Hopefully False Positive

[reformed]

After a one-time high risk encounter with a prostitute (unprotected intercourse) I decided to do a 2 week and 4 week ultrasensitive qualitative PCR by DNA test.  The 2 week was undetected and the 4 week was "reactive" which means positive.  My 4 week antibody test was negative.  Obviously I freaked out at the reactive test especially since I was beginning to be fatiqued and had a dry mouth all the time. I also had the classic sore throat and small rash at the 3 week mark.

I went to a doctor and explained everything.  By this time my wife knew everything too. The doctor retested the qualitative PCR (at a different lab) and did an ultrasensitive viral load.  Both came back undetected and he believed that I was probably negative and recommended I take the 6 month antibody test.  I took the test at 6 months (for HIV-1) and the test was negative! 

My concern is that because I had a reactive result on the PCR test and because my high risk exposure was in Toronto (lots of foreigners) I may have a false negative on the antibody test because of the high prevelance of non-B subtypes among HIV-1 infections in females in Ontario.  Is there a more sensitive antibody test that is not tuned to subtype B but is equally sensitive to all HIV-1 Group M subytpes that will put my mind at rest?  Should I request a doctor to review a western blot along with a more sensitive antibody test?

Please help.....  I cannot bring myself to have sex with my wife and it has now been over 1 year!  Put yourself in my shoes.... a positive result with some symptoms! Please don't tell me to get counselling.

The only ongoing symptoms have been dry mouth. I firmly believe that if there is a better test that will give me greater assurance I will be able to put this behind me. Please advise.

Desperately seeking to move on.

[Darkfiber]

reformed

The PCR test is not approved as a diagnostic tool. We have seen false positives with PCR on this board.

Thatīs why we are suggesting an Elisa antibody test after 3 months.

The negative ELISA tests are suggesting that you are not infected with HIV.

The current Elisa tests cover all common subtypes of HIV. HIV 2 is only common is some isolated african countries.

Elisa is still the best test used to find HIV infection.

Hope this helps.

Darkfiber

[beto_andolini]

Monsieur,

This is exactly the reason why it is NOT recommended to use PCR tests in diagnosing HIV infection.  PCR tests can on occasion produce "false positive" results.  

You are CONCLUSIVELY HIV NEGATIVE given that you had tested so past the 13 week window period.  You did NOT need the six month test.  I don't really know much about the HIV types, etc.  However, you can be confident that you are HIV NEGATIVE.  Please move on with your life.

Beto

[Ann]

reformed,

As the others have pointed out, this is exactly why PCR testing is NOT approved for diagnostic purposes - they have a high rate of false positive results.

Funny how out of four PCR tests, you choose to ignore the three negative ones and want to insist the single positive one is the correct one. Not to mention you want to ignore the negative antibody tests, which by the way, are the only tests you can actually use to determine your hiv status. Even if all four of your PCR tests came back positive, your status would have had to be confirmed with ELISA testing.

PCRs are well known for false positives. ELISA antibody tests are well known for their accuracy. Trust your antibody tests - you are absolutely hiv negative. Forget about this subtype nonsense, at six months, if you had any sort of hiv it would have been picked up. It would have been picked up at three months as well.

You are hiv negative. Protect that negative status in the future by using condoms for intercourse unless you are 100% certain of your partner's hiv status. Use condoms and avoid hiv infection. It really is that simple. And stay away from PCR testing!

Ann

[reformed]

Ann,
You have to understand that a positive result makes an already anxious person convinced he may have HIV.  I have not been able to have sex with my wife since this event and she doesn't like condoms.  This is the only time I have ever been involved in a high risk situation.  I am finally ready to move on but I would like one more confirmation with an antibody test that is known to be more sensitive or accurate for non-B subtypes (such as all Group M and Group O).  Heterosexual transmission in Ontario is 20% non-B subtype according to the Canadian government studies. There is a technical article from 2002 that explains current PCR & viral load tests may show nondetectable with non-B subtypes (even group M subtypes).  Eliminating this possibility on my repeated PCR tests (done with Labcorp) by taking a more sensitive antibody test for non-B subtypes combined with a western blot test would allow me to have sex once again with my wife.  I am willing to make this commitment but I want to know what test to ask for and how to get it. Can you offer any suggestions other than seeing a shrink?