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Check out this Last Post in Holidnys Section-SCARY
      #5637 - 06/14/00 04:16 PM

I work for an AIDS service organization answering HIV-related health questions. This one has stumped me: A woman called to report that she first tested HIV-positive in December 1999 after having a negative test in May 1999. She had two viral load and CD4 tests with the following results: Mid-January 2000: V.L. = 31,000 CD4 = 560 Late January 2000: V.L. = 6,000 CD4 = 553 So far, this seems pretty routine. Here's the unusual part: I talked with her extensively about all the risk factors for HIV transmission (unsafe sex, needle use, blood transfusion, or any other exposure to blood). She insists that her only possible exposure (going back 2 or more years) was through unprotected sex with one male partner. Her partner has repeatedly tested HIV-negative, most recently in April and May 2000. If possible, I'd like your help figuring out the possibilities: 1) Could both her antibody and viral load tests be false-positives? Could any other infection/condition contribute to false-positives in both antibody and viral load tests? 2)Could her partner's antibody tests be false-negatives? Or could he be one of the rare people who don't develop measurable antibodies? If so, would it make sense for him to have a viral test to look for the virus itself? 3) Are there any other tests you'd recommend for either this woman or her partner to help clarify the situation? Thanks very much for your help! E.B. - Boston

Dr. Holodniy's Response:
1). Unlikely. Not that I am aware of, particularly on 2 separate days.
2). Maybe and possibly. But did you test him, or is this by verbal report? Female to male transmission is less likely, but it may be warranted to do a VL or DNA PCR test in this case.

3). Not for her, see #2.


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Re: Check out this Last Post in Holidnys Section-SCARY new
      #5640 - 06/14/00 04:41 PM

Call me optimistic, tell me "I like to change words for my own good", (maybe is because im a lawyer) but Dr. Holodny do admit that there can be false negatives, but hey, in that post there isnt any actual numbers, like tested at 3 months but positive at 4, etc, etc. So, Dr. Holodny is a firm believer, as well with Dr. Carl Cohen from Harvard Medical School in the 3 month window period, so there are two possibilities: one Dr. Holodny thinks that false negatives can be due to testing before the 3 months window period or two: like Dr. Holodny has said, the possibility to test after 3 months is less than 1%.

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Re: Check out this Last Post in Holidnys Section-SCARY new
      #5641 - 06/14/00 04:46 PM

Have you considered that she may have had another exposure that she is not admitting to, this seems most likely. People are not always truthful about everything. J

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