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What do my lab test results indicate?

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Posted on Thu, 5 May 2016
Question: Dear Doctor,
Brief overview of my health condition:
1- Protected intercourse and unprotected oral(tongue kissing , bj) with 3-4 csw 5 months back and right from then contineous stress and anxiety of contacting hiv and std's.
2- Trying to forgot everything after my 12 weeks negative results but still symptoms after 5 months driving me crazy
Symptoms still persisit
- Burning mouth,lips and tongue
- Weekness , headspins , feeling faint and breathing discomfort(like in high altitude)
- Burning foot and hands sometimes
-apathus mouth ulcers 3-4 in last 30 days
- light senstivity and blurr vision
My questions:
1- If my results are negative than still why all such physical troubles going on.
2- Why hiv pcr rna report its mentioned as <72 ul/ml , not negative?
3- My heart beleiving i am free and fit but how hard m trying to conveince my minds but all efforts going in vein.Do u believe i should retest after 6 months.
4- Is there any known case of hiv 3 month turn positive after 6 month ?
5- Why there is so confusion about window period of hiv across the world. But window period we are factoring in XXXXXXX and which version ( ver 3 ,4) of elisa test are used in XXXXXXX hospital XXXXXXX ( elisa hiv1-2 antibody).when they are upmost conclusive (days/months) with no further XXXXXXX and testing require.
Please refer my test reports status.
Report details:
34 days ( approx 5 weeks)
Elisa hiv 1-2 - neg
Hep B and C - neg
Herp simplex virus 1-2 - neg
Ecg- normal
TMT- normal
Lft- normal
87 days( 12 week+ 3 days)
Elisa 1-2 hiv- neg
Hep b and C - non reactive
Hiv pcr rna quantitative - <72 ul/ml
Vldr - neg
Day 110
Ana - 1:100
C protein - neg
Esr- neg
Tsh -5.5
Vit D - 17
Uric acid - 470 ( normal 200-420)
Day 150
Tsh 2.4
Full blood count - reports attached
Doc , i have no energy left to fight with my mind everyday and to live in fear and ambiguity. Please suggest me what to do as patient and more as ur friend or younger brother.
doctor
Answered by Dr. S. Murugan (5 hours later)
Brief Answer:
You are free from HIV infection. Symtoms not related to HIV.

Detailed Answer:
Hi,
Welcome to HCM.
I saw your reports. Except the slight rise in Uric acid level all other blood parameters are within normal limits.
I understand how much mental tension you are having. You had already discussed your problem with many consultants in HCM itself.
You are absoultely free from HIV as per your ELISA report after 12 weeks and along with the RNA PCR report. They are confirmatory and conclusive. You can simply forget those incident and can concentrate in your day today activities. If you have not convinced, then you can have a consultation with some psychiatrist also.
Regarding your specific queries:
1. Your symptoms are not specific to HIV infection. They can occur to anybody. Sometimes due to anxiety also. Your treating physicial will fix the diagnosis and guide you for further treatment.
2. HIV RNA PCR test done to you is a quantitative test used to assess the prognosis of the disease and to assess the response to treatment and not for diagnostic purpose. DNA PCR is more of diagnostic. Quantitative RNA PCR has the capacity to recognize viral particles up to the extent of lower limit given by the manufacturers. But in your case, it has definite value along with ELISA and it ruled out the possibility of HIV 1 infection.
3, 4, 5. In normal circumstances the window period would never go beyond 12 weeks after the exposure. Don't get confused from materials you get from websites.
I am, in my practice of 25 years with HIV medicine (had come across around 2000 cases sofar), yet to come across a single case who becomes positive after 3 months nonreactive results. This window period (6-8 weeks, may be extended up to 12 weeks) is applicable to all types antibody tests.
Get well soon.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (6 hours later)
Dr XXXXXXX Sir,

