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RNA/PCR 4TH GEN TEST AND SYMPTOMS PLEASE HELP!!!
May 6, 2014

Hi Dr. and thank you for taking the time out to read my questions. 19 Days ago I was at a party at a strip club and cannot remember much of the night. I can remember a lap dance and according to my friends I was gone for about 20 minutes throughout the night. If I was exposed it would be unprotected vaginal intercourse. So let's just say for argument's sake it was unprotected vaginal... 5 Days after the "event" I had some flu like symptoms. A fever that hovered somewhere around 100 degrees, some diarrhea but nothing too substantial. I had a loss of appetite as well as some pretty serious fatigue. I would literally fall asleep with the remote control in my hand and would sleep for about 17hrs per night. This whole ordeal lasted roughly 3-4 days. About 9 days after the "event" I started to check my groin for swollen lymph nodes and decided it was time to go to a doctor. My groin began to hurt and slowly after so did my underarms. Right around the ten day mark I noticed my throat being slightly red. Not really painful just red. I have been keeping an eye on it and up to this day it is still red. At this point it has been 19 days. I also started to notice that my tonsils are more swollen than prior and that they seem to be white?? Still not so much pain, other then when I check it 15+ times per day. Around day 13-14 I began to notice that my skin was burning and semi itchy around my chest area as well as my legs. It would have small clusters of rashes that would come and go. I went to a dermatologist who told me the proper name, which I have now forgotten but he said it's usually a flare up from a virus. I went to an infectious disease doctor, he listened to my story and decided it was appropriate to do an RNA PCR test. (I know not recommended for diagnoses but I'm on a short timeline here). The test was administered 10 days after possible exposure. The results came back negative, in which case the doctor told me that they were about 95% accurate at that time and to clear my mind of the terror and anxiety. 14 days after the event I went for yet another early test and found a place that did the 4th generation rapid test. This test scans for antigen and antibodies which shortens the window period. It was done with a finger prick, the results once again came back negative. Once again I was told that the test was accurate at this point. After each test I would question the results based on my symptoms. I would begin to research the test to find out if I could rely on the accuracy of each and at which point. I plan on getting the antibody test at day 25 which from my understanding is the median for accurate test results. I know that the golden rule is to get the anti body test at 12 weeks, as stated previously I don't have 12 weeks, for reasons I'd rather not discuss. Also, I'm aware that the symptoms cannot really determine anything. Also, I have been having very mild night sweats recently, could that be anxiety or strickly hiv? So here comes the hard part.... 1-Is it possible for the RNA PCR to completely miss the virus? Even though now it seems as if I have had 5-6 of the major symptoms? (From my understanding the test goes down to about 20 copies and is considered very sensitive?) 2-Is it possible for the 4th generation to miss it as well? (I did this as sort of a backup to the RNA) 3-Is my throat being red for 7+ days an indicator of HIV? 4-Does the rash that is generally associated with HIV burn as well as come and go? 5-Will taking the antibody rapid response test at 25 days give me accurate enough results? 6-And Last but not least I know the PCR is not used as a diagnostic but can I have some sort of piece of mind with the negative result? Please doctor at this point you are one of my only hopes, please help me

Response from Mr. Cordova

1: It should have been able to pick up an infection by 10 days.

2: The antigen portion of the test should have been able to pick up an infection.

3: No.

4: No. Although in some cases it can be itchy.

5: 28 days will give you a good idea of your true status. 90 days is conclusive. I would not expect the results to change between 28 and 90 days.

6: Yes, but test at 90 days with an antibody test to be certain.



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