POZ Community Forums
HIV Prevention and Testing => Do I Have HIV? => Topic started by: jjmh78 on July 01, 2006, 12:32:11 pm
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Good afternoon to all!
I had a high risk exposure (unprotected receptive anal) in early March. About a week later came down with flu and a constellation of other symptoms. During that time my primary care did a quantitative viral load thinking that I was possibly in acute infection before seroconversion. He repeated the tests at 3 months post exposure and antibody came back non reactive, viral load at undetectable >50 copies. I plan on following the CDC recommendation to re test at 6 months and have been ABSTAINING until all this is cleared up. Should I be concerned that my 6 month test will be positive after all the negative tests so far? I know that symptoms do not equal HIV, so, feeling the way I have been for the past few months, I would prefer to move testing towards something else if it is unlikely that I am HIV infected.
Thank you for any advice you can give
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Your 3 month test results are conclusive. The CDC lowered the testing several years ago from 6 months to 3 months.
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Thank you for your response...I guess why I have anxiety is because when I asked my doctor if this was conclusive he said he wanted to repeat serology at 6 months. The other parts that create a problem is that I have symptoms of something(I admit it could be my own anxiety/hypochondriasm) and it is difficult to let go of HIV because of how I feel, a confirmed diagnosis of HIV+ partner and this 6 month window.
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Well, unless your doctor is using seriously outdated testing technology (outside the third world, where do you get your hands on those old tests?) a three month result is considered definitive.
One option, if you want, is to find a local HIV specialist and go to him/her and get the most advanced test available. Another is to call your doctor and ask for the specifics of your test, then cross-reference the test specifics with what your local HIV specialist can asertain.
Seems like an awful lot of work though, and at the end of the day, you will still be HIV negative. As for symptoms, you said a mouthful when you mention stress. People can, and often do, manifest an amazing array of symptoms based solely on stress. From pain, to swollen lymph glands, to nausea and weight loss, to rashes. And more. Much more. That's one of the main reasons why we don't discuss symptomology here as a rule.
From what you have described, you are reliably and conclusively HIV negative. Um, and of course, in the future, use condoms and all that. But you know that already :)
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No my doctor is here in NYC (where I live) and has many HIV+ patients. All of my labs (viral load, antibody and CBC's) have been performed by Quest Diagnostics, who, I believe, would be using the most advanced tests available. As far as sex goes, I'm taking a break for a while and spending some time with my Jack Russell and reading again!
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"An individual who tests negative three months after an exposure does not require further testing unless he/she may have repeated exposures or if their antibody test results are incompatible with their clinical history."
What clinical history is this speaking of? I am not doubting the ultra reliablility of tests at three months, I just want to know what this is refering to? Is it refering to oral symptoms, blood counts ect. Is it the clinical history before or during the testing period?
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Unknown, don't be hijacking threads. Post all your questions and thoughts in your own thread.
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I have another question regarding the tests performed...Would it be safe to say that given the timing of the tests performed (antibody/quantative rna at 2.5 weeks post exposure to known HIV source, quantative rna 1 month after exposure and antibody/quantative rna at 12 weeks after exposure) that if I were infected that something would have shown up by now? Is it likely that my body suppressed the viral load quickly without producing antibodies that were detectable at 3 months? All my testing has been for HIV-1.
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Yes, it is very safe to say that with those tests you list "something" would have shown up by now. The most current HIV tests include both HIV 1& 2 by the way.
The RNA is a very sensitive test -- so much so that the problem is sometimes getting a false negative, (but not a false positive). A negative on that at 28 days is next-best to home free, although it's recommended to re-test and confirm the result at 13 weeks. You've already done that so I don't see any need for re-testing, despite your doctor's suggestion to do that.
The CDC is conservative in this matter and considers 13 weeks to be a reliable testing point with the exception of those who are either IV drug users or under treatment for cancer or other such immune depleting circumstance. Which are categories I do not believe are relevant for you.
So as far as I can tell from what you've written HIV is a closed issue for you. Further testing is not warrantedbut do it if you must for your peace of mind.
If you are continuing to have symptoms that's something to discuss with your doctor. This is not an HIV situation.
Cheers,
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Thank you everyone for your help. I will update this thread in September when I take the "peace of mind" test... ;)
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So, here I am again...I went to the doctor today because I have had a horrible cold. He found lymph nodes swollen in my neck and above my collar bone and said he wanted to test again for HIV. He drew my blood for yet, another antibody test. This one is now at 4 months past possible exposure. On the way home I started crying (for the hundredth time in the past 4 months) and wondering why I don't have an answer yet for all of this. I thought I was done with HIV, now he says that I could get it and not turn positive for a long time...I am so confused and scared now. All I want is to know something!