I was following your post in healtcaremagic from quite a long time and trust me your suggestions are saving many lifes and setteling the fears of patients like me.
Coming to my case as all doctors mentiond i am negative and i should forgot all such issues. Beleive me till 4-5month( XXXXXXX 2016) i was very happy with my negative results and trying to settle my anxiety of last 4-5 months.
But symptoms after 5 months till now again put me into fear zone of hiv.
1- On and off fatige and feeling faint and breathing discomfort is the most scary symptom started 3-4 weeks before. I have never experienced such symptoms even during my initial anxious days(sept-oct-nov). When i was not able to think anything beyond hiv.
2- All joint pain , soar throat, mouth ulcers started 3-4 weeks back.
3- I am feeling pain in neck , my back , armpit and it feels like lymph node will appear soon.
4- My nails are getting white from top and white marks in some finger nails ( pic attached check 4th nail from thumb). I was checking all my body parts from last 5 months and trust me it was not like that before 2 months. Now i heard nail decolouration (white and tarry nails are hiv symptom).
5-I didnt had any unprotected sex with my life partner in last 5-6 months. But now she had skin rashes , night sweat ( one night) and severe headaches and leg joint and calf pain which are also driving me crazy. Only thing is oral unprotected in last 6 months which includes only kissing on cheeks and other body parts not even lips and close mouth.
Sir i want to move on into my life but these all symptoms started after 4.5 - 5 months (post 2 months of my elisa and pcr test.
According to my Internal medicine doctor my PCR test is negative since test assay have detection limit upto 72. But than why in result its not mentioned as negative though in interpretion section point 1 was- 1- negative- no hiv rna strain detected
2- <72 - hiv -1 rna detected <72ul/ml
3- >72 to 1* 10^7 - hiv 1 rna detected from 72 to 10^7 and withi the linear range of assay.
4- > 10^7 - above the range of assay.
My doubt is why point 1 was not written in results section and how realiable is point number 2 to consider as negative results.Is it the common way of refering the results in XXXXXXX and reputated hospital like XXXXXXX
These symptoms always dragging me to if , else and buts statement nd security of life of my wife and family and challenging me not to trust my results.I hope u understand my point and my condition.

Dear sir , my last question from all the respect from my heart ..... If u were in my place and u hv similar situvation like me what would be ur opinion on pcr test and on hiv status and reason of all such symptoms etc. I am just 10 days away from six month mark... Do i need to retest or no need at all for that.

Pls consider me as ur child and take me out of this mental situvation . Trust me it was my first and last exposure and I learned my lesson well.

Regards

Worried boy.n
doctor
Answered by Dr. S. Murugan (28 minutes later)
Brief Answer:
Your symptoms could not be due to HIV as well as your wife's rashes.

Detailed Answer:
Hi,
Welcome back.
Acute infection in HIV would manifest by 4-6 weeks after the exposure in the presence of an infection. It would be self limiting within 2-3 weeks. Then the individual remains asymptomatic for 5-10 years. Then only real manifestations of AIDS could occur according to the severity of immune defficiency. This is the natural course of HIV infection.
So symptoms occuring or persisting till 5-6 months after the exposure could not be due to HIV as per our follow up of hundreds of HIV positive individuals. Nail changes in HIV can occur only in late stages or due to certain ART drugs and can not occur by 5 months of infection. I don't want to discuss each and every symptom of yours as they could be due to your anxiety. Consult your physician about your problems. I will not recommend to test once again for HIV once again after 6 months to any of my kith and kin at this situation because I am sure that you are not having HIV.
RNA PCR test kit can not detect the virus if present in low titre mentioned below the minimum level needed for its identification (threshold). If you want more information about the same you have to ask micobiolgist or a Laboratory specialist.
Kissing over cheek is not the way of transmission for HIV. When you don't have sex contact with your wife, there is no possibility infection for her even if we consider that you are having infection.
Don't imagine the odd possibilities and trust that you are free from HIV.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. S. Murugan (21 hours later)
Dear Doctor,

Thanks alot for your contineous support. Last few question on followup . Pls bear me and pardon me if m asking repeated question and am apologising in advance.
1-I dont have unprotected sex but have protected intercourse 6-7 times with my partner including unprotected oral ( kissing neck and chest etc)
2- Everytime i am asking for PCR results , i am
Always getting probability answers not conclusive answer. At 87 days my elisa is negative and pcr rna <72. Sir i am an engineer and understand quantitative and qualitative values. Just i want in medical terms less than cut of is always negative supporting elisa test as well clinically.
3- Now coming to my symptoms . I dont care if they ate due to anxiety or even cancer heart attack or any other disease but just need assaurence that my results are 100% negative . And if there is any ambiguity in anyways what should i do next. Or there is no need to do anything and i can relax for my whole life and forgot this episode.


Regards


doctor
Answered by Dr. S. Murugan (1 hour later)
Brief Answer:
You are 100% free from HIV infection.

Detailed Answer:
Hi,
Welcome back.
1. Kissing over chest and neck have no risk for HIV.
2. When the HIV ELISA is negative by 87 day after the risk activity, undectable viral load with HIV RNA PCR indicates that you are free from HIV infection.
3. Your symptoms are 100% not due to HIV.
You can siply forget that incident and relax.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (26 hours later)
Hellow Doctor,

Thanks for confirmative suggestion. I will consider this postively and promise you and myself to start forgotting the episodes of past. My last question on this subject is:

- From last 2-3 weeks , i am experiencing my throat having pain and irritation. There is a while layer and creamish substance covering the back of throat wall . I can also observe very very small whilte dot on inner gum ( right side) and some in tonsils.Please refer the picture attached ... Back of my throat looks like similar.
Is it anything alarming with respect to such things appearing inside mouth.Socondly my neck in last 2 weeks i am feeling like lymph node but cant feel anything swollen.These certain menifestation started from last 2 weeks. Hope they have no relations to my fear. Would you be able to help me what should i do to rectify such discomforts.

