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Dr. Andrew Rynne

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What are symptoms of HIV?

Answered by
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Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 2623 Questions

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Posted on Tue, 19 Aug 2014 in HIV and AIDS
Question: Dear DRs,

On 23/5, 28/5, 3/6 had few times unprotected oral sex.
Very scare to get HIV infected.

23 days 4 th generation elisa combo test was neg;
27 days RNA PCR test was neg;
35 days combo test was neg;
42 days combo test was neg;
48 days combo test was neg;
48 days RNA PCR test was neg;
( all tested in lab )

Can doctors give me an idea of my status?
I got some synmptons of ARS few weeks ago.
Sore throat; lymph not feeling well; shoulder rash; painful feet.

Am i infected? How long to take the antibodies to grow? My lab reports are reliable?

Really go crazy.

Please help.

Regards.
doctor
Answered by Dr. Prasad 24 hours later
Brief Answer:
Not likely to be from HIV

Detailed Answer:
Hi,

Before we continue this discussion, I would like to share with you an important aspects of oral defense system. There are plenty of antibodies, viral inhibiting factors and other secretions that restrict spread of infection through saliva. And HIV is a fragile virus. There has been plenty of research and scientific studies conducted on this topic and all those studies reveal HIV spread from oral secretions are sparce to minimal. Therefore even if your partner was HIV infected, the chance of you getting HIV through oral intercourse is less than 1%.

So all these scare about HIV is unwanted.

Further latest tests performed for HIV are very advanced and accurate. Various combo tests and PCR test has ruled out presence of HIV infections. We can very well rely on those results.

So in a nutshell, any of your symptoms are from other infections and not HIV.

Though it is now unwanted information, for sake of completion I shall answer your second question. Antibodies start to form anyway after 2-3 weeks. Routine HIV antibody test pick up HIV much later say around 3-4 weeks. But the combo tests as well as PCR tests pick up HIV infection within 2-3 weeks. Therefore you can rely on all your test results.

Hope this helps.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 27 minutes later
Hi! Dr. XXXXXXX
Thanks for your reply.
Sorry for my poor english skill. In fact, if the tests are reliable, why other DRs ask me to do the final test in 12 weeks? This made me very confusing.
I got night sweat last night and nerve pain on my neck yesterday. I m very scare. Very tired.
So i need other tests?
And can Dr you suggest what shall i do?

Regards.
A
doctor
Answered by Dr. Prasad 7 hours later
Brief Answer:
Repeating test to clear your apprehension...

Detailed Answer:
Hi,

Well, during initial days of HIV diagnosis when only antibody testing was available repeating HIV tests after window period was mandatory. As HIV antibody window period can last for 3-6 months there was a need to repeat the test 3 to 6 months later. However the latest 4th generation HIV tests that tests antigen (as in combo test) and PCR techniques has minimised / nullified the need to repeat tests. Therefore in my opinion we can safely rely on those test results.

In fact, I see some of the doctors who answered you requesting for a second test at 12 weeks only to put all your fears and apprehension to rest. The repeat test is not for clinical suspicion, but a means to help you get over this fear of HIV.

If you feel you are assured after this reply, you need not repeat tests. You don't need another HIV tests after combo and PCR tests are already negative.

The night sweats and nerve pain are most likely part of your anxiety symptoms. Talk to a doctor about your fears, he/she might start you on anxiety treatment. That is definitely needed NOT HIV Tests!!

Hope this helps.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 1 hour later
Dear Dr. Passad,
Thank you for your reply.
I did another 4th generation Elisa combo test in different lab today. Due to my anxiety of last night's night sweat.
In fact, can you give me some idea about the probability of "false negative" of all my tests before?
And did u ever seen any case happen turn to positive after 6 or 7 weeks combo test and rna test?
I m very tired......
Please help!

Regards
XXXX
doctor
Answered by Dr. Prasad 14 hours later
Brief Answer:
With multiple tests, I'll rule out false negatives

Detailed Answer:
Hi,

Routinely used tests for HIV - antibody tests, p24 antigen estimation tests and PCR test are highly sensitive tests. Antibody tests and PCR tests are extremely sensitive with sensitivity ranging close to 99.9%, which means these tests give accurate results (without false negatives) almost all the times unless there is an error with the instruments or faulty methods. Similarly p24 antigen are more than 95% sensitive.

We may doubt about false negatives when one form of test is done at a specific interval. However when multiple forms of tests performed over a period of time are negative, I will rule out all chances of false negatives.

Therefore in my opinion you can safely rely on the test results. It's time that you put the fears to rest and move on. If the thought persists to trouble you, visit a doctor and try a brief course of antianxiety pills. Anxiety about HIV creates more havoc than the infection itself. I can give you the assurance about HIV negativity, but you need to visit a doctor for anxiety treatment.

Hope this is clear.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 2 hours later
Hi, Dr XXXXXXX
Thanks for your wording. Honestly it made me feeling better.
It's 50 days blood sample test yesterday. The result is negative today.
I m very tired. It's talking about 40 days to go.honestly i planned to do the blood test weekly!
Dr. What is the possbility to turn positive in coming 40 days?
I know you already explained in the last reply. Can you tell me more?
Once again, thanks for your wording.
Please stay with me here. I really cannot sit alone.

Regards
XXXX
doctor
Answered by Dr. Prasad 2 hours later
Brief Answer:
Get over the thoughts...

Detailed Answer:
Window period for individual tests are different. Individually HIV antibody tests are subjected to this window period tests where the test results are not reliable between 3 - 12 weeks (in rare cases it extends to 6 months). Therefore there is a need to repeat the tests.

Here, you are talking about other tests - PCR, P24 antigen as well as antibody tests performed at various intervals with negative results. All these results clearly confirm your negative status. I would ignore the information printed on each of those tests as the information provided doesn't take into the account your medical history and past laboratory tests results.

In a nutshell, chance of HIV through oral mode is extremely poor even if partner was infected. Repeated tests proving HIV negative is another reassuring fact. I am more than convinced in your case and I will not order another tests.

I strongly suggest you put this thought behind. Consider antianxiety drugs if you are troubled.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 3 days later
Dear Dr XXXXXXX

It's 54 days today, I did just did another combo test and RNA PCR test this morning. Combo test reault is Neg. RNA will be ready by tomorrow evening.

Dr. XXXXXXX Any comment?
doctor
Answered by Dr. Prasad 28 minutes later
Brief Answer:
I think I have already given my comments earlier..

Detailed Answer:
Hi,

Think I have already given my comments. I would really be surprised if any of the tests now or in the future come positive. In other words, I am more clear that the chance of you becoming seroconverted to positive is almost close to zero. So do not be worried.

Let me know if you have any other concerns.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 22 hours later
Dear Dr. XXXXXXX

Because of my anxiety, it's very horrible.

The RNA PCR report result is negative today, it's a 54 days report.
Can you give me some idea? Am I rules out of HIV?

Regards
doctor
Answered by Dr. Prasad 18 hours later
Brief Answer:
Get this thought off...

Detailed Answer:
As I mentioned in my previous discussions, all these tests are highly sensitive and specific tests. Chances of inaccuracy are close to zero. You should stop repeating this tests. Visit a doctor for anxiety treatment. Perhaps look for integrate couselling and testing centre (if you have such centers in your country) who can help you get over this anxiety.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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