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HIV Transmission and Education >> Am I Infected?

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Anonymous
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Anyone thinking of taking a PCR please read!
      #29136 - 03/02/02 02:28 PM

Many people on this site debate the use of PCR testing vs antibody testing. The following case proves why one must use ELISA/antibody testing vs PCR testing to prove their status (I found it on John's Hopkins AIDS Service):

Question: "I have a patient with a positive HIV EIA and Western Blot (all bands) done 3 times in 2 different labs by separate phlebotomy dates, but undetectable (<50) HIV-1 RNA PCR done twice with fresh specimens, undetectable HIV-1 DNA qualitative, and undetectable HIV-2 RNA. The EIA was done as initial screen for sperm donation, and is the first one he ever had. He has never been treated for HIV. His CD4 is around 1000. He has no symptoms or signs. He used IV drugs 10 years ago and is HCV positive with a high HCV viral load. He has no other chronic or acute disease. Does this make sense to you?

Answer from Dr. Gallant: "It would be a good idea to repeat his viral load using a bDNA assay, to be sure that he doesn't have a non-B sub-clade. However, there are people, usually long-term non-progressors, who maintain undetectable viral loads despite having HIV infection. Your patient may be one of them."


All of us must realize an ELISA at 6 months is the gold standard, and it also proves why experts recommend antibody testing after 2-3 months exposure vs PCR testing.



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Anonymous
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Re: Anyone thinking of taking a PCR please read! new
      #29137 - 03/02/02 02:42 PM

Anybody have any comments on this? Does this mean all of the PCRs we've taken mean nothing?



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Richard
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Re: Anyone thinking of taking a PCR please read! new
      #29138 - 03/02/02 02:48 PM

Dr Gallant also stated on several ocassion that PCR is good in window period to rule out ARS. He also together with Dr. Holodny has confirmed that he has never seen or heard the case that somebody was both PCR and Elisa negative to turn positive later on.

If you search both those answers you will find them under HIV testing category.

In the early stages of infection the amount of virus suppose to be very high - that is why PCR can be useful. Later on when antibodies are produced the imune system can suppress the virus to undecetable level - but that is very rare - and very good sign for eveybody who is infected.

After 3 months it is unnecessary to use PCR, as Elisa should be positive.

Having said all of this from the reading about it - I can't personaly be convinced that my negative PCR at seven weeks is definite indicator that I am not infected.



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Anonymous
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Re: Anyone thinking of taking a PCR please read! new
      #29139 - 03/02/02 02:59 PM

Richard - did you take an ELISA the same time you took your PCR? I agree with you - both Dr. Gallant and Dr. Holodniy have said PCR testing in the 1st few months would yield a positive result - before antibody production. After that time ELISA is the preferred test over PCR. Dr. Henry of TheBody encourages RNA PCR test if one has a negative ELISA at 3 or 6 months yet is still concerned with being infected. I guess each Dr. is different - Gallant will call you a fool if you test with PCR after 3 months with a negative ELISA, yet Henry gives you thumbs up.

Hang in there - you are almost at your 3 month mark. I remember being in your position - I had a negative PCR as well around 6 weeks yet still couldn't accept it until I tested at 3 months (which was negative).



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Richard
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Re: Anyone thinking of taking a PCR please read! new
      #29140 - 03/02/02 03:13 PM

Yes I took PCR at seven weeks, and severeal Elisa's last one at 13.5 weeks negative. Which obviously means that it was negative at seven weeks as well.

But, still can't beleive result. I also took p24 Antigen at 5 weeks also negative.

I now have this constant growling in my stomach - all the time that drives me crazy and puts me back on the same road again.



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Anonymous
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Re: Anyone thinking of taking a PCR please read! new
      #29144 - 03/02/02 03:45 PM

Great, im awaiting PCR results and now ur telling me this is not accurate?



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Richard
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Re: Anyone thinking of taking a PCR please read! new
      #29145 - 03/02/02 03:48 PM

Just this minute Hopkins Dr. Gallant said the following:

This is exactly why I tell people not to be ordering expensive PCR tests to rule out HIV. You can have a negative PCR and be infected. The ELISA/WB is the gold standard. PCRs should be used in symptomatic patients to diagnose acute retroviral syndrome.

Note that PCR should be used in SYMPTOMATIC PATIENTS.



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Anonymous
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Re: Anyone thinking of taking a PCR please read! new
      #29146 - 03/02/02 03:51 PM

Richard - your negative tests are very re-assuring and prove your negative status. Negative PCR and ELISA after 3 months - what else could you ask for? You have to believe your test results not your symptoms. I would tell you to test once more at 6 months to be absolutely sure, but I doubt that would help you. You and I are so similar. We both had a Negative PCR and ELISA at 3 months yet still were not convinced of being HIV negative. However I am now at 1 year and just received another negative PCR and ELISA which means I am NEGATIVE! Thus what I am trying to say is believe your results and stop worrying. You will only waste your life. Keep testing if you want to but it will only tell you what you already know - you are HIV negative. Basically, anything that happens to your body will be magnified from here on out. Doesn't matter if its a small twitch, a sore throat, runny nose, rumble in your stomach - you will immedately think HIV. Don't do this to yourself!



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Anonymous
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We need Dr. Bundy here new
      #29148 - 03/02/02 04:01 PM

I think we need comments from Dr. Bundy here.



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Anonymous
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Re: We need Dr. Bundy here new
      #29149 - 03/02/02 04:05 PM

How do you know he's not related to Ted Bundy?



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Anonymous
Unregistered

Re: We need Dr. Bundy here new
      #29150 - 03/02/02 04:07 PM

Who is Ted Bundy?



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Anonymous
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Re: We need Dr. Bundy here new
      #29152 - 03/02/02 04:11 PM

Please tell me you're kidding! Ted Bundy is only the most frightening serial killer of our time, which is why you should be careful asking the unknown for advice - especially with a name like that.



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Richard
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American Academy of Family Physicians new
      #29153 - 03/02/02 04:12 PM

Please read the following about PCR and p24 Antigen, at the following link:

http://www.aafp.org/afp/20010915/tips/11.html



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Anonymous
Unregistered

Re: We need Dr. Bundy here new
      #29154 - 03/02/02 04:18 PM

That's not very nice at all to make such connection.
Read the posts of Dr. Bundy and you will see that it is quite knowlegable.

I don't say we should take an advice from this board as conclusive for anything - but at the same time some information is usefull - particurarly from people who know what they are talking about.

Let's here the opinions of other as well and don't enter into discussions that would take us away from the subject.




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Anonymous
Unregistered

Re: American Academy of Family Physicians new
      #29155 - 03/02/02 04:21 PM

I agree NAT/PCR and p24 antigen are good tests. If they weren't the American Red Cross as well as other blood banks would not be using them. However despite all of these fancy tests the ELISA is still the best! The other tests help one mentally get through the window period, but in the end in order to be 99.99999% sure one has to have a negative ELISA at 3 or 6 months - depending on what window period you're comfortable with.



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