Confusing Results

Question

Hi Our Precious Doc

I must say my heartfelt gratification to your undying, untiring work here to educate the world on HIV risks... You are really a gift from God to all of us here... A big thank you and will donate to your foundation again.

What do you think of the persistently p24 antigen detected in the body? Does it meant a different strain or Group O which WB cant pick up? Why is there p24 antigen in the first place if it is a false positive for so long? How can it be eradicated? PEP?

My abbott HIV 1/2 Ab quick test always show a faint reaction but ELISA is Non-reactive. Another ELISA HIV Ag/Ab was reactive so could this due to the p24 they detect using Ag? What test can detect Group O effectively?

So am I alright based on these confusing results? It has been 3yrs now. I never live a day except keep worrying and I have lost weight that everyone I kw noticed. I felt extremely tired for the last 4mths with rashes frequently on my chest, neck, face, hand and pimples- like itchy rashes on my legs.

Is a low neutrophiles count 1.49/mm3 and high lymphocytes 52% an indication of infection?

Thanks Doc and God bless you a long life to come...

Answer

Hello,

The p24 antigen test is highly specific, but not very sensitive. The primary use of this test is as a supplemental HIV diagnostic screening test. It may pick up some HIV infections an average of six days earlier than an HIV-antibody test. However, not all recently infected HIVers will have detectable levels of p24 antigen! P24 antigen alone cannot be used to diagnose HIV infection. It must always be used alongside other HIV diagnostic tests, such as ELISAs and Western Blots. If you've had a persistently detectable p24 antigen, but a non-reactive ELISA, you are HIV negative. Having a persistently detectable p24 antigen has nothing to do with group O. Most likely it's a test anomaly (cross-reacting protein) that has absolutely nothing to do with HIV. There is no reason to try to "eradicate" a false-positive test result. PEP is not certainly indicated and would not be helpful.

As for group O, this is an extremely rare subtype. In the rare instances it has been identified, it was found most often in West Africa (orin West Africans). Current HIV screening tests will usually detect group O (80% of the time).

As for your "confusing results" over the past three years, please note if indeed you were in the midst of seroconverting to HIV positive, your definitive seroconversion to HIV positive would have been complete long ago!

Your fears are unwarranted. You are HIV negative.

Thanks for your kind comments and donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). Both are very much appreciated.

Be well. Stop worrying and start WOO-HOO-ing.

Dr. Bob