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Skin Rashes, Fainted, Low BP, Vitamin Deficiency, Blood Test Normal Except Low PCV & MCV, HIV -ve, HIV Infected Parents. HIV?

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Posted on Thu, 14 Jun 2012
Question: Hello Doctor,

My cousin's parents diagonalized with HIV a few years back (may be 6-7 years) and her mother died 3 years back.. My cousin's age is 19.. She went for the screening 5 months back and got negative result.

2 months back she got some rashes on hands and doctor mentioned that they were due to some irregular periods.. Recently she got fainted with low blood pressures 106/55 and 90/60... Doctor said, that was due to multivitamin deficiency.. Blood test report looks very much normal except Hbg percentage 10.2, PCV, MCV bit less than lower threshold..

Could these be symptoms of raise of HIV even if she tested negative sometime back? Is there any chance of HIV being active for these many years (if at all we assume she got infection during birth)?

Thanks.

doctor
Answered by Dr. Gyanshankar Mishra (1 hour later)
Hi,

Thanks for posting your query.

First of all your cousin need not be worried as she has been tested HIV negative.

Now, Considering the history of both parents detected to be HIV positive and your cousin being tested HIV negative, a couple of factors need to be addressed here:

1. Which HIV test was done previously by your cousin who tested negative?

2. If there is any doubt regarding the affection of HIV by your cousin, ask her to get her p24 antigen testing for HIV (Human Immuno-deficiency Virus), which is positive even in window period.

As far as low blood pressure and anemia is concerned:

1. She needs to keep herself well hydrated - drink plenty of oral fluids, fruit juice, never skip breakfast, lunch or dinner, eat plenty of fruits, avoid strenuous work for some time.

2. Get a peripheral smear done- for typing of anemia & after consultation with her doctor, she may be started on multivitamin tablets, Iron supplements (either tablet or syrup) and also a course of deworming medicine.

Hope the query has been answered.

I wish her a healthy and happy life.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Gyanshankar Mishra (2 hours later)
Thank you very much for the information...

I am not sure which test was done before...

Will this p24 antegen testing give us the accurate result? What is the window period?

One more thing I missed out to mention in my previous query is that she has fluctuations in her body weight... During September last week she weighed around 53KG, after 2 weeks or so she dropped to 48 and then moved to 49.5 and now 47...

Thanks.
doctor
Answered by Dr. Gyanshankar Mishra (57 minutes later)
Hi again,

HIV window period is an interval between the time of HIV infection and the production of measurable antibodies in the blood of an individual. This is called HIV seroconversion or window period.

Normally the HIV ELISA test is done for screening and a Western blot test is done for confirmation. HIV P24 antigen testing is done for detection in window period. Even ELISA test done twice at intervals of 3 months is good enough for detection.

The current average HIV window period with state-of-the art antibody testing is 25 days; and the standard outside limit is 6 months, by which time >95% of people who are actually infected would have seroconverted.

Patient may become symptomatic after as long as 10 years of getting HIV infection but the antibodies will be detected after the window period (usually 3 weeks to 6 months).

So your cousin can get a repeat ELISA test for HIV or if she wants to do a confirmatory test then she can go for western blot test which has slight advantage over p24 test.

As regards to the weight loss (most probably due to anemia), if she has no other symptoms like fever, abdominal pain, cough, etc., I suggest her to improve her diet by taking regular healthy meals. She should also take 6 monthly course of deworming medication / daily iron and multivitamin supplements as advised in previous post. Her diet should include XXXXXXX leafy vegetables / lots of fruits/ fruit juice / avoid junk foods/ plenty of fluids.

Hope the information helps.

Regards
Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

Answered : 600 Questions

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Skin Rashes, Fainted, Low BP, Vitamin Deficiency, Blood Test Normal Except Low PCV & MCV, HIV -ve, HIV Infected Parents. HIV?

Hi,

Thanks for posting your query.

First of all your cousin need not be worried as she has been tested HIV negative.

Now, Considering the history of both parents detected to be HIV positive and your cousin being tested HIV negative, a couple of factors need to be addressed here:

1. Which HIV test was done previously by your cousin who tested negative?

2. If there is any doubt regarding the affection of HIV by your cousin, ask her to get her p24 antigen testing for HIV (Human Immuno-deficiency Virus), which is positive even in window period.

As far as low blood pressure and anemia is concerned:

1. She needs to keep herself well hydrated - drink plenty of oral fluids, fruit juice, never skip breakfast, lunch or dinner, eat plenty of fruits, avoid strenuous work for some time.

2. Get a peripheral smear done- for typing of anemia & after consultation with her doctor, she may be started on multivitamin tablets, Iron supplements (either tablet or syrup) and also a course of deworming medicine.

Hope the query has been answered.

I wish her a healthy and happy life.

Regards,