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Author Topic: Somewhat odd situation from lab  (Read 734 times)

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Offline LookingForAnswers

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Somewhat odd situation from lab
« on: January 17, 2014, 03:26:54 PM »
Hello, and thank you for allowing me to join the forums. I have browsed this site off and on for years as I have multiple friends with HIV and I wanted to keep myself informed as much as possible.

I am a gay man in my mid 20's. I recently went to the doctor last week for a regular physical and standard std/sti/hiv screening. I was notified earlier in the week that my tests came back non reactive, but the lab attached a note requesting an RNA test.

I am well outside of the window period, have not had any sexual contact in well over a year, and I do not do any type of drugs. I found this odd that the lab requested further testing as I wasn't even borderline, it was a definite non reactive. Unfortunately, I live in an area where people still like to assume all gay men have HIV and AIDS, and the nurse herself couldn't even tell me what test they did. I asked if it was Eliza or Western Blot and she had no clue and apparently had no idea there was a western blot for HIV. She said it just said HIV-1 and HIV-2. As far as I was aware (I could be wrong) this test doesn't check specifically for the virus, but for antibodies.

What I found alarming was her response when I asked her what the lab said. "Well they found some traces of HIV in one of your samples, so they wanted to do an RNA test to double check."  For one, how would they find traces of the virus if it was only for detecting antibodies. Second, how would I show nonreactive well outside of the 6 month window period?  I understand false negatives, so I was concerned. I went and bought an oraquick test and took it following the instructions 100%. It came back negative. Yesterday I went to take the RNA test and will hear those results probably on Monday.

This nurse also freaked me out when reading the Hep B portion. "It says here you have an immunity to it..." Long awkward pause followed by, "Have you ever had the vaccine?"  I informed her that I had to have the vaccine in 2009 to work at my previous job. Then she flipped the page and it apparently said the immunity level I had was in line with what a vaccinated persons's immunity would be.

I don't know if the lab wants to do additional testing because they assume since I am gay, I'm also lying about my 1.5+ year celibacy or what the deal is.

Is this standard for a lab to request an RNA test when the test comes back non reactive, and not even borderline?  This has been the most stressful 2 weeks of my life, though the oraquick test did put my mind to ease a bit.

I plan on finding a different doctor, will probably ask one of my poz friends who they see so I know I'm going to a doctor that is knowledgable about it.

Sorry for the long post, but I have not been able to find info online about labs requesting an RNA test after testing negative 1+ year outside of the window period.

Online Jeff G

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Re: Somewhat odd situation from lab
« Reply #1 on: January 17, 2014, 03:45:17 PM »
You can rest easy because you are HIV negative . All of the test and the window period are in line and conclusive that you do not have HIV . The oraquick test coming back negative is sufficient in its own to confirm you do not have HIV . If you continue to question what test were run then I would call them back and ask again to be counseled on your test results . The truth is that its clear you do not have HIV . 
 
Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Offline LookingForAnswers

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Re: Somewhat odd situation from lab
« Reply #2 on: January 17, 2014, 03:58:04 PM »
Thank you very much for the quick reply. I figured after the oraquick was the nail in the proverbial coffin and it put my mind at ease. I also always practice safe sex when it happens, I just was confused as to whether the RNA was standard procedure after a neg test as the nurse clearly was not able to provide any substantial answers.

Thanks again for the answer, and you definitely made me feel a lot calmer about this. I hope you have a great weekend!

Online Jeff G

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Re: Somewhat odd situation from lab
« Reply #3 on: January 17, 2014, 04:07:09 PM »
You are most welcome .

Offline Ann

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Re: Somewhat odd situation from lab
« Reply #4 on: January 17, 2014, 04:56:30 PM »
Looking,

As Jeff says, you don't have hiv.

If I were you, I'd seriously question their insistence on RNA testing. Maybe they get kick-backs from the lab; who knows. I do know that RNA testing is very expensive. And totally unnecessary in your case.

Yes, please do find another doctor. This one (or at least his nurse) is living in the last century.

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 LookingForAnswers

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Re: Somewhat odd situation from lab
« Reply #5 on: January 17, 2014, 07:20:16 PM »
Looking,

As Jeff says, you don't have hiv.

If I were you, I'd seriously question their insistence on RNA testing. Maybe they get kick-backs from the lab; who knows. I do know that RNA testing is very expensive. And totally unnecessary in your case.

Yes, please do find another doctor. This one (or at least his nurse) is living in the last century.

