[Question #10871] Continuation [Question #10825] My 4th generation HIV -ve 28th and 58th

19 months ago

As continuation to the previous thread, as doctor Dr hook suggested that 58th day of 4th generation test(Ab/Ag) is good enough to eliminate the HIV. Since I got few new symptoms so bit worried. Just back here with few question and double confirm the same.Just to brief history again I am a kidney transplanted patient taking the below medications for the last 20 years. For last 15 year below are my medication.Prednisone -5mg ,Tacrolimus - 1mg, Mycophenolic acid - 360 mg. I had vaginal sex with CSW with condoms initially and somehow the condoms came off in-between. It would have lasted for 2 minutes without condom. I called the girl twice, and she told she is 100% safe. Not sure how much I can trust her. I was having fever, diarrhea and vomiting on 52nd and i took second test of 4th generation on 58th day and it is negative.But still the symptoms like numbness in the legs, fatigue(sleeping for more than 12hrs per day), dry throat , dry lips, bloating ,nausea, little bit of stomach pain, burping, and vision enlargement continues

19 months ago

I took 4 th generation test on 28th day and 58 th day --Negative(on Quest diagnostic lab). I took ECLIA antibody test alone on 75th and it is negative(took it in INDIA but as per the govt standards it has been tested)

1. I understand for my case it will take longer to detect the antibodies, can 11 ECLIA antibody test can be considered as conclusive or it will take longer time for my case (any idea approx how long for immune suppression patients)?

2. Do you recommend another 4 th gen test (I am running 82nd day) since I have symptoms which I mentioned above?

3. Will there be any possibility of antigen get delayed since I am under immune suppression drugs ?

4. I read somewhere in the internet symptoms of ARS will not be observed since if the person is taking immune suppression drugs.

5.I got symptoms on 52nd day and tested on 58th day(ie 4th gen test) so in that case it will show as positive in the test correct? Also i hope Quest diagnostic lab is reliable in USA ?

Edward W. Hook M.D.

19 months ago

This is a repetitive question. My answers are not going to change. 4th generation tests for HIV test not only for antibodies to the virus but for the virus itself (the HIV p24 antigen is a part of the virus). Thus even though your immunosuppressive therapy might delay or hamper your antibody response, the virus would be detected if you were infected. You should believe your tests. You do not have HIV. Further, many of the symptoms you describe are not those of HIV- they are however signs of anxiety among other things. In response to your specific questions:

How much your therapy does or does not hamper antibody production varies from person to person however it would be expected that if you are going to make antibodies, you would have made them by now. In addition, as I explained above, if you were infected your p24 antigen taken as part of the 4th generation test you took on day 28 would have been positive.

2. Do you recommend another 4 th gen test (I am running 82nd day) since I have symptoms which I mentioned above?

Repeat testing is a personal choice. If you chose to re-test, I am confident the test will be negative again.

3. Will there be any possibility of antigen get delayed since I am under immune suppression drugs ?

No, if anything, antigen production would be accelerated by your immunosuppression.

4. I read somewhere in the internet symptoms of ARS will not be observed since if the person is taking immune suppression drugs.

Not everyone who acquired HIV develops the ARS. The ARS occurs because of interactions between the virus and antibodies. It is theoretically possible that someone taking immunosuppressive therapy might be less likely to develop the ARS.

5.I got symptoms on 52nd day and tested on 58th day(ie 4th gen test) so in that case it will show as positive in the test correct? Also i hope Quest diagnostic lab is reliable in USA ?

Quest is highly reliable. Yous summary statement is correct.

I hope this repeat answer will help you put your fears about HIV aside. EWH

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19 months ago

Thanks a lot doctor. Your words make me feel much better.

You are awesome doctor. As you told it is a negative again.

Between just for my satisfaction I took 2 antibody test alone.

1. E.C.L.I.A method antibody test only on 75th and the value is 0.17 which is negative

2. CLIA method antibody test on 82nd day and the value is 0.475 which is also negative but value is high compared to previous week

Both are within the range and it is below one(1) only and I am not sure why there is a sudden increase in the value within a week(from 75 to 82nd). Is there something I need to worry about or it will differ based on the lab and the technology used.

Edward W. Hook M.D.

19 months ago

It is entirely normal for values of these tests to fluctuate or or down when tests are repeated. That in no way suggests any change in your status. BE confident that you DO NOT have HIV. EWH---

19 months ago

Thanks doctor. I understand I am not infected with hiv. But still there is some fear and I know most of them are repetitive questions but just want to hear from you as this is makes me relaxed. Sorry for the inconvenience

1. Just want to hear from you that are you 100 percentage sure I am not infected with hiv.

2. Is there any way I can come out of fear?

3.The antibody test on 75 th and 82 nd day would have showed positive even though I am immune suppressed right or we can’t confirm it.

I know the testing is up to me, if you were in my situation would take another test 4 th generation test (since I am immunosuppressed) or move on with the existing results.

Also I got blurred eyes for last 2 days, just want to confirm it is nothing related to the ARS

I m sorry incase if I asked something wrong.

Thanks in advance.

Edward W. Hook M.D.

19 months ago

Final responses. There should be no need for follow-ups. Should you return with additional repetitive, anxiety-driven questions, your question may be deleted without a response and without return of your posting fee.

1. Repetitive. I am confident you do not have HIV

2. Your fear is emotional in nature, not science based. I would encourage you to discuss your continuing concerns with a trained counselor or mental health professional. There is no need for further testing.

3. I would believe your 75 and 82 day test results. Your degree of immunosuppression is modest and while it might somewhat delay development of antibodies, it is unlikely to prevent it.

My advice is to accept your test results and move forward without concern. I would not pursue additional testing.

Blurring of vision is certainly NOT a sign of the ARS.

Please don't worry. Seek counseling. I say this out of concern for you, nothing more EWH

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