Welcome to the Forum. I'll be pleased to try to address your questions:
1-- Is this nurse wrong? Its really bothering me and now I'm doubting the reliability of my 8 week negative. This is a pretty reputable clinic and now I'm wondering if she knows something I don't know about this particular test.
Yes, she is incorrect. She is quoting that standard recommendations from the manufacturer's package insert and the CDC which reflect old data and older studies. The manufacturers will not change their insert since to do so would require clinical trials costing millions of dollars- they have nothing to gain corporately from doing another study of an already approved test. As for the other "official" recommendations, these recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel they cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.
2-- My understanding is that acute HIV symptoms are due to the body's reaction not to the virus itself but the antibodies produced by our bodies. Does this include lymphadenopathy? According to this post by Dr. HHH http://www.medhelp.org/posts/STDs/Test-Results/show/246301 40%
will show up positive after 2 weeks of onset of ARS, and 100% after 17 days?? But Dr. Hook says that a test will show positive after only a few days after the beginning of symptoms. (I realize that 6 weeks can be late for ars, but most sources put the time frame at 2-6 weeks post exposure, with 6 weeks being rare). Who is right? Would you say that my negative test 2 weeks after the onset of my swollen glands rules out HIV? I'm worried since I've NEVER had swollen glands above my waist in my life.
I cannot comment on Dr. Handsfield’s figures although I would point out that the data he quoted were from studies performed more than 7 years ago. I can however confirm you that the symptoms of the ARS are due to the reaction of HIV antibodies with the virus and that soon after the symptoms start, antibodies are detectable. Whether this is one week or, occasionally two is less clear and the data vary from study to study.
Your negative test 2 weeks after the onset of symptoms does rule out HIV as the cause of your swollen glands. (and I would challenge the idea that you have never had swollen glands above the waste- if you have had a sore throat, I am confident you had swollen glands).
3-- All my life I've had a white tongue in the mornings. But I've heard that it could be a sign of a weak immune system—however I rarely get sick and my CBC are normal. When you say people with weaken immune systems are late to develop antibodies do you mean folks with seriously compromised immune systems or ppl with a weaker-normal range as well?
This talk of a "weak" immune system indicated by a white tongue is a lot of mythology. There are many causes of discoloration of the tongue. Our statements about delayed antibody responses in persons with weakened immune systems refers to people with profoundly weakened immune systems such as persons receiving cancer chemotherapy.
4-- I've been very stressed since week 2. Can sleeplessness, prolonged stress, drugs like gabapentin, and cephalexin delay production of antibodies?
5-- And finally, if you were my doctor would you say that my 8 week test is conclusive? I've heard that in states like Massachusetts (not my state) the window period is 6 weeks using standard AB test. Can I move on?
I urge you to move on. I would tell you (and am, that your tests prove that you did not get HIV form the encounter you have described. EWH