Ann

I know this is my last post in this forum, but I wanted to thank both you and Jeff again. I'm sure I'm negative, however this whole debacle was just stressing me out. I live in the South in the USA, and unfortunately it is hard to find doctors that 1.) Understand that just because I'm a gay male, that doesn't mean I participate in risky behavior; and 2.) Understand that I am telling the truth about my last even slightly possible exposure. I'll definitely get in touch with a few of my poz friends and ask which doctors they see, regardless of my HIV status. I too was wondering if the office is getting kick-backs from the lab.

The whole RNA request kind of shocked the hell out of me. The nurse specifically said they found traces of HIV in one of my samples. Again though, that made no sense as I was under the impression the standard HIV-1 and 2 tests only looked for antibodies, for which both came back as nonreactive. She didn't say they found some antibodies, she said they found traces of the virus.  I'm wondering if she is confused about the cut off index and thinks any number above 0.00 means there is HIV. Either way, I already gave blood yesterday for the RNA after I bought an Oral in home test the night before due to the vague description she was giving me on the phone. I needed to be able to put my mind at ease since this doctor's office has put me through the ringer for over a week now. It sounded much like a nurse telling someone, "Well you don't have cancer, you just have some cancerous cells in your lymph node," or, "You aren't pregnant, you just have some cells creating a fetus developing in your body." 

I think looking for a new doctor who has a nurse that is knowledgable about HIV and other health concerns is the best thing at this point.

Thank you both, again. I definitely appreciate the reassurance.

Offline Ann

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Re: Somewhat odd situation from lab
« Reply #6 on: January 18, 2014, 07:43:57 AM »

The nurse specifically said they found traces of HIV in one of my samples. Again though, that made no sense as I was under the impression the standard HIV-1 and 2 tests only looked for antibodies, for which both came back as nonreactive. She didn't say they found some antibodies, she said they found traces of the virus.  I'm wondering if she is confused about the cut off index and thinks any number above 0.00 means there is HIV.


Looking,

You're right, it makes absolutely no sense whatsoever. The standard hiv tests only look for antibodies and in no way could (or should) someone tell you that they found "traces of hiv" on an antibody test. This person obviously has no idea of how the tests work. It's not rocket science either. It's basic medical knowledge and not something for a health care worker who administers - or relays the results of - these tests to be confused or ignorant about. 

Scandalous! If I were you, I'd refuse to pay for the unnecessary test. (And people wonder why insurance premiums are so high? I wouldn't be surprised if your insurance carrier refuses to pay for this test, btw.)

You need to know that sometimes PCR tests can yield FALSE positive results. DNA PCR tests are much more prone to this, but it can happen with RNA PCR tests as well, particularly with some of the more sensitive ones on the market today. If it does come back with "detectable" virus, unless that value is over 500-1000 then it's a false result. I don't want to alarm you with this info, but forewarned is forearmed.

A negative antibody test result trumps any result on the PCR test. When PCR tests are used as diagnostics (which is what they're trying to do), any result must still be confirmed with further antibody and (only in the case of a positive antibody result) Western Blot testing.

Further antibody testing is unnecessary in your case, as the PCR test should never have been run following a non-reactive (negative) antibody test. I'm giving you this information in case it comes back with a false detectable result (a false result would typically be in the tens or low hundreds) so they don't scare the shit out of you with their ignorance.

I can't tell you how much your situation pisses me off. Practitioners who don't know their ass from their elbow where hiv testing is concerned have no business performing the tests. Sheesh. >:(  They need to be reported to your local health department.

[/rant]

Good luck finding a decent, knowledgeable doctor. I hope your friends can point you in the right direction.

And remember, use condoms for anal or vaginal intercourse, correctly and consistently, and you will remain hiv negative.

Ann


PS - In addition to your friends' recommendations, you can ring a local ASO (aids service organisation) for two things.

One, they may have a list of gay-friendly GPs.

Two, I'm sure they'd be very interested to hear about your experience and they might be able to arrange for everyone employed at this doctor's office to undergo an hiv awareness course so this isn't an ongoing situation with them. They really need to get up-to-speed with their hiv testing knowledge. There is NO EXCUSE whatsoever in the 21st century for this level of ignorance from someone who is providing hiv testing. I sincerely hope you do this - if we don't rail against ignorance, who will do it on our behalf?  :)

You can find an ASO near you by using poz.com's Health Services Directory. Just put your zip code into the appropriate field in the lower half of the page.
« Last Edit: January 18, 2014, 08:09:04 AM by 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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