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Is it possible to test negative hiv ab 1&2 and pcr rna not detected at 90 days and then test positive later?

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Is it possible to test negative hiv ab 1&2 (87 days) and pcr rna not detected at 90 days and then test positive later? How accurate are those test at 90 days? Since i had diarrhea and vomit 1 month after possible exposure that only happened 1 time,would that mean the virus/antibodies would be present and shown up on those test at 87 and 90 days? Can hiv cause inflammation in the terminal ileum? All my problems started with abdominal pain but have been unsuccessful at determining the cause.I've had man other test with no diagnosis of the cause.I have NOT noticed any fever,no sweats,no weight loss or no swollen Lymph Nodes.I have low platelets and abdominal pain that went from severe for a couple weeks to very mild.It has now been a year.
Posted Tue, 27 Nov 2012 in HIV and AIDS
 
 
Answered by Dr. Arnab Maji 8 hours later
Hi

Thanks for your query.

It is quite usual to have negative HIV antibody tests at 87 days because it takes time to be positive. Usually it takes time around 6 weeks to be positive but sometimes it may take as long as 6 months to be detected in the serum.

On the other hand in this interim period when antibodies are not detected in the serum, the test of choice to detect HIV infection is detection of viral neucleic acid like HIV RNA PCR. This test has a high sensitivity of even more than 90% with a high specificity. Therefore as this test is also negative at 90 days then chance of HIV infection is very less. Though I will suggest it to repeat this test again because in few instances there may be false positive result.

HIV can cause inflammation in terminal illeum. All your problems may be present in the stage of HIV seroconversion and fever may be absent many a times.

You have told that many other possibilities have already been excluded by investigations. It will be of great help for me if you kindly mention in your follow-up the tests which you have undergone so that I can suggest you other tests which may be helpful to you too.

Awaiting for you to listen you further.

Regards,
Dr Arnab Maji
Above answer was peer-reviewed by
 
Follow-up: Is it possible to test negative hiv ab 1&2 and pcr rna not detected at 90 days and then test positive later? 50 minutes later
I had a bone marrow biopsy, upper scope, ct scan, MRI, colonoscopy. I tested positive XXXXXXX 1:1280. Then I tested for lupus, lymes. All came back negative. My platelets drop to about 45,000 and have gone back up to 73,000 as of last test over the past year.after 10 months I started having soreness in my neck and had an X-ray that shows multilevel degeneratives. Does any of this sound like HIV? I never noticed fever, swollen lymph nodes, no rash,etc... I started with abdominal pain on & off for 3 weeks. Vomit & diarrhea 1 night, positive XXXXXXX pain in bottoms of feet that lasted about 4 months,terminal inflammation & now multilevel degeneratives.what can cause a late seroconversion? Is my negative test at 90 days conclusive? Have you ever seen it turn positive after 90 days?
 
 
Answered by Dr. Arnab Maji 8 hours later
Hi

Thanks for writing back my requirements.

Serum XXXXXXX is positive in high titre and now you have to confirm systemic lupus (SLE) by doing some serum assay like serum anti-dsDNA. In SLE low platelet count is very much possible because of immune-thrombocytopenia. All the symptoms you are suffering from can be clearly explained by SLE. You have recurrent infection, inflammation, soreness in neck, inflammation in ileum. All these can be due to SLE. Another important entity in this regard should have to be excluded is immune thrombocytopenic purpura (ITP). As per my knowledge your symptomatology is more consistent with SLE rather than HIV.

Late seroconversion is very rare, but could happen. Therefore, for completely conclusive and definitive results, official HIV testing guidelines still recommend re-testing at 12 weeks (90 days) post exposure. Even though I must advise you to gor another HIV DNA PCR testing after 90 days of exposure because few studies said this test has a window period of 4 weeks to 3 months of exposure. If it again comes as negative result then we can say with 100% certainty that you are not HIV infected.

Hope I have answered you. If you dont have further queries you may close the discussion here. If you have then please write back to me with your queries.

Any kind of review on my answer will be greatly appreciated.

Regards,
Dr Arnab Maji

You have
Above answer was peer-reviewed by
 
Follow-up: Is it possible to test negative hiv ab 1&2 and pcr rna not detected at 90 days and then test positive later? 1 hour later
My pcr RNA viral load test that came back not detected was done at exactly 94 days, is that not conclusive?the ab 1&2 was at 87 days. ive been ruled out for lupus, crohns, ,lymes,leukemia,h pylori,ulcers,hepatitis. From the beginning i had severe abdominal pain in the middle of the night that happened in 3 episodes over a 3 week period. I vomited & had diarrhea only one time during an episode & haven't thrown up or no diarrhea since. I've never noticed fever or swollen lymph nodes,sweats. I was good for about a few months with nothing more than low platelets & then my feet bottoms started hurt.10 months into in & then my neck showed multilevel degeneratives. Have you seen or heard of a pcr RNA test going from negative to positive after a test at 94 days? Is it possible to be infected with the HIV virus & have symptoms like(abdominal pain,vomit,diarrhea,low platelets) & still not show up in the 2 test at 3 months? Thanks for your help
 
 
Answered by Dr. Arnab Maji 1 hour later
Hi

Thanks again for writing back.

