCR test?
Apr 16, 2011

Dear Dr. Frascino, Sorry, I should have been clearer in my email below. The doctor said that I had been xposed apparently to soften the blow. He clarified today that although I have no antibodies, I am infected it will be only a matter of time before the antibodies show up. I only had sex once in the two months before the test it it was brief oral sex without ejacuation, both giving and getting. I went to Kaiser in the first place because I was concerned because I had a rash with the flu, but I have very sensitive skin, so rashes are not all that unusual for me. I guess they decided to give me the PCR nd antibody test because I am gay and wanted to rule out AIDS. My question is, if I am reading the statistics correctly, arent the chances of the PCR test being a false positive greater than the possibility that I could get HIV from a brief session of oral sex? I plan to take the HIV antibody test again next month, but of course, I am very stressed out now.

Dear Dr. Frascino, I got a call from my doctor at Kaiser today that I have been exposed to HIV but have no antibodies to the disease. He didn't say so, but I would assume that they gave me the PCR test since that test does not test for antibodies. The thing is that I have had sex about 6 times over the past six months, no anal intercourse, and only light, pre-ejaculation oral sex (albeit without a condom). I can't tell you how upset I am. Your blog is one of the few things that have given me hope. How worried should I be that I am HIV positive?

Response from Dr. Frascino

Hi,

Thanks for the clarification. At this point you apparently have a negative HIV-antibody test and a detectable "PCR." The FDA has approved only one RNA test for HIV-diagnostic purposes (HIV-1 APTIMA). I don't know which type of "PCR" test you had, qualitative or quantitative. Nor did you mention the viral load level, if indeed you had a quantitative PCR RNA viral load test performed. Generally PCR tests are not used for HIV diagnosis, but can be helpful in catching HIV acute retroviral syndrome (ARS) during the window period before detectable levels of anti-HIV antibodies are produced. Your HIV-acquisition risk is essentially negligible: a single brief episode of oral sex with a partner of undermined HIV status within the two month period before the test. With this minimal degree of risk, it is indeed possible (even likely) that your detectable PCR is a false positive. Follow-up testing to sort this out without delay is certainly warranted!

Write back and I'll post your follow-up test results. I'm here if you need me, OK?

Good luck.

Dr. Bob



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