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Author Topic: HIV test reliability or new strain???  (Read 14356 times)

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Offline ademalu

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HIV test reliability or new strain???
« on: June 21, 2010, 07:00:06 am »
Reading this  from HIV Testing Lesson got me worried about reliability of HIV testing
Am I Infected?  (A Guide to Testing for HIV)  
No diagnostic test will ever be 100 percent reliable, but if you test negative at the appropriate time (i.e., 13 weeks after possible exposure to the virus), you can consider that to be a dependable confirmation that you are HIV negative.
Well here is my situation
had exposure in mid may 2009 with CSW condom broke ,had rapid test in June and August 2009 all came out negative. had Elisa (elecsys)  test end for HIV 1 and 2 sept 2009 came out negative. Had QL DNA PCR test mid october 2009 came out negative. Several Rapid test every two months there after up to early march 2010 all negative.  Mid March 2010 had Elisa (elecsys)  test end for HIV 1 and 2 came out negative. Had QL DNA PCR (DBS) test end May 2010 ( after more than 1 year) which came out negative. I believe the DNA PCR test are for HIV 1. Can the QL DNA PCR detect genetic material for HIV 1 and 2.  But the body experiencing increased sweating,burning sores and hoarse voice. I was experienced a couple of night sweats in june, july and august 2009. I also had  red streaks moving from point to point on my body  in July 2009. could it be HIV.
 I did my cd4 early may 2010 and it was 400  and cd% 32. This got me worried because I have a fungal infection tinea pedis  that is failing to clear on my feet soles even with Oral and Topical medications. I have read that fungal infections are a problem with people who have a comprised immune system  were as healthy people will simply and easily fight them off. My soles are getting sweaty as well when I have shoes on and off. The skin under my fingers has become reddish for about half the nail size. I am also having a consistently dry throat.  
I am now past the  6 months window. I have done Hepatitis A,B and C tests all negative. Syphilis, Gonorrhoea, and Chylamadia All negative. Tuberculosis  negative.  I have had unprotected sex with wife  who has also developed a horse voice and some soles which indicate minor fungal infection. She has had several rapid finger prick test (determine for HIV 1 and 2) since early june 2009 up to early mid june 2010 all came negative. She has a hoarse voice as well Considering  that  I am  in sub-Saharan Africa where HIV is rampant and our soldiers go to West Africa for peace keeping missions and the CSW confirmed she had a soldier boyfriend who went to Sierra Leone. CSW first said she was HIV+ and later changed she was joking she is HIV-.  
 Is the Elisa (elecsys)  for HIV 1 and 2 able to detect antibodies to all subtypes for HIV 1 and 2? Is the QL DNA PCR able  detect genetic material for all subtypes for HIV 1 and 2? The question is if all the tests are negative then what is affecting my health. Is it that  there is a HIV new strain or is it one of these Circulating Recombinant Forms (CRFs) whose antibodies and genetic material  can not be detected. All doctors I have seen have said I am conclusively negative and should stop worrying. How can I stop worrying when I have lost some weight and I have gained a bit but only my tummy is bulging or is it LIPO? Confused I need help.  
« Last Edit: June 22, 2010, 02:45:08 am by ademalu »

Offline Andy Velez

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Re: HIV test reliability or new strain???
« Reply #1 on: June 21, 2010, 07:10:51 am »
Adema, you have more than reliably tested negative for HIV. You ARE HIV negative. Period. Your risk was minimal to begin with. The condom protected you until it broke. It was a brief and single possible exposure. Additionally, HIV is a fragile virus not easy to transmit and it is significantly more difficult to transmit from female to male than the male to female. So it's no surprise to me that you tested negative.

If your wife's symptoms persist she should check them out with her doctor. Neither her hoarse throat nor your foot fungus or anything else mentioned are HIV specific. And you can't pass to her a virus you don't have.

Husbands and partners who have strayed often remain unduly anxious about their status simply because of the guilt factor after the fact. Despite your doubts and fears your multiplicity of negative test results are a fact. And that facts say you are HIV negative. Period.
Andy Velez

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #2 on: June 21, 2010, 09:08:13 am »
Andy
Thanks for your quick response. one thing i did not  mention is that i used to have bouts of flu every month before exposure and i have read somewhere on the net that flu can cause delayed seroconversion. i do not have those bouts of flu after exposure. could the body have failed to produce specfic antibodies to HIV due to the flu virus i was have.  could this be the case?
« Last Edit: June 21, 2010, 09:39:34 am by ademalu »

Offline Ann

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Re: HIV test reliability or new strain???
« Reply #3 on: June 21, 2010, 09:39:36 am »
ad,

Flu does not delay seroconversion. Certainly not out to the time you've tested.

