Final Question / Calling on A Board Certified Immunologist
Aug 2, 2011
Let me start by saying that without you, and this site, there is no chance that I could have made it through the last five and a half months. Your responses are always clear, responsible and have a personal touch that will routinely give us a much needed laugh as we try to navigate through whatever bad decision we made that got us here.
Thank You Doctor Bob.
That said, I will try to make my questions as concise as possible as I have NO IDEA how you get through all this email day in and day out...
My exposure was insertive oral sex for six seconds at a massage parlor. I freaked out, and abruptly stopped the act. I have had a PCR DNA test at the 20 Day mark (negative) and negative antibody testing done out to the 5.5 month mark (22 weeks).
What happens next has been an odd set of circmustances / coincidences to say the least:
I have had diarrhea a few times a week that started about 12 days after the incident, and has persisted ever since. This is truly the only significant potential symptom, well that and a few HSV1 outbreaks (cold sores inside my mouth) over the last 5 months.
My doctor was trying to rule out other conditions, and as such tested me for Celiacs Disease, which was negative, but did reveal that I had low (but not absent)IGA. My IGA was 39 (Normal Range was 70-400). The low IGA sparked additional IGG, IGM testing.
The results of my IGG and IGM testing revealed a normal result (IGG waas 789 (600-1400 normal) and IGM was 80 Normal (normal 40-140).
My questions are as follows:
1) Would having a tetnus shot 8 weeks prior, and the first Hepatitis Vaccine (3 shot series) 5 days prior to my IGG / IGM test impact my results (i.e. give me a false normal reading?) Since I am on the low side of normal, this has me questioning my HIV testing / Immune System strength..
2) Do my Immunoglobulin Levels Indicate That if in fact I was HIV positive that my Antibody Testing would have caught it or do they being on the low side of normal indicate it might take me longer?
3) Can I stop testing, consider myself conclusively negative and sprint naked into the Ocean Screaming WOO-HOO or do I need any further testing? (I am at the beach on vacation and will await your response to pull off the all nude WOO-Hoo (will do it at night)
You indicated that you doubted I had CVID or a Significant Immune Disorder, I believe my tests indicated you were correct, but I wondered if your opinion would change based on the timing of my immunizations / IGG / IGM levels.
Lastly, and most importantly, I will be donating $500.00 to the Robert J Frascino Charitable Foundation. Although we have never spoken, like so many of us out here, I do feel like I know you, and it will be the LEAST I can do to support someone who has meant so much to me.
Please respond, and I am headed straight into the ocean (provided it's warranted) in the buff to affirm my true final WOO HOO!!!
Here's to your continued success Dr. Bob, YOU deserve it! Consider me an ally here in the Carolina's,and since you have my email address, please call on me if there is EVER anything I can do for you!
Response from Dr. Frascino
Thanks for your very kind comments. Board-certified clinical immunologist at your service!
1. Your tetanus and hepatitis vaccinations would not affect your total IgG and IgM results. I wouldn't consider your IgG or IgM levels "on the low side" for this type of testing assay. They are both perfectly normal.
2. As I indicated above, I wouldn't consider your values "on the low side." Your normal levels do not suggest any immune weakness or problem in making IgG and IgM antibodies to HIV or anything else. There is no reason to fear delayed seroconversion based on your test results.
3. Yep! Your six-second hummer at the rub-a-dub-dub-palace carried only a minuscule risk for acquiring HIV and your negative HIV-antibody test at 5.5 months and undetectable qualitative HIV PCR DNA at 20 days are conclusive, definitive and WOO-HOO-able. Now, Ryan, do we get a chance to see a video of you charging naked into the ocean screaming WOO-HOO like a banshee in heat??? (I promise not to put it on YouTube.)
4. You absolutely do not have CVID or any other significantly immune disorder.
5. As for the $500 donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org), when that comes in I'll do some naked cartwheels right into the pool in my backyard, okay?
Many thanks for your generous and compassionate support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's urgently needed and very warmly appreciated. In return I'm sending my best good-luck/good-health karma that you are now and will forever be HIV free.
Okay, Ryan, time to drop trou freeing Sergeant Pepper and the boys and make that mad dash to the ocean while screaming WOO-HOO!
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