Regards
doctor
Answered by Dr. S. Murugan (4 hours later)
Brief Answer:
Throat infection is not necessarily be due to HIV.

Detailed Answer:
Hi,
Welcome back.
I am not able to see any picture of throat. Pictures of the reports and nail only are available in this site.
Throat infection is the commonest problem in any community, at any age and at any point of time. It could be due to bacteria or virus other than HIV in the absence of an HIV infection. Pus forming infection could appear as white deposits. Any physician or an ENT surgeon will be able to differentiate the oral thrush from others. Similarly with the presence of a throat infection cervical lymph adenitis is also common and can produce strain over neck. So consult an ENT Surgeon and get well soon with traetment.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (1 hour later)
Dear Doctor.

Just help me in the this very spl point:
My wife had constant headache from last 1 week.Headache become mild in morning and it started increasing as the day progress. She also experiencing high legs and thigh pains from last 2 weeks.
She has severe abdonal pain as well , from last 3-4 days with the start of her mensural cycle 4 days back.
I am not able to understand what is going in my life. If i am hiv infected and since i know very well none of my last intercourses with her unprotected ( except kissing and breast sucking etc).why she is also experincing such severe symptoms.
In one time intercourse in sept , the condom which i used has expirey dat of Dec (after 2 month). Hope the condom quality was good till that time.

Please help me my wife problems are driving me crazy.

What could be the reason of her health issue , what should i do.

Regards
doctor
Answered by Dr. S. Murugan (3 hours later)
Brief Answer:
Your wife 'S symptoms are unlikely to be due to HIV

Detailed Answer:
Hi,
Welcome back
First of all, you are free from HIV. Then you had protected intercourse with your wife. Then where is the question of HIV to your wife. There is no such possibility at all.
Head ache, dysmenorrhea, pain over leg and thigh can occur to any body. Even prior to AIDS era itself such symptoms were quite common especially with women population.
Without a positive HIV test, nobody can diagnose HIV. In your case, it is clearly established that you are free from HIV. So your wife also has unlikely to have HIV infection.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (3 days later)
Dear Sir,

My wife headache is still continued and not setteling down. I met with local GP here and he had prescribed few medicines but they are not helping her much. Full day she is experinencing headache and pain in left hand. Although her legs pain are gone now.She had done few test and here is the reports attached. Just want to know your opinion is everything is all right or not? Anything suspecious related to my previous worries.
She had very low vitamin D from
So long i dont know but yes tested 5 months back and had value of 5.5.
Please doctor i am in big tension due to her contineous headache.
What does it mean of so many low and high values in CBC and urine test (1+).
Pls suggest.
doctor
Answered by Dr. S. Murugan (12 hours later)
Brief Answer:
Your wife's problem is not related to HIV/STD.

Detailed Answer:
Hi,
Welcome back.
Your blood parameters are almost normal and not anyway related to HIV/STD.
Head ache is a vast field ranging from general medicine, ENT, ophthalmology, neurology, neurosurgery etc. and not comes under my perview. Her Thyroid stimulating Hormone raised a little as well as lymphocyte percentage.
Consult first a general physician or internal medicine specialist. As per his/her guidance, investigate the cause of head ache for your wife.
It is not related to HIV/STD as long as her monogamous relationship with you is ensured and as you are free from HIV.
DR S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. S. Murugan

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What do my lab test results indicate?

Brief Answer: You are free from HIV infection. Symtoms not related to HIV. Detailed Answer: Hi, Welcome to HCM. I saw your reports. Except the slight rise in Uric acid level all other blood parameters are within normal limits. I understand how much mental tension you are having. You had already discussed your problem with many consultants in HCM itself. You are absoultely free from HIV as per your ELISA report after 12 weeks and along with the RNA PCR report. They are confirmatory and conclusive. You can simply forget those incident and can concentrate in your day today activities. If you have not convinced, then you can have a consultation with some psychiatrist also. Regarding your specific queries: 1. Your symptoms are not specific to HIV infection. They can occur to anybody. Sometimes due to anxiety also. Your treating physicial will fix the diagnosis and guide you for further treatment. 2. HIV RNA PCR test done to you is a quantitative test used to assess the prognosis of the disease and to assess the response to treatment and not for diagnostic purpose. DNA PCR is more of diagnostic. Quantitative RNA PCR has the capacity to recognize viral particles up to the extent of lower limit given by the manufacturers. But in your case, it has definite value along with ELISA and it ruled out the possibility of HIV 1 infection. 3, 4, 5. In normal circumstances the window period would never go beyond 12 weeks after the exposure. Don't get confused from materials you get from websites. I am, in my practice of 25 years with HIV medicine (had come across around 2000 cases sofar), yet to come across a single case who becomes positive after 3 months nonreactive results. This window period (6-8 weeks, may be extended up to 12 weeks) is applicable to all types antibody tests. Get well soon. Dr S.Murugan