You do not have hiv and no further listing of your symptoms is going to change our minds.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #4 on: June 21, 2010, 10:07:55 am »
Thanks Ann
So what is your comment on the low cd4 count of 400 and the possibility of new strains that may not be detected.

Offline Andy Velez

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Re: HIV test reliability or new strain???
« Reply #5 on: June 21, 2010, 10:29:45 am »
CD counts fluctuate for all sorts of reasons. If you are concerned about that you need to discuss it with your doctor.

We would have already told you if your tests hadn't covered all types. You are worrying needlessly about HIV.
Andy Velez

Offline Ann

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Re: HIV test reliability or new strain???
« Reply #6 on: June 21, 2010, 11:23:18 am »
ademalu,

Your CD4 count is not low and your CD4% is very good. I'd love to have a % that high.

You do not have hiv!

If you read the Welcome Thread before posting like you're supposed to, you will have read the following posting guideline:

Quote

Anyone who continues to post excessively, questioning a conclusive negative result or no-risk situation, will be subject to a four week Time Out (a temporary ban from the Forums). If you continue to post excessively after one Time Out, you may be given a second Time Out which will last eight weeks. There is no third Time Out - it is a permanent ban. The purpose of a Time Out is to encourage you to seek the face-to-face help we cannot provide on this forum.


Please consider yourself warned!

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #7 on: June 23, 2010, 08:03:29 am »
Ann

Thank you and sorry for breaking the rules on the forum. it is just difficult when you pass through a time like this and read many stories especially on the net where HIV test kits made by  different manfacturers are used and report different results on the same blood samples. Please bear with me i did not intend to undermine your valuable advice and the great work you people are doing.Yes i agree with you the tests i have done are conclusive and on paper everything is ok. The discomforts on the body are the ones that cause me to ask all these questions and even thinking of new strains that my not be detectable. especially when you read cases like in this link  http://www.cdc.gov/eid/content/15/1/129.htm. Were HIV was  undetectable. Please accept my apologies. Please  see below:
 A 44-year-old Caucasian woman sought treatment at our hospital with a 1-week history of fever, unsteady gait, and progressive confusion. Her medical history included hypothyroidism, depression, and chronic alcohol abuse. The patient's first test for HIV was negative at 19 and 12 months prior to admission during routine intake screening for jail inmates (Abbott HIV AB HIV-1/ HIV-2 [rDNA] enzyme immunoassay [EIA] kit; Abbott Laboratories, Abbott Park, IL, USA). Six months before admission, the patient had a viral exanthem of blistering rash on her lips, palate, and chest. Two weeks later, she had oral thrush and a leukocyte count of 1,700 cells/μL. An HIV ELISA result was negative. Three months before admission, she was admitted to a different hospital for weakness, abdominal pain, intermittent fever, diarrhea, persistent oral candidiasis, and ethanol withdrawal. She had leukopenia and thrombocytopenia. A fourth HIV ELISA result was negative. The patient had been admitted to our hospital one week before the current admission with symptoms of fever, confusion, and urinary tract infection. Lumbar puncture showed an elevated protein level (106 mg/dL). A fifth HIV test result 6 days before most recent admission was negative. Five days before admission, she had been discharged to a rehabilitation facility.

On this hospitalization, she had fatigue, headache, disequilibrium, dysarthria, and blurred vision. Initial examination showed fever of 101.3°F, poor word recall, and a wide-based gait. Laboratory tests showed mild anemia and a leukocyte count of 2 × 103 cells/μL.

 
Over the next few days the patient's fever persisted and her mental status fluctuated. Tests on hospital day 2 showed a CD4 count of 101/mL (16.9%). Magnetic resonance imaging (MRI) of the brain showed diffuse symmetric white matter disease (Figure, panel A). Samples sent on hospital day 9 eventually showed wild-type HIV with a viral load >500,000 copies/mL. Repeat cerebrospinal fluid (CSF) test results were negative for cryptoccocus antigen, and PCR results were negative for cytomegalovirus, herpes simplex virus (HSV), and JC polyoma virus. The next day a sixth HIV ELISA result was negative. The serum level of HIV p24 antigen was 202 pg/mL.

