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Symptoms in partners but negative antibody test (late hiv?)
Feb 10, 2012

Hello Doctor

I am a 29 year old male.My question is regarding testing and its reliability 10 years after a high risk exposure(unprotected sex). In 2001 i had unprotected sex with a women whose HIV status is unknown to me. I remember falling quite sick after that so i had to see the doctor, I can recollect since my symptoms were so severe, i had weakness, body pain and fever with soar throat. I was treated with antibiotics . In 2009 my partner and i had protected sex but unprotected oral sex many times, after a few months she had the same symptoms i did in 2001 ;fatigue with tremors, body aches and fever. I was ignorant about HIV so i didn't do any testing or ask her to. Recently January 2012 when my third partner had the same symptoms I was shocked and i went to seek help, the physician told me it could be an STI and i did 2 tests for HIV antibodies. It was the fourth gen HIV ELFA and CMIA (BOTH NEGATIVE ), i asked my partner to do a test for HIV (ELISA) since i was really scared as the symptoms are so much like that of Acute HIV, her reports were negative (maybe since she is in the window period not sure)she will do another test at 3 months after our last sexual activity (29th dec 2011).

I did a CD4 test as i was curious, my cd4 count was 700 cells/ml, cd8 cells 750 , my cd4% was just 25%, cd4/cd8 ratio was .93 (limits 0.73 - 2). My CBC is normal. I don't know why both my partners had these extreme flu like symptoms (couple of months after sexual activity began). I am really concerned for these two people now. Doctor i really need your expertise in helping me clear some questions.

1. In my case is my HIV report Conclusive or is further testing needed (DNA PCR) ? ( apart from antibody test)

2. I did a VDRL and TPHA both negative. Tested for Herpes ELISA which was negative. Do you feel i need any particular test for Syhpilis (FTA-ABS)?

3. Could i be a slow progressor with undetecable antibodies? Why is my CD4% low?

4. Doctor do you suspect any other disease? I don't know where to begin.

My health has been good so far. I am worried about these unusual occurrence of symptoms in my partners. I am lost and i need your opinion.

Thanking you

Yours Sincerely Zack

Response from Mr. Cordova

Hi there:

To answer your questions:

1. Your HIV test is conclusive. Any HIV test done outside of the three month window is conclusive. You do not need to test for this incident anymore.

2. While a VDRL test can provide a false-negative if done during the early or late stages of infection, I would feel confident in the results of the TPHA.

In health,

Richard



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