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please, please help me, I will be mad
Jan 29, 2012

Dear doctors, I am from Turkey,sorry for the bad english. This is the second time I am asking a question. First one has not been answered yet, I know you r too busy and it is very hard to answer all, but please help me. I had an unprotected oral sex and protected sex with a sex worker on 31 august 2011. She recieved oral sex and I received oral sex. On 6 december 2011, I got tested for HIV. First one was a 4th generation test but I do not know the name of the essay. They told me it was reactive but low reactive but still it must be confirmed. I gave blood for Hiv-rna and WB. While waiting I decided to have another test. I went to a hospital and had ELISA, it turned out negative. Anyway, after WB result came and it was NEGATIVE and HIV_RNA undetectable. It did not make me calm down. So i decided to see a professional. I went to see a proff. doctor who is expert in sexual tran. diseases. She told me that I did not have HIV. She told me go and retest for screening test again, if it would make you feel any better, you will see it will be negative know. So on december 23 2011 I got tested by both Architect HIV1-2 combo AgG and P 24 , and ELFA(vidas hiv duo combo ultra. The architect was low positive again 1.19 cut off 1.00 S/CO. Vidas was negative hiv 1-2 0.05(cut-off 0.25 S/CO), P 24 : ND. I feel terrible, whats going on? Do I have HIV and Am I seroconverting?

Thank you for your time

Response from Dr. Wohl

This is the problem with repeat testing after a minimal to non-exposure. The risk is higher that you will get a false positive than that you are really infected. The more sensitive but less specific HIV testing found low positive, indicating that there was an antibody that the test was picking up but it was not because of HIV. How do I know? Because your more specific test found no antibodies to HIV and the p24, which looks for an actual viral protein was negative. That means no infection, acute or otherwise.

Sensitive tests are designed to catch as many of the folks with the disease as possible, even if that means being non-specific and falsely indicating positive when the person is negative. Specific tests hone in on the truly positive, even if they miss some cases. This is why we use the combination.

If you had acute HIV, your p24 and your HIV RNA levels would be sky high.

You are HIV uninfected.

DW



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