Infected?

[sg_18]

Hello Doctor,
I was on a trip to thailand in till september mid and had multiple exposures with asian CSW but mostly protected for vaginal sex. I returned to states and felt ill in sep end with fever and sore throat altough very mild for a few days. on oct 4th local aids organisation were offering free tests here so I had one which they said was positive and took additional blood for research. Before this I was tested a year ago and didnt have any risk factors till thailand. One week later I was told that additional testing was negative and I should be tested again in a month. This monday (20th oct) I went to my doctor who gave me an HIV test in which he sent a blood sample to labcorp and He told me yesterday that it was negative. While I was there he did a rapid test which again showed postive. He gave me an appointment for next month and was non-commital. What is happening with me? Should I get a new doctor? What would you recommend a patient in this situation/ Please help, Thank you,
-SG

[Edward W Hook, MD]

If it costs you nothing, I would go on and send the specimens.  If you don't I suspect he will request that you do so you mihgt as well just go on and get it done.  .  Take care.  EWH

[sg_18]

Ok I think I will not worry too much about it then. But should I go ahead and send the blood sample next month? He said it wont cost me money.

[Edward W Hook, MD]

Read my answers.  I do not agree.  EWH

[sg_18]

Doctor,
I got a call from a doctor who works with the state HIV test center and he said I am not in the clear because I had 2 different brand rapid tests positive and thus I should get another PCR next month and antibody and if its negative he would send my blood to CDC to get analyzed for rare strains etc.
I was getting out of this and felt good but now this.... do you agree with his assessment...

[Edward W Hook, MD]

My impression is that your docotr is being overly conservative.  he is jsut following up to be sure but I would urge you not to worry.  Any follow-up tests that you have will be negative.  EWH

[sg_18]

One last time: My doctor is not convinced and wants to test again in 3 months. This really got me depressed. He says multiple positive rapid tests of different brands is very accurate and we cant ignore this fact and that I might be infected.
Do you agree with him? Please let me know, this is very scary and confusing for me.

[Edward W Hook, MD]

These results clearly indicate that you do not have HIV.  No circulating virus (the PCR test) and no antibody.  ARUP is the 3rd largest laboratory in the U.S. and does excellent work.

False positve results are sometimes quite difficult to explain becasu ethey can arrise from many, many different causes.  Guessing what might be causing yours is of little use.  EWH

[sg_18]

Thankyou for your comments. Regarding what test will convince me, I think your word would. I got more results today from ARUP Labs. My doc got this done through a State program. HIV 1/2 combo Abs negative. HIV-1 RNA ANT real time PCR less than 48 copies. I also got a letter saying that these had to be positive if it were HIV hence the rapid test was a false positive.

1. Do you think there analysis is correct?

2. could it be something that is a bit different and is not currently being detected?

3. Lastly if its not HIV what could be the possible reason for positive rapid tests for the last 2 months from 2 different manufacturers.

Thankyou,
Best Regards, SG

[Edward W Hook, MD]

One last answer (I am getting tired of repeating myself).  If you have a false positive result with a test and you repeat the same test, guess what, it will be positive again.  This is because these tests are well standardized and reproducible.  That is the reason we do different, unrelated confirmatory tests.  A PCR test would do this, as do other tests. You  need to get the test that will convince you that you do not have HIV which is what I beleive it the case.  Talk to your docotr about this.  EWH

[sg_18]

Doctor,

i got another rapid test and it was still positive. The labcorp test is still negative, what should i do now? Am i positive or not.

[sg_18]

Doctor,
My physician didnt perform the HIV PCR test but he did some tests along with CBC. He says something about CD4 being 865 and 51% which according to him is good news. The last antibody test was negative. Should I get the test you mentioned? why does he dont want to do it? The only thing he mentioned was it is expensive. Thank you

[Edward W Hook, MD]

labcorp does good work.  I still think, as said before, that your test was a false positve test.  EWH

[sg_18]

Doctor,
I took a test through requestatest.com and they sent the sample to Labcorp and it came back negative. Its now about 2 months since thailand. Is this test as reliable as the rapid tests? Which one should I believe more? Thank you.  

[Edward W Hook, MD]

From your description of events, I expect that you do not have HIV.  Let us know as you have more test results over time.  EWH

[sg_18]

Thank you for the reply. From your reply it seems I can be hopefully of being HIV negative? am I correct? or is it just a theoretical possibility. cause having someone say I tested positive on HIV test has broken me to the core

[Edward W Hook, MD]

Your doctor is fine. He is being appropriately cautious.  

Your international travel and some unprotected sex with commercial sex workers in SE Asia makes it plausible, although unlikely that you have HIV.  My best guess is that your had either equivocal or false positive tests (two terms for pretty much the same thing) when sampled by your local AIDS outreach group and on the rapid test your doctor did and that the further, confirmatory testing which was done to further evaluate the result showed that your tests were false positive.

I also suspect the reason your doctor is being a bit cautious is because he/she realizes that "false positive" tests can actually be a signal that once is just in the process of developing antibodies to the virus.  The fact that you got similar sorts of outcomes nearly 3 weeks apart (Oct 4 and 20th) suggest that you have a real false positive and not that the antibodies are just in the process of appearing.  

The best follow-up for results such as yours is repeat testing as your doctor has scheduled.  An answer could also be gotten quicker if your doctor was to do an HIB RNA PCR test on your blood.  You should discuss these possibilities with your doctor and make sure that you have a full understanding of what is going on from him/her as you might have additional false positive tests in the future (they often remain present for long periods of time or even permanently).  From what you say however, it appears you have a false positive test, not HIV. that's good news.

Hope my comments help. EWH