On hospital day 13, she was started on zidovidine, lamuvidine, didanosine, and nevirapine. Within 24 hours, seizures and catatonia developed in the patient. An electroencephalogram showed diffuse wave form slowing. A repeat MRI showed worsened white matter disease (Figure, panel B). The result of a seventh HIV screening ELISA performed on hospital day 15 was negative. Two days later, the HIV viral load was 241,789 copies/mL. On hospital day 19, her serum levels were within normal limits: immunoglobulin (Ig) M level (164 mg/dL), IgG level (1,440 mg/dL), a 3× normal IgA level (1,060 mg/dL), and no oligoproteins. The CSF had an IgG level >10× normal (72 mg/dL), elevated IgG levels for HSV1 (1:160) and HSV2 (1:40), was negative for virus culture, and showed a negative rPCR result for JC polyoma virus. On hospital day 23, the eighth HIV ELISA result was negative. The Abbott HIVAB HIV-1/HIV-2 (rDNA) EIA was used throughout the hospitalization. On hospital day 24, supportive care was withdrawn and the patient died. Throughout her hospitalization, blood, urine, and CSF cultures remained sterile.

Autopsy showed acute HIV encephalopathy and cerebral vasculopathy. The findings included multifocal microglial nodules, perivascular inflammatory cells, vasculopathy with mural fibrosis and perivascular hemosiderin deposition, degeneration of the central white matter, and neuronal apoptosis (Figure, panel C). She also had Pneumocytis jiroveci pneumonia and hepatosteatosis without cirrhosis.

There are several possible explanations for the patient's HIV seroconversion failure. The first explanation is that the patient was subacutely infected but had a retarded humoral response. Delayed seroconversion has been documented up to 42 months after infection (3), but this seems unlikely with current ultrasensitive assays. Another possibility is that she was infected with a strain undetectable by screening ELISAs, such as HIV-1 Group N or a rare Group M subtype recombinant variant. This hypothesis also seems unlikely because of the rarity and geographic distribution of these strains (4). A third possibility is transient seroconversion with reversion to seronegative status (5,6). However, given the number and frequency of screening tests in this case, even transient seroconversion would probably have been detected. Another hypothesis, one consistent with the patient's rapid demise, is infection with a particularly virulent HIV variant, which led to rapid immunocompromise and failure of seroconversion. Such infections have been observed in rapid progressors, in which CD4+ T-cell depletion is so swift that B cells receive no T-cell help and are therefore not able to mount an effective immune response (7). In addition, chronic alcoholism may have contributed to immune failure and a rapidly progressive disease course (8–10).

This case raises several disturbing and interesting questions and possible avenues for future research. The diagnosis of acute HIV encephalopathy with a CD4 count of 100 cells/μL raises the likelihood that this patient was infected with at least 1 strain containing particularly neurotropic properties, possibly with X4 or R5X4 tropism, or that her brain was particularly primed for HIV-induced damage. Understanding the neurotropic properties of different strains of HIV may help prevent similar adverse outcomes in other patients.

« Last Edit: June 23, 2010, 08:33:03 am by ademalu »

Offline Andy Velez

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Re: HIV test reliability or new strain???
« Reply #8 on: June 23, 2010, 08:42:44 am »
Adema, you maybe interested in delving into "interesting cases."

We're not here to bat this back and forth indefinitely. We focus on specific situations as they are presented. And in your case you have reliably tested negative for HIV. You ARE HIV negative. Period. End of story. Keep using condoms consistently for vaginal and anal intercourse and you will stay that way in terms of sexual risk for HIV.

You need to stop surfing the net for more material to unnecesarily feed your fears. Really. We're not going to continue this back and forth with you. HIV is not your problem.
Andy Velez

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #9 on: June 24, 2010, 11:06:52 am »
Thank you Ann and Andy I will wait and see what happens and time will tell and I will surely keep you posted.

Offline Ann

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Re: HIV test reliability or new strain???
« Reply #10 on: June 24, 2010, 09:03:36 pm »
ademalu,

Don't bother. We already know that you do NOT have hiv. Don't waste our time.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #11 on: June 28, 2010, 09:07:11 am »
Please find qoute from someone who believes that they are other HIV virus that are not known. check the setence in red.

