Is this case closed after four years of tests?

[whatnexthere]

Hi Dr. I have written before to you about my case. My exposures go back greater than 10 years, but I only started testing approximately 4years ago. Since that time I have had multiple RNA, DNA 1&2, antibody, antibody duo, rpr, tp eia, fta-abs. All have been negative. I still to this day have a very strange symptoms. I will not list them as they are many and you have said symptoms are unreliable. If you would like I will list them in a reply. The unfortunate thing is that my wife and children(7 & 11 yo) have frequent strange illnesses as well. My latest test were just prior to Thanksgiving and were negative for HIV and syphilis. I have a few questions please
1) Can testing for HIV with so many test of different types still yield a false negative result? Especially this far out.?
2) is there any other more sensitive test for HIV that could be done?
3) is there anyway that I have waited too long to test for HIV, and therefore all tests are falsely negative?
3) is there any way that testing for syphilis too late could miss it with the RPR, FTA-ABS, or TP eia, and therefore all my tests could be falsely negative?
4) is there any better test to do to conclusively be sure for either disease?
5) is there any reason I cannot have unprotected sex or five wife or feel guilty doing so? My last exposure was 4 1/2 years ago.
6)can I feel absolutely confident and w/o doubt that this is not HIV/syphilis and that I HAVE TO look elsewhere for the cause?
I thank you for your time very much.

[Edward W Hook, MD]

I suspect this question is derrived from further searching on the internet, a great source of misinformation and anxiewty for persons such as yourself.  Get over it.  You do not have an STI.  Testing for mycoplasma hose role as an STI is contraversial at best and which is a normal finding in many people is a waste of time.

Further questions will be deleted without coment. EWH

[whatnexthere]

Thank you very much for your time. I will forget about std then. If you would answer only question, I will not reply. I have read about mycoplasma and possible chronic low grade infection.
1) Is there any good/reliable test to test for that?

Thank you and I will look elsewhere for causes. Just thought that maybe fits my symptoms/risks.
Take care and Merry Christmas.

[Edward W Hook, MD]

REpeating questions does not change the answers.  Final answers to your mostly redundant questions.  

1)it seems that bruising is the common theme in our house. And these are for no reason. They will just appear out of no where. Given this fact does that change your opinion or do tests win for HIV and syphilis?
No change in myopinion or advice.

2)from what I have read, those "rare" strains have been identified by either a standard antibody or PCR?
You should stay off the internet.  Undetected "rare" strains are a myth.

3)do elite controllers have either a positive antibody or DNA for sure?
Yes.

4)are you aware of anyone who has been dx with HIV someway, but all their HIV testing was negative? Can that occur?
No.

5)as far as syphilis, is there any way that you can have after long/delayed time from exposure years back, negative tp eia, fta-abs, rpr(pro zone effect), and still have latent/dormant/active disease?
No (again)

6)based on my case alone and not factoring in all other concerned worried wells and their replies, am I to take your opinion that  the combination of ALL my tests and their negative results, ABSOLUTELY rules out HIV AND SYPHILIS, no matter what I/my family are experiencing?
Correct

7)Is there ANY std that I may have missed? I've tested negative for all. Even HTLV. ALL past 3 years last exposure but with exposures from 10-15 years ago worrying me. Again my last full battery was mid 2012 and latest HIV /syphilis about three weeks ago.
Please be realistinc and forget about STIs from long past exposures.

8)can I be CONFIDENT THAT I haven't given my wife/kids any std!
Yes.

I know it's long, but the holidays have me reflecting,, but the symptoms are real. I just want to find out what I have and treat it.
Then give up on the idea that you have some sort of STI and work with your doctor to find out what the problem really is.

There will be no further answers to this thread. EWH

[whatnexthere]

