HIV testing period

[Majedroro]

Dear doctor,
Thanks for the help, I have had unprotected sex several times with different girls with really unknown history most are massage girls, I stopped this permanently last year since I have had serious health issues last time I did it I had ( night sweating , headache, tired from just walking, swallen lymp node nick, funges, rash, fever... Etc) regardless of all symptoms as stated in this forum many times, my question are:
( tested CIMA test at 2months, 7months  and 3rd generation Elisa test 6 months)
1- my doctor said I have Low WBC, does LWBC delay the HIV antibody as my body can not fight the virus ( the doctor says it could be!!) ?
2- I had all known HIV symptoms, my tests are (-) when should I stop to worry is 7 months enough?
3- based on your experience is there anything called HIV virus carrier where a person can get his sexual partner infected but his body do not produce anti body that's why his test shows (-) result?
4- I have read in one of the  French web site that three months is the max period provided that the WBC is 3.5 and above, mine always low like 3 or even 2.5, is this correct?
5- based on your experience what are the cases reported with false (-) after six months, I read very old paper dated 2003 shows that people may have very very long window period, is this correct?
6- I am thinking to take CIMA test this week after one year, do you recommend this test?  And I did and found (-) do you agree it's 100% regardless of all kind of diseases I have ( low WBC, swallen lymph nodes, or even any kind of unknown cancers)?
7- why there are a lot of conflicting answers in internet for HIV testing in specific not others diseases, what is the world wide reference for HIV?

[Edward W Hook, MD]

Lab error is the major reason for false negatives and would be expected to occur less than 0.01% of the time (i.e. with less than 1 in 10,000 tests)

The combination of a p24 antigen test and antibody test detects both virus and antibody.  Further explanation is complicated and beyond the scope of this Forum. EWH

[Majedroro]

Thanks Dr Edward for your swift and confirmed answers,
For question #3 sorry it's almost same as one so there is no impact of Low WBC on testing as you said. I will not do the test as advised by you.

Two last thing if you allow me, regarding the false negative result would you recommend testing twice at different intervals to have 100 reliable results just to over rule human errors in the lab? Or there are other medical reason for false negative ( like late window period)

Second, for p24 comp test, just to confirm my understanding that:
1- it's equivalent to PCR or NAAT test?
2- can you please explain how this test work, is it applicable to late period after exposure?

Thank you doctor very much and very very sorry for this follow up question

[Edward W Hook, MD]

Welcome to the Forum.  I'll be happy to comment and make a suggestion.  Your tests conclusively prove that you do not have HIV.  There is no benefit from further testing for HIV. The symptoms that you describe are non-specific and could be caused by many other problems.  I suggest that you work with your doctor to look for other causes of your symptoms because there is no doubt that you do not have HIV.  Further testing for HIV is a waste of time and resources.

In answer to your specific questions:
1- my doctor said I have Low WBC, does LWBC delay the HIV antibody as my body can not fight the virus ( the doctor says it could be!!) ?
Your doctor is incorrect.  If you had HIV your low white blood cell count would not delay production of antibody.  If you had HIV, you would have a positive test long before now.

2- I had all known HIV symptoms, my tests are (-) when should I stop to worry is 7 months enough?
It is time to stop worrying about HIV and to look for other causes of your symptoms. There are many other problems which can cause tests sorts of problems.

3- based on your experience is there anything called HIV virus carrier where a person can get his sexual partner infected but his body do not produce anti body that's why his test shows (-) result?
No, this is not a concern.

4- I have read in one of the  French web site that three months is the max period provided that the WBC is 3.5 and above, mine always low like 3 or even 2.5, is this correct?
I am not sure what the question is here. There are people who have low WBCs for reasons that are not clear.  Most of these people live entirely normal lives.

5- based on your experience what are the cases reported with false (-) after six months, I read very old paper dated 2003 shows that people may have very very long window period, is this correct?
The  paper you mention is over 10 years ago.  While even today a single test might be falsely negative for a variety of reasons (and this is very, very rare), your multiple tests prove that you do not have HIV.

6- I am thinking to take CIMA test this week after one year, do you recommend this test?  And I did and found (-) do you agree it's 100% regardless of all kind of diseases I have ( low WBC, swallen lymph nodes, or even any kind of unknown cancers)?
Repeat testing is a waste of time.  I see no need for further testing.  You have already been tested on several occasions with this test and had negative results, the results will not change.

7- why there are a lot of conflicting answers in internet for HIV testing in specific not others diseases, what is the world wide reference for HIV?
There are many good references, depending on what you want to know.  You need to stop worrying about, and looking for HIV and turn your thoughts to other possible causes of your symptoms.    

I hope these comments help. Take care.  EWH