RE: TESTING LIMITATIONS--HIV-2??

Question

Thank you Doc. All of my antibody tests were HIV 1/O/2 by quest,labcorp, and rapid tests oraquick and clearview complete. I also had specific HIV-2 EIA done at 55 weeks of last exposure and was negative. Is that good enough? Is the HIV-2 window any different? You think any type of HIV would be detected? Thanks for all of your responses.

Answer

Hello,

Not surprisingly, you've already had numerous tests for HIV-2. HIV 1/O/2 tests for HIV-1, HIV-2 and group O. Your EIA HIV-2 is also an HIV-2-specific assay. Is this good enough? Not only is it good enough; it's also highly excessive.

Stop testing!

Dr. Bob

RE: TESTING LIMITATIONS--will donate again Dec 27, 2010

Doc, I hope you will clarify a few things. As you recall I have had MULTIPLE HIV antibody tests out to 64 weeks with latest test being complete clearview which was neg. I also have had prior nat testing. They were HIV-1 proviral DNA at six weeks, six months. HIV-1 RNA at nine months, and HIV-1 bdna at 13 months. I think the thing that gets me is that all of these along with antibody tests are all group m. From what I have read, these tests "may" not detect some of the lesser common HIV strains/groups. That along with my symptoms are why I remain concerned about this and that HIV-2 would not be detected with these tests. I still have BAD floaters, sore throat, strange smell I detect(coming from Throat?)lump in throat, white tongue, and now BAD reflux, hard to eat. Could all of these tests(antibody tests done in plenty)oraquick, labcorp, quest miss the screening? I just don't want to be that slow seroconverter that gets missed. How is kne to COMPLETELY rule out the ODD type of HIV? Thanks again Doc.

	Response from Dr. Frascino

Hello,

Chances are with your extremely excessive testing, you've already been screened for HIV-2. (Check the laboratory result slip.) If not, the test is readily available (even though it is not warranted in your situation). As for ruling out HIV, you've already had every available HIV test, most of which were not warranted. Consequently, there is nothing else to be done. I have tried to assure you that you are definitively and conclusively HIV negative. HIV is not your problem. No way. No how. No additional HIV testing is warranted. I just can't say it any more straightforward than that. If you cannot accept the overwhelming and irrefutable evidence that you are HIV negative, your next step should be to seek psychiatric help for your irrational fears. Your general internist should be able to evaluate and manage your reflux and other symptoms. One thing is absolutely certain: the cause of your symptoms is not HIV.

Dr. Bob

RE: TESTING LIMITATIONS---I DONATED AS PROMISED Dec 20, 2010

Doctor Bob, I did as I promised and donated to the foundation. A few main questions are this. 1) do you without a doubt think that a test at 14 months of last exposure is conclusive? 2) Is there any chance that the "STANDARD" antibody tests could miss a GROUP N/O/CRF/RARE STRAIN? --remember my exposures were with ASIAN women,. What worries me is the lingering symptoms including sore throat(feels like something in it), muscle twitching, and INCREASING BAD FLOATERS. Also, my latest labs as I shared showed increased CMV and EBV levels, and thinking there may be a relationship. I plead a last answer from you. Thank you

Response from Dr. Frascino

Hi,

  1. Yes.

  2. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. A negative HIV test outside the window period trumps symptoms each and every time. Your increased CMV and EBV titers have absolutely nothing to do with HIV. You have had every available HIV-related test. All are negative or undetectable. You just can't get any more negative than that! Your HIV concerns are unwarranted. HIV is not your problem. No way. No how. No additional HIV-related tests are warranted. You've had way too many already. I can't say it any more straightforwardly than that!

Thank you for your tax-deductible donation to The Robert James Frascino AIDS Foundation. I'm delighted my good-luck/good-health karma continues to bat 1,000!

Be well. Stop worrying. Start WOO-HOO-ing.

Dr. Bob

TESTING LIMITATIONS???--I really need answers please Doctor Bob-- WILL DONATE $100.00 Dec 18, 2010

Doctor,

I have asked you these questions previously but hope you will answer for me as well as others. I had MULTIPLE exposures with ASIAN women here in the United states at massage parlors over the past 3-4 years. My last exposure was september of 2009. Since that time I have had white coating on tongue, strange smell, sore throat((lump)I believe to be related), low grade off and on fevers during the day, few instances of night sweats, weight loss, BAD FLOATERS, increases CMV and monocytes levels, muscle twitching, hand and leg tremors, left leg numbness, groin pain, oral lesions, small hemes in mouth, and poor skin healing,and easy nose bleeding . I have had MULTIPLE HIV tests including oraquick advance blood, Quest HIV 1/O/2, labcorp ICMA HIV 1/O/2. These have been at 59,62,63 weeks respectively. I also had HIV-1 proviral DNA at 6 months, HIV-1 viral load RNA at 9 months, HIV-1 bDNA at 55 weeks, and HIV-2 EIA at 55 weeks. A few question I beg you to answer. 1)is an EIA the same as an ELISA test? 2)I know you have said not to worry about rare strain/groups/crf, but is it possible that these tests I have had Could have missed infection? 3) are there any other tests to do to rule out HIV of ANY SORT? 4) with these symptoms, could I be further along with HIV and still not detectable? 5)is there any direction you would point me to take with the symptoms as well as elevated CMV igm and EBV igg levels? I am SO SCARED, and doctors don't think I should worry anymore about this but multiple doctors cannot explain. 6) Coukd I be one of those rare late serooconverters or unlucky enough to get infected with that rare strain? Please doc I need your help.

Response from Dr. Frascino

Hello,

  1. Yes.

  2. No.

  3. Nope. You've had them all.

  4. No, absolutely not.

  5. Continue to follow up with a good general medicine doctor regarding any persistent symptoms. I would also urge you to seek psychiatric evaluation and treatment to help you confront and conquer your irrational fears of being HIV infected. The psychiatrist could also help manage your anxiety related to this issue and assist you in accepting the overwhelming and irrefutable evidence that you are HIV negative.

  6. No, absolutely not.

Thank you for your tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending you my good-luck/good-health karma that you are now and will forever be HIV free and that you accept the reality of your HIV-negative status.

Good luck. Happy Healthy Holidays!

Dr. Bob