There is no chance of having HIV infection after having negative HIV RNA PCR test after 94 days of exposure.

Your flu-like symptoms like abdominal pain, vomiting, diarrhoea can occur due to HIV infection but low platelet is very rare especially in this early stage of HIV infection. Moreover you have negative HIV RNA PCR. This virtually excludes possibility of having HIV infection.

Moreover you have multilevel degenerative changes at the neck level along with problems in your both feet. This may be due to peripheral neuropathy though neck level degeneration can not cause foot symptoms but it may be a manifestation of generalised degenerative changes of nervous symptoms. SLE was a strong possibility but your doctor has already excluded it. From the whole picture it is clear that some disease of auto-immune etiology is responsible for the whole picture. Multiple sclerosis is a possibility. Go for nerve conduction velocity testing of both lower limbs. Therefore consult a neurologist, go for detailed physical examination and required investgations to establish etiology.

Hope I have answered you. If you dont have further queries you may close the discussion here. If you have then please write back to me with your queries.

Best Regards,
Dr Arnab Maji
Above answer was peer-reviewed by
 
Follow-up: Is it possible to test negative hiv ab 1&2 and pcr rna not detected at 90 days and then test positive later? 2 days later
Can medications like Cipro or Metronidazole effect the results on Hiv ab 1&2 or Hiv pcr rna? I stopped taking both medications about 3 weeks before the hiv test were taken. Being that i was completely healthy before all this,(never anything wrong with me), would this be any reason for a late seroconversion (after 3 months)cause i was so healthy before? Since i had abdominal pain & got sick,would that mean that the antibodies would be present and should be detected? Is it possible to have those symptoms and not show up yet cuz' of the window period or medications like cipro or metro? I read about mixed opinions on the "window Period" time,what are your thoughts?Would My AB 1&2 at 87 days & Hiv pcr rna test at 94 be conclusive? Thank You
 
 
Answered by Dr. Arnab Maji 4 hours later
Hi

Thanks again for your further queries.

You need not worry to this extent. Medications like ciprofloxacin or metronidazole cannot make any effect on neither HIV1&2 antibody nor HIV RNA PCR.

HIV late seroconversion is a very rare phenomenon and even if occurred it will occur usually at 3 months of exposure. Your HIV RNA PCR was done at 94th days of exposure and this seroconversion again doesnot influence the result of HIV RNA PCR test. So you need not to be worried for that. You may have some other underlying diseases but to the best of my knowledge this can not be due to late seroconversion or intake of those ciprofloxacin or metronidazole medications.

Hope I have answered you. Feel free to post your further queries if you have or close the discussion here if you dont have.

Regards,
Dr Arnab Maji
Above answer was peer-reviewed by
 
Follow-up: Is it possible to test negative hiv ab 1&2 and pcr rna not detected at 90 days and then test positive later? 10 hours later
This is my last question, i apologize! It's just that it has been over a year of problems & symptoms and i still haven't found the cause so i can't help but my mind to keep wandering. My question is since i was completely healthy with no medical history before this, could the window period of seroconversion be longer if i had a strong immune system? Some posts say it could take up to 6 months to be detected.But you say the 3 months should be enough time to be a conclusive result correct?
 
 
Answered by Dr. Arnab Maji 4 hours later
Hi

Thanks again for your query.

Look you need not be apologised for that. Its our duty to alleviate your anxiety and let you know the actual situation.

Yes you are right that window period may extend upto 6 months but very rarely. Usually it extends upto 3 months. But even if it extends upto 6 months, HIV RNA PCR cannot be negative in this window period because viral replication continues to occur and infact this is the test of choice in this period to detect latent infection along with serum p24 assay. These tests are highly specific and their main utility is to diagnose HIV infection in window period. Antibody to HIV1&2 appears after window period gets over. If it extends upto 6 months then these antibodies may remain undetected in serum by conventional ELISA test in those 6 months. But this is never true for HIV RNA PCR.

Hope I have answered you. Feel free to post your queries if you have.

Regards,
Dr Arnab Maji
Above answer was peer-reviewed by
 
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