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jj,
I'm sorry your doctor is putting you through this unnecessary grief. You have already tested conclusively negative for hiv. Your doctor obviously doesn't know much about hiv. His comment tht you could "get it and not turn positive for a long time" is pure bunkum.
The vast majority of people who have actually been infected will seroconvert and test positive by six WEEKS. Not months, WEEKS. The average time to seroconversion is only 22 days. You also had PCR testing and if you were positive, you would have tested positive on the PCR at your twelve week test, if not one of the earlier ones. During primary hiv infection the viral load (which is what the PCR test result is called) would be sky high.
You are hiv negative. You might want to find a doc who knows something about hiv infection. Yours doesn't.
Ann
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Ann - thank you, and to all who have responded to my posts. It has been so hard to think that this is over and then deal with it all over again. I can accept whatever the answer, but it is NOT KNOWING anything that makes it hard. My roomate says he doesn't like my doctor and I get the feeling that I should get a new one after all this. I get these results back Monday, so I will post again and let you all know.
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My ID doctor also said that the 6 month test is the definitive one. Maybe he is using the old standard, but that is what he said to me.
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Ronnie:
Sadly, your doctor is using obsolete information. The testing window was lowered to thirteen weeks several years ago by the NIH, the WHO and even the CDC.
I am always amazed, and dismayed, when an ID specialist does not maintain current on his practice and his craft.
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I'm not trying to be a pain and I realize you guys are giving the best advice available, but when I go to the CDC website, the closest I can find that says they follow a three month protocol is the following quote:
"Single Possible or Known Exposure
Most infected persons will develop detectable HIV antibody within 3 months of exposure (126). If the initial negative HIV test was conducted within the first 3 months after exposure, repeat testing should be considered >3 months after the exposure occurred to account for the possibility of a false-negative result. If the follow-up test is nonreactive, the client is likely not HIV-infected. However, if the client was exposed to a known HIV-infected person or if provider or client concern remains, a second repeat test might be considered >6 months from the exposure. Rare cases of seroconversion 6--12 months after known exposure have been reported (134). Extended follow-up testing beyond 6 months after exposure to account for possible delayed seroconversion is not generally recommended and should be based on clinical judgment and individual clients needs (54). "
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5019a1.htm
This statement sounds like they follow the three month rule partly. Does anyone have another link where the CDC states the policy more clearly? I realize that the CDC is very conservative and other countries and US states use a definite 3 month or less window, but was just curious if anyone has a link with a definitive statement from the CDC.
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Ronnie - Maybe one of the moderators can clarify, as I have read the same thing on the CDC website. I think that given my known date of exposure and all of the tests I have had, it is unlikely that I am infected. The CDC has to be conservative given the fact that they are establishing the giudeline for millions of people, especially when it comes to certain situations. But believe me, I am concerned having had a known exposure during a high risk behavior...I am very interested to see how the test turns out that my Dr did on Thursday last week (4 months post exposure).
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Jimh78: We both are in a similar situation. We both had a potentially very risky possible exposure and we both have tested a lot and all tests so far have been negative. We have also both had symptoms of something. The only difference I can see is that I elected to take the pcr proviral DNA tests rather than the RNA tests and my event was early February. Good luck to you and I hope everything turns out great for you! To the moderators: I apologize ahead of time if you consider this post a hijacking of the thread.....
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Ronnie - Maybe one of the moderators can clarify, as I have read the same thing on the CDC website. I think that given my known date of exposure and all of the tests I have had, it is unlikely that I am infected. The CDC has to be conservative given the fact that they are establishing the giudeline for millions of people, especially when it comes to certain situations. But believe me, I am concerned having had a known exposure during a high risk behavior...I am very interested to see how the test turns out that my Dr did on Thursday last week (4 months post exposure).
hmmm....looks like no one wants to clarify this?? CDC wants SIX months.
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<<hmmm....looks like no one wants to clarify this??>>
Hmm .... looks like we aren't all your monkeys, who will respond to each and every query or defend/condemn each and every web site.
This site spends hundreds of hours researching HIV related topics specifically for the benefit of this forum. Everything we claim is backed by first-tiered peer reviewed scientific data.
This site is very specific regarding the three month testing window:
<<There is a "window period" which is the time it takes the body to produce antibodies after HIV infection has begun. For the vast majority of those who will test positive, antibodies to HIV will develop within 4-6 weeks after exposure. Some will take a little longer to develop antibodies. To make certain that you receive a reliable test result, it's necessary to wait at least three months (13 weeks) after your last possible exposure to the virus before being tested.>>
http://www.aidsmeds.com/lessons/HIVtests.htm (http://www.aidsmeds.com/lessons/HIVtests.htm)
Also, look at the testing window on avert.org
http://www.avert.org/testing.htm (http://www.avert.org/testing.htm)
Other sources for information:
Busch MP, Kleinman SH and Nemo GJ. Current and Emerging Infectious Risks of Blood Transfusions. Journal American Medical Association, Feb 26, 2003; 289(8): 959.