For Me, HIV/AIDS Is Not a Chronic, Manageable Disease

By ScotCharles


June 8, 2010

I am not a researcher -- I can only speak from my own experience -- but far too many people mistakenly believe that HIV no longer causes chronic illness because of the potent anti-retrovirals available. Over the last five years in particular, I have become aware that both doctors and the non-infected public have the ill informed opinion that HIV/AIDS is completely controlled by medications. The belief that HIV/AIDS is no longer a health threat has caused many to become complacent about avoiding infection and has also caused many to view the illnesses of the HIV infected as unimportant.

Most people do not know that the anti-HIV meds do not eliminate all the virus from the body; they merely reduce levels of the virus to undetectable levels, or less than 75 copies per milliliter of blood with commonly used tests. At these undetectable levels, the blood of a 180 pound man may contain as much as 431K copies of HIV.1 That viral load does not include the unknown thousands of HIV copies lurking about the body

My Doctor also told me that it has been documented that HIV can remain undetected for 12 years in some cases and mutations are making it difficult to pick new strains so i should keep testing every 3 months for some time. What are your comments and  what is the difference in realiability for the DNA PCR and RNA PCR for detecting the genetic material of the HIV virus. is genetic component for HIV 1 and 2 picked up by any viral load test.

Offline Andy Velez

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Re: HIV test reliability or new strain???
« Reply #12 on: June 28, 2010, 09:11:30 am »
You may be willing to obsess unnecesarily about HIV and your situation. We're not going to indulge you in that nor respond to the nonsense you're passing along here.

You now have the 28 day Time Out from the site which y ou have been warned about. Don't make the mistake of trying to get around it by creating a new name. We'll spot that right off and it will get you banned permanently from the site.

HIV is not your problem. If you can't accept that then get some professional help to deal with the issue. We can't address that with you in this setting.
Andy Velez

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #13 on: August 26, 2010, 02:50:56 am »
The medical people and counsellors do not want to think outside the box. They found HIV 1 and HIV 2 and the associated subtypes. what makes them so sure they are no new variants. I challenge them to come to Africa where they send cheap testing kits and are making HIV spread like a wildfire. People are walking confidently that they are HIV negative when infact not. I hope I don't get a time out I am just being objective. What else could cause sickness in myself and my spouse after  a risk exposure. The only sensible thing is that it is HIV. The tests of course continue to be negative 15 months. I have lost weight in the feet and  legs and gained it in the tummy. I have a consistent low CD4, sweat alot and persistent fungal infections. Your comments

Offline Ann

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Re: HIV test reliability or new strain???
« Reply #14 on: August 26, 2010, 04:14:54 am »
ade,

My only comment to you is that you seek counselling in order to discover why you cannot accept your CONCLUSIVE negative hiv test results. Stop chasing an illness you do not have and go see a doctor to find out what, if anything, is actually wrong with you.

And make no mistake, if you keep coming here to question your conclusive negative results, you will be given a second time out and it will last for 56 days.

PLEASE CONSIDER YOURSELF WARNED!

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline ademalu

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Re: HIV test reliability or new strain???
« Reply #15 on: September 07, 2010, 10:07:11 am »
I just had  cd4 count check over the weekend. last time in early May 2010 Cd4 count 400 and CD% 32 (Lab1) another lab Cd4 count 379 and CD% 37 (Lab2)..  this time ealy September  Cd4 count 650  and CD% 39 (Lab2)). Could   this  be a conclusive and indicate  that the initial drop was due to anxiety and depression
« Last Edit: September 07, 2010, 10:09:03 am by ademalu »

Offline Ann

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Re: HIV test reliability or new strain???
« Reply #16 on: September 07, 2010, 10:24:20 am »
ade,

The only conclusive test you have is your conclusive negative hiv antibody test.

CD4 counts can fluctuate by hundreds even in the course of one day, so there is absolutely nothing conclusive about CD4 counts. You don't need to be monitoring your CD4 counts - YOU DO NOT HAVE HIV!!!

Damn, I'd give my left arm to have a CD4% like yours. Get a grip already. Stop chasing an illness you do not have - and getting your CD4 counts done does indeed constitute chasing hiv. Knock it off.


I'm giving you that second time out you were warned about. You know the drill, don't attempt to create a new account unless you want to be permanently banned.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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