Thank you. I have read ALOT on the forums and would like to finish up with a few questions.
1)it seems that bruising is the common theme in our house. And these are for no reason. They will just appear out of no where. Given this fact does that change your opinion or do tests win for HIV and syphilis?
2)from what I have read, those "rare" strains have been identified by either a standard antibody or PCR?
3)do elite controllers have either a positive antibody or DNA for sure?
4)are you aware of anyone who has been dx with HIV someway, but all their HIV testing was negative? Can that occur?
5)as far as syphilis, is there any way that you can have after long/delayed time from exposure years back, negative tp eia, fta-abs, rpr(pro zone effect), and still have latent/dormant/active disease?
6)based on my case alone and not factoring in all other concerned worried wells and their replies, am I to take your opinion that  the combination of ALL my tests and their negative results, ABSOLUTELY rules out HIV AND SYPHILIS, no matter what I/my family are experiencing?
7)Is there ANY std that I may have missed? I've tested negative for all. Even HTLV. ALL past 3 years last exposure but with exposures from 10-15 years ago worrying me. Again my last full battery was mid 2012 and latest HIV /syphilis about three weeks ago.
8)can I be CONFIDENT THAT I haven't given my wife/kids any std!
I know it's long, but the holidays have me reflecting,, but the symptoms are real. I just want to find out what I have and treat it.
Thank you.

[Edward W Hook, MD]

The problem with symptoms is that htey ahve so many possible casues.  Again, that is the reason that tests are so important.

1) so even if a person had classic symptoms of either these two diseases, they absolutely have been rolled out?
Yes they have been.  You do not have HIV.

2) is it nearly impossible that for 4 years or more, a person could have a negative RNA, DNA, and antibody test, and still have HIV?
Yes, this would be unheard of.

3) is the exact same go for syphilis And the tests that I have had?
Correct.

4) if I have had syphilis in the past or currently, would at least one of those test be positive for sure? If So, which one?
A treponemal test would be positive- either the EIA or the FTA, (they are similar tests)

5)do I absolutely need to stop testing for both of these diseases as a result of all those other negative tests?
Further testing is a waste of time and money and could be keeping you from addressing the more important task of finding out why you have the symptoms you have.  

Take care.EWH

[whatnexthere]

Thank you very much for commenting. If it wasn't for some REAL physical symptoms, i would have put those concerns aside long ago. I know that people including yourself say that these tests are VERY sensitive, but I just don't want to miss anything.
1) so even if a person had classic symptoms of either these two diseases, they absolutely have been rolled out?
2) is it nearly impossible that for 4 years or more, a person could have a negative RNA, DNA, and antibody test, and still have HIV?
3) is the exact same go for syphilis And the tests that I have had?
4) if I have had syphilis in the past or currently, would at least one of those test be positive for sure? If So, which one?
5)do I absolutely need to stop testing for both of these diseases as a result of all those other negative tests?

Thank you for all your time. Have a Merry Christmas and happy new year.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  The short answer is that it is far past time to stop testing.  The tests for STIs, including HIV are highly accurate and while the time to definitive results varies for different infections, there are no STIs for which tests are not reliable at 3 months and for most STIs, far sooner.

In response to your specific questions:
1) Can testing for HIV with so many test of different types still yield a false negative result? Especially this far out.?
No, absolutely not.  Believe your tests and if you have been reading about mythological states such as "delayed seroconversion" or infection with "rare HIV subtypes", I suggest you put those concerns aside.

2) is there any other more sensitive test for HIV that could be done?
No, absolutely not. You have proven (multiple times) that you do not have HIV.

3) is there anyway that I have waited too long to test for HIV, and therefore all tests are falsely negative?
No, once a person has HIV test the tests are positive from then on.

3) is there any way that testing for syphilis too late could miss it with the RPR, FTA-ABS, or TP eia, and therefore all my tests could be falsely negative?
Again, no, this is simply not possible.

4) is there any better test to do to conclusively be sure for either disease?
No.

5) is there any reason I cannot have unprotected sex or five wife or feel guilty doing so? My last exposure was 4 1/2 years ago.
No, there is no reason to worry about unprotected sex with your wife.

6)can I feel absolutely confident and w/o doubt that this is not HIV/syphilis and that I HAVE TO look elsewhere for the cause?
Yes- see below.

Your post suggests an undue level of concern and apprehension about the possibility of an STI or HIV.  Please understand that sorting out symptoms is what the tests are for. You have had multiple highly reliable tests which clearly prove that whatever symptoms you are experiencing are NOT HIV, syphilis or any other STI.  thus there are two things you need to do. First, if the symptoms continue to trouble you, you need to look elsewhere for causes.  Symptoms are, in general, non-specific- that's why we need tests to sort them out one form another.  Second, if these concerns continue to trouble you, you are more troubled by guilt or shame over your past behaviors than is appropriate. I would suggest you talk this through with a trained counselor.

I hope these comments are helpful. EWH