When can a person be confident?

[iscrewedupbig]

Doctor, I have now had about 12 total HIV antibody tests which all were negative. They were all after at least six months exposure. They consisted of leashes rapids, and standard antibody tests which were performed at different labs. It has now been about a year and just received by negative from Labcorp. They use ICMA methodology. I also to have had pcr RNA and DNA which were negative after six months. I just got back bloodwork from my doctor and from December of 2009 to now my monocytes have risen from 7% to 15%. My doctor seems non-worried about. I continue to have low grade fever(99.6),night sweats, white tongue which gets little filaments on it from time to time. They come and go. If you could just answer a couple of questions please.

1) How unlikely is it that I could still be positive after all of this testing?
2) Will the current antibody tests find the "rare strains/group N/CRF's/outliers" since they mainly focus on the "M" group?
3) Since PCR RNA/DNA really on look at group M, are they any added value?
4) How do they determine the "odd/rare" strain if there are no screening tests for it?
5) is there any test(s) I can do to further rule out me as the one that "slipped through"?

I want to continue sex with my wife but am scared that I may or may have infect her. Please and thank you

[Edward W Hook, MD]

You are correct. Take care.  EWH

[iscrewedupbig]

Thanks for your input. I will seek care other than my primary. Either internal med or ID doc. Thank you again for your responses.

[Edward W Hook, MD]

Last answer.  Your concerns are unrealistic and overblown and no number of "what if" questions will change that. You do not have HIV.  It is past time for you to stop worrying and move on.  EWH  

[iscrewedupbig]

I understand the deletion. But as a FINAL comment, you would say NO WAY it is HIV after a negative test after a year? No matter symptoms, strains etc?  Please please answer, there will be no follow ups whatsoever. Thank you.

[Edward W Hook, MD]

Last answer.

I can't think why a person would want to have an isolated Western blot test without having been first screened using the standard tests.  They take longer, are more expensive to do and are no more accurate that the standard tests.  EWH.

[iscrewedupbig]

Very quick question that may give alot of people some good information. I found a site online that does HIV 1 western blot by itself. 1)What is your opinion on doing this without an antibody test? 2)can this test show positive band  with something other than HIV, therefore being false positive?  I would not ask this of you, but very scarse information when searching this forum. Thank you

[Edward W Hook, MD]

No, none whatsoever.  You need to believe your test results. EWH

[iscrewedupbig]

Last comment here. Are there any scenarios in which you as a medical expert, and following/evaluating a person like myself, would advise further follow-up testing(same or different kind), no matter what the risk, high or not?  Would it matter to you where (geogrphically), and who you were with?  Thank you. That's it from me.

[iscrewedupbig]

Thank you for all of your information and reassurance. I will make an effort to disregard HIV as source of current symptoms. There is just so much information out there, true and false about HIV and possibility of missed types of HIV and extension of window periods. I agree that I have had LOTS of testing, but it sure looks like I should look elsewhere as to root of the problem. As an HIV specialist I am taking it that you would release me to care of good internal medicine doctor and say GOODBYE to HIV possibility?  Thanks for all of your time.

[Edward W Hook, MD]

Welcome to our Forum.  I will try to help but I must admit, having looked at some of your over 40 other posts to a variety of sites, it appears that there is little anyone can say regarding the facts of HIV tests and testing that will help to resolve your inappropriate concern that you might have gotten HIV from what was likely a no risk exposure to begin with.  I note the you also have various posts about non-specific findings and have gotten useless laboratory tests like CD4 lymphocyte counts as well.  You are wasting your time- with all due respect, you do not have HIV.

It is important to realize that of the various HIV types, each type differs from other types by only a very, very small amount and the majority of the proteins and nucleic acids which make it HIV and are the targets of HIV tests are shared by all HIV types. Your testing has included tests which test for a variety of different targets for testing- all are negative, not equivocal and not positive- negative.  There is no amount of testing that is going to give you a different answer.  

To briefly address your specific questions:

1.  As Dr. Handsfield has told you, you are more likely to get hit by a meteorite than to have HIV. That is to say, you can be sure that you do not have HIV.
2.  They would still detect infection. With a very unusual type they might yield an equivocal result but they would not be negative as your tests have been.
3.  Yes they are, they too tell you that you do not have HIV.
4.  See above.  The rare strains still would  give a result which is at least equivocal.
5.  You are not. There is no need for further testing.

I will not engage in the sorts of long, drawn out exchanges that you have had with others.  You do not have HIV.  You need to believe this. If you cannot, my sincere advice is that you do not need more testing for HIV, you need to speak with a counselor or mental health professional who can help you to work through your inappropriate anxiety.

EWH