I know HIV is should be out of the question because of my test results, but Im still worrying I may have gotten a false negative results, and maybe my one and only “false positive” Antigen P24 test was actually correct.

I’m not in general a doctors person but for the last 1 year I cannot keep myself out of a doctors office due to health complications.

1) My rheumatologist did the HLA B27 test among with other tests and all came back negative. Is there a possibility that I may still be suffering from ReA causing my pains? Now Im having extreme back pain and need to visit an orthopedist.

2) For the past few weeks I have been experiencing bleeding cuts and scabs in my nose that does not heal no matter what I do (and without prickling my nose). This has never happened to me before and Ive seen in numerous webstites that high levels of IgE (mine is at 180) and bleeding such as this is a normal situation for HIV + patients. Could this be my case?

3) Im worry that the labs in my country are not as reliable as they should be and thats why Im not getting the right results. I live in a 3rd world country

4) Right now Im taking 5mg of prednisone daily by pills and some more through nasal spray, how much could this affect my HIV test results if I seek to retest? Ive seen some of your answers in this forum stating that steroid like this could actually interfere with HIV antibodies and testing. In case of retesting it would most probably be a only antibodies test.

5) Ive seen in this forum that urine tests could fail to diagnose up to 5% of Gono and Chlamydia infections. How can I rule this out?

All this kind of normal situations that most of the time go away on its own but now Im in need to visit a doctor for each one of them. Never suffered before from cuts and scabs on nose that wont heal by themselves, not even after cauterization of blood vessels. 

In response to your new questions:

1.  Some persons with reactive arthritis are not HLA B-27 positive.  I agree with Dr. Handsfield that your symptoms are most likely coincidental and only marginally suggestive of reactive arthritis.  I suspect your rheumatologist said much the same thing.  I also worry that you are now seeing an orthopedist.  Somethings if you ask the same question of enough people you will find someone willing to provide unwarranted and potentially harmful interventions which are not needed.  Did your rheumatologist refer you to the orthopedist?

2.  No.  Your IgE is only marginally elevated and elevated IgE are non-specific and can be caused by many processes.

3.  I cannot comment on the quality of the laboratories where you have been tested however, in my experience most lower income nations have good, high quality laboratory services available.

4.  Taking low dose prednisone (5 mg is low dose) would not effect your test results.  In theory and on occasion, taking prednisone can delay antibody formation but if you were infected more than a year ago by the interaction you described to Dr. Handsfield, your would already have antibodies which would show up in your test.  Further, prednisone would have NO impact on the presence of p24 antigen which is also tested for in most combination HIV tests.

5.  You indicated you have had multiple tests, including swab tests.  While a single urine specimen may infection in a single urine specimen, this is virtually never a problem with multiple tests, particularly if some of them have been swab tests.

I hope this additional information and perspective is helpful.  I agree with Dr. Handsfield when he said " It seems pretty clear that you are linking a sexual experience with very nonspecific symptoms that in fact have nothing to do with that event. Probably 90% of all humans have some or all these symptoms at one time or another. None sound serious. Most important, the combination of low risk at the time, absence of symptoms typical of any STD (almost all of which would have shown up within a couple of weeks, not months or years later), and your negative test results are conclusive evidence against any infection from the sexual exposure on your mind."  EWH

Im still worried about my symptoms. 

1) What could cause a stinging pain in my left toe whenever a pee? Thats pretty weird

2) What do you think about the constant cuts and scans on my nose that wont heal naturally? That has never happened to me and Ive been seeing that HIV is something that could cause it. My ENT said it was allergic rhinitis (that I see is commong on HIV+) and FYI my Ige levels have been higher this year reaching +180

3) I took an influenza shot about a month ago, could that affect any HIV test causing a false positive or negative result?

4) What would a HIV+ person be experiencing 1 year and 8 months post exposure without any treatment?

5) Like I said in my previous post a had a “false negative” Antigen P24 reaction (the cut off value was low 5.5 vs 3) and then negative confirmatory PCR and Western Blot tests (the P24 was negative on the WB). 3 months later I retested using a combo test and it was negative. It was 2 different labs and thats my worry. Do you think maybe the first P24 was actually real? Keep in mind this positive reaction was 1 year post exposure. Is it possible to have still P24 one year later?

6) My rheumatologist didtn refer me to an orthopedist, but finding myself now with a extremely painfuk back pain, I believe I have no option right? I just keep having to go to doctors frequently

1) What could cause a stinging pain in my left toe whenever a pee? Thats pretty weird.

I have never heard of this combination of symptoms in relationship to any STI.

1) From what I understood, prednisone can only affect initial antibody production, but cannot affect or reduce already present antibodies, right?

2) It was of my understanding that Antibodies clear out Antigen P24 and thats why the combo test is so reliable, one of the two will always be present. But now I see that both antibodies and antigen P24 could co exist up until 1 year post exposure? My doctors answers at that moment was that theres no way P24 would be present one year post exposure. If it remains positive then my “false positive” test could have indeed been real positive?

4) What would be your final assesment towards my case regarding STIs and specially HIV? Do you think I should keep seeking/retesting for HIV or can I absolutely rule it out?

In reply to your newest questions:

Further testing for STIs, including HIV is a waste of time and resources.  There is no medical or scientific reason for further testing.

This exchange is now over.  I wish you the best and hope you can put your worries aside.  EWH