PLEASE ANSWER - Andy Velez and HIV experts

[cuni]

Hello all. I'm from Romania  sorry for my bad english, i'm 27 years old. On 12 november 2006 i have a remove tonsilites surgical operation , after 2 weeks i started to have night sweats(2 weeks),lack of energy, an altered state of consciousness,memory loss , I was very dizzie (vertigo). Those symptoms last about 3 weeks and then I started to have abdominal pain ,permanent nausea and muscle pain  .Now at 4 months after the operation I have loss of apetite,nausea and very bad muscle pain in my legs and arms. I was cheked by 5 doctors I have take a lot of medicines but I still don’t feel well.I think that I was infected with HIV from the operation(even if you will tell me that the instrument are sterilised) because before I was very healthy and I never felt like this. I was HIV tested at 3 months and at 4,2 months after the operation and the result was negative but i'm still worry that i got HIV from the operation. I have done all kind of blood analyses but it where all good even if i feel sick even now after 4 months from operation .   
               I read that in some cases it can take up to 6 months to detect hiv antybodies, even CDC says that. I don't have other illnesses (like you said cancer that can reduce my immune system ,so in what cases the body don't produce enough antybodies that can be detected .I have read all your responses to other people worried that they are infected and you say that at 13 weeks the result is conclusive .PERIOD as Andy Velez likes to say, but a lot of sites say that it can take up to 6 month to produce antibodies for HIV . This is what CDC say on their site : “ Most people will develop detectable antibodies within 2 to 8 weeks (the average is 25 days). Even so, there is a chance that some individuals will take longer to develop detectable antibodies. Therefore, if the initial negative HIV test was conducted within the first 3 months after possible exposure, repeat testing should be considered >3 months after the exposure occurred to account for the possibility of a false-negative result. Ninety seven percent will develop antibodies in the first 3 months following the time of their infection. In very rare cases, it can take up to 6 months to develop antibodies to HIV. “ As you see they say 97 people from 100 will
develop antibodies in the first 3 months. How will I know that I’m not the other 3 who don’t produce antibodies in 3 months ?
  Also I have some sugestion:you must make a rule that everybody in “Just tested POZ” should write how was their seroconversion(what symptoms ) and how long after they think they were infected they tested positive because this is what most people want to know when they are worried about a possible infection with hiv.
  Please answer me what do you think about my case and tell me why are you (Ann , Andy Velez, Rapidrod and others) so sure when you tell to all people that at 13 weeks the result is conclusive. I repeat I was tested (at the hospital in my city were they collect blood from people for blood transfuzion so I think they  made a reliable test ) at 3 months and at 4.2 months after the opaeration .  Also i did an endoscopy , 4 ecographie and all blood tests - all good ,that's why i'm so worried because the doctors can't find anithyng wrong with me

[Andy Velez]

For a longtime now the CDC has recommended 13 weeks as a reliable testing point EXCEPT in situations which involve IV drug use or a severely compromised immune system such as from treatment for cancer. Nothing you have suggested leads me to think either of those factors are relevant for you.

It's no surprise that you tested negative because you have simply constructed a scenario for transmission whcih has absolutely no basis in HIV science. You've decided for whatever reasons of your own that the instruments used for your surgery were somehow HIV-contaminated. Which frankly is ridiculous. HIV is a fragile virus which is not transmitted in an airborne way via instruments or any other such objects.

So you have absolutely no basis whatsover for this construct you have come up with. And simply because you are having symptoms which you've never had before does not by default mean HIV is the issue.

You need to discuss with your doctor(s) what is going on and find out the real reason. This not an HIV situation no matter what your thoughts and fears are saying otherwise to you.

 

[cuni]

Thank you Andy , but i want to know if you are a doctor and have some experience in HIV or you just say that a test at 13 weeks is conclusive  only based on what CDC say. Maybe my body is very week (because i have no energy, i don't sleep enough ,i don't eat well, i have nausea, muscle pain) and can't produce antibody detectable to test. I want to know that because this is not a game and you have a big responsability when you say to someone that his test at 13 weeks is conclusive and don't need to retest. So:
1)  your answers are based on your experience or on what CDC say ?
2)  why so many doctors recomand a retest after 6 months even to normal people(nondrug users, or the other with cancer)
3)  are anyone of the rest of the forum members who responds to our questions an HIV specialist ?
4)  as you can see evreybody is so worried about this window period and i want to know how is determined at 13 weeks , based on what people say or is somehow scientific determined ? Because i guess ( in fact i'm sure) that nobody was infected with HIV and than the doctors test them at some period intervals to see when they produce antibodies. So what was the method used to determine this 13 weeks period for a conclusive result ?
5)  what do you think about my recomandation that you must make a rule and everibody in " I just tested POZ" must write about when and how they think they were infected, about their symptoms and when they tested pozitive for HIV. I want that rule because everibody in "Am i infected?"when enter on this forum this is what is looking for.

