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Bdna Viral load
Sep 13, 2004

Dear Dr Conway,

I recently tested positive by bdna. Viral load was 58000, cd4 160, this is 6 months after infection.

My symptoms include oral thrush,OHL, severe muscle wasting and spasms with muscle loss and facial wasting, diarrhea every other day.

Problem is that although my viral load is very high and detectable by bdna( proving infection), I am still negative by Elisa/Wb and PCR-DNA 7 months post exposure with a still rising bdna viral load!

My doctor says that since I am still technically negative, he cannot start treatment. I need treatment doc, my health is deteriorating very quickly!

What can I do to prove infection by elisa/wb? I understand this is probably a rare strain but treatment will not be given to me unless the elisa/wb is positive.

Thanks,

Response from Dr. Conway

In a small number of cases, HIV viral load testing (whether PCR or bDNA) can be falsely positive. However, this is usually with a value of 5,000 copies/mL or less. This would not apply to you. It is also true that the bDNA test can pick up some rare strains that are missed by the PCR test, but this is much less common with the newer PCR tests. However, this may still apply to you. The antibody tests may take a few months to turn positive after HIV infection has occurred, but I would still expect that your ELISA would be somewhat positive, and your Western blot indeterminate this long after the exposure. Could it be that there was a more recent exposure that caused the transmission of HIV and the timing you present is not exactly correct? In this case, I would probably do a CD4 count to see if the absolute count and percentage are decreased, as other evidence that you might be infected with HIV. As for treatment, I would simply point out that some (including myself) feel that treatment in the acute phase of HIV (before the HIV antibody test is positive) can be particularly beneficial...as long as you KNOW the person is infected with HIV.



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