Lindback S, Thorstensson R Karlsson AC et al. Diagnosis of Primary HIV-1 Infection and Duration of Follow-up after HIV Exposure. AIDS, 2000; 14(15): 2333-2339.
In addition:
<< most people will create enough antibodies in just 4 weeks after infection. We call this 4 week to 3 month time frame the window period>>
http://gmhc.org/health/testing.html (http://gmhc.org/health/testing.html)
<< Most people will develop antibodies detectable with the latest blood tests within 4-6 weeks after infection with HIV. Some people may take longer; but nearly all (99%) will have antibodies by 3 months following infection. >>
http://www.metrokc.gov/health/apu/infograms/testing.htm (http://www.metrokc.gov/health/apu/infograms/testing.htm)
And with NAT testing, the window is sharply reduced further:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10532610&dopt=Abstract (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10532610&dopt=Abstract)
and finally:
<< 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.>>
http://www.cdc.gov/HIV/pubs/faq/faq9.htm (http://www.cdc.gov/HIV/pubs/faq/faq9.htm)
A six month caveat is based solely on the anecdotal evidence collected in the early to mid 1990s, where people with severely compromised immune systems (chemotherapy patients, those taking powerful anti-immune drugs after organ transplants) took longer to seroconvert.
by all means, trawl the net and find outdated, inaccurate, and misleading information. And bring it here if you want. Banter back and forth with other worried wells. Get testy when none of us responds as quickly as you'd like.
Doesn't change the fact that this site remains one of the best researched and thoroughly referenced HIV risk assessment and testing sites on the net. Which, when you consider that this entire forum is a secondary function of it's primary purpose, is pretty remarkable.
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Ronnie, Mandy,
Please do not hijack this thread any further, and that includes responding to this message. Please keep all your addtional thoughts or questions in your own threads, please.
Thank you both for your cooperation.
Ann
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Thank You Ann and JK, everyone was making me more worried, in addition to my own doctor! I understand that all moderators participate here in the "Am I Infected" forum do so because they CHOOSE to and, in my case (known exposure/high risk behavior), I am very thankful for every bit of time you have taken to ease my concerns.
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So I called my doctor and told told me "I am glad to tell you it was negative, so at this point, it is safe to say whatever is going on with you is not related to HIV." He said that we are going to watch, wait and see what those lymph nodes/other symptoms are all about. So that's the news for now. ;)
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That's a great phone call to get and should relieve your mind.
Hopefully whatever is causing your swollen nodes, etc. will be diagnosed and resolved before long.
Cheers,
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Jimh78: Congratulations! My ID doctor told me the same thing today and also told me No More Testing! :)
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So...I went to my GP for a follow up for all my swollen nodes, assorted symptoms etc...He reviewed my tests and said "I don't know what's wrong" and referred me to an Infectious Diseases doctor and to get a chest x ray. Now I am worried that maybe he did the tests wrong or something and when the ID doctor tests me they will be positive. Does this sound unreasonable? I guess I never expected him to say he didn't know what was wrong, but I guess going to another doctor is a good idea...
I guess what I am having anxiety over, AGAIN, is my doctor's competence and hoping that he didnt screw anything up, skewing my results. I know I have had negative tests, but now I am questioning everything. Any advice? ???
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Seek out a mental health professional to help you accept your negative results.
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Actually I have been in therapy since all this, thank you for the advice.
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Jim: Even if your doctor was not competent (which is doubtful but possible) he/she does not perform the lab tests you have taken so his/her competence or lack thereof has nothing to do with your actual lab results.
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if you cant trust your conclusive negative results......I'll gladly trade ya for mine. If you dont know how to accept your results, try mine* (I was diagnosed in the late stages of Aids).
Be grateful and accept your test results as accurate, and quit wasting the focus of your life on this situation.
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Any advice? Yes, make sure you are discussing with your therapist why in spite of having reliably tested negative you are clinging on to your fears about HIV. What's driving your fears which at this point have absolutely no basis in HIV science.
A fear is a feeling. A test result is a fact. Get the difference?
You are HIV negative. Period. End of that story. No kidding.
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Update: Went to an ID doctor today who is testing me for a host of other things that cause non-specific symptoms, such as mine, that have no correlation to HIV. As the moderators in this forum have said time and time again, symptoms do not equal HIV. I have been stuck on thinking that I must have HIV because of my high risk behavior and symptoms, but am letting that go now and considering this whole thing a learning experience. Thank you all for your support through this!