[Andy Velez]

Cuni, are YOU a doctor? If not, you seem to be practicing medicine on yourself without a license. That's a very dangerous thing to do.

You need to see a licensed doctor to discuss your symptoms.

Unless there is something you haven't mentioned like having had some unprotected intercourse or are an intravenous drug user who has shared needles with others, then this is not an HIV situation.

If you don't like what you've been told here you are free to go elsewhere for help. Perhaps this site is not for you.

[cuni]

         Excuse me Andy if you think i was rude when i asked if you are a doctor . I see that you are disturbed about my questions but as you see in "Am i infected?" almost all people don't trust in this 13 weeks period because a lot of doctors recomends a retest at 6 months.
          I promise that this is my last post (except my test result at 6 months after exposure wich will be on middle of MAY) if you answer at those questions and No i don't have any other exposure after operation but there are many cases of infections aquired in hospitals by pacients and thats why i'm so worried.Romania is a very poor country and the hospitals are so dirty and i don't trust they sterilised surgical instrument as well as they should.

[Andy Velez]

There maybe other infections acquired in poorly maintained hospitals in your country, but it is very unlikely that HIV would be one of them. It's a fragile virus and when exposed to the air soon loses its viability.

Go ahead and get tested if you feel you need the negative test result to put your mind at ease. The CDC is quite conservative about testing and has for a longtime recommended 13 weeks as a reliable testing point. The only exceptions are situations which involve HIV drug use or a severely compromised immune system from cancer treatment or such.

We can't account for what doctors or other sites may say about testing out to six months. With the sensitivity and accuracy of today's HIV tests six months has become an outdated testing point. But you go ahead and do whatever you like. Maybe doing that is the only way you will let go of this concern.   

[cuni]

http://www.thebody.com/Forums/AIDS/TreatExp/Current/Q176902.html   here you can find a response from an hiv expert about the 3 or 6 months reliable testing period. What do you think about it ? He don't say that a 3 month negative test is 100% reliable and he treated a lot of hiv infected people. From his answer the conclusion is that you must retest after 6 month after the exposure

[cuni]

Testing with Caution
Aug 5, 2006

Hello Dr. Daar,

I notice that the physicians who very generously give their time on this website vary somewhat in their advice as it relates to the window period after a possible HIV infection and testing. Some rely on a three month window very strongly whereas others rely on 6 months and sometimes longer.

You appear to be one of those who prefer a more conservative approach. Is this because you have encountered patients who have tested positive after a 6 month window or is it because you believe in being certain/cautious with such a serious viral illness?

I greatly appreciate the time and effort that you give here in answering these questions.

Regards,

Warren

 
 
 
  Response from Dr. Daar

Hi Warren, Thank you for your posting.

The short answer to your question is that I tend to be conservative on these types of issues. For what it is worth there is a general concensus that seroconverion more than 6 months after an exposure is rare. It is recognized that most seroconversions do occur within the first 3 months and there are case reports beyond 6 months, although always difficult to verify that there were no other exposures in these select cases.

Delayed seroconversion (after 6 months) may occur with increased frequency in those who received antiretroviral theapy after an exposure (so called PEP) or in those who were infected with hepatitis C at the time they acquired HIV.

Based upon this information you may hear different experts say different things but in general we probably would all agree that after a specific exposure testing should occur at 3 and 6 months. The first test should help people rest a bit easier since most will have seroconverted by then if they are infected, and then 6 months to usual stop worrying completely. Most would agree that 12 month follow-up testing is optional with the exception perhaps of those who received antiviral therapy after the exposure and/or acquired HCV at the time of the exposure in question.

I hope that provides some clarity as to why you hear different opinions.

Best, Eric
 

[Ann]

cuni,

If you want to disregard our advice that a test at three months is sufficient and conclusive, go ahead and test again. Don't be surprised when you get another negative result.

Ann

[cuni]

i am well surprised that my 5 month test did it today is negative again. It's so hard to believe that i don't have HIV when i felt so bad and had almost all the symptoms of HIV and the doctors can't find anything wrong with me. I will do another test after 1 month.I hope it will be negative too.

[RapidRod]

You can test till the cows come home, but it's not going to change.