[Question #11153] İmmunize/ HIV/ HPV

16 months ago

Hi again doc.

I will have questions about hiv and later hpv. I learned an alarming situation regarding my vaccination, immune and antibody status. Therefore, my anxiety about HIV had decreased but increased again. I was vaccinated against hepatitis B and measles in my childhood (I even remember having measles when I was little) but even though I am 22 years old, I am not immune to hepatitis B and measles (tests are negative). I told it to a doctor and she was surprised and asked, hadn't you been vaccinated?

There was no immunities too in my test 2 years ago. Aren't vaccines protective for life?

I researched on the internet, this can happen to people with immune problems. My cbc values seem normal but

But I have antibodies against these (I was also vaccinated against rubella when I was a kid):

Anti CMV IGG pos 57,00 UA/mL

Anti rubella IGG pos 231,00 UI/mL

EBV EBNA IGG (>1O pos) 16.48 S/CO

Why does my immune system have antibodies against some but not others?

What if my body has HIV and does not produce antibodies against HIV?

By the way, I took 2 tests again: 270. day HIV AgAb Negative

280. day HIV-1 RNA PCR Not Dedected

Edward W. Hook M.D.

16 months ago

Welcome to our Forum. Thanks for your questions. I can provide partial answers to some of your questions about antibodies but if you wish for a more detailed response, you should seek information from a clinical immunologist. You don't mention your age and I'm not sure it's relevant but following immunization, antibody levels in the blood tend to be highest soon after immunization and then gradually decline. In a modest number of persons vaccinated against hepatitis B antibody levels fall below that detectable levels over time. These people despite the absence of measurable antibodies are still protected from Hepatitis B, both because the cells that produce antibodies are still in the body and because of the protected effect of cellular immunity which is not reflected in measurement of antibody levels. Thus despite the absence of measurable levels of hepatitis antibodies, if you were vaccinated during childhood you are probably protected. The fact that you have antibodies to other common viral infections or vaccines like CMV, rubella and EBV is evidence that you make antibodies.

Regarding HIV- you can be 100% confident that you are not infected. The tests you have not only tested for HIV antibodies but for the virus itself in the form of the HIV p24 antigen in your AgAb test and in terms of viral DNA in your PCR tests. There is absolutely no reason to think you might be infected with HIV

I hope that this information is helpful. As I said above, if you have additional questions about why you do not have detectable antibodies to hepatitis B or measles, you will need to look elsewhere. EWH

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16 months ago

Thanks for your answer.

I am 22 years old. I guess you didn't see it because I wrote it complicated. Actually, the doctor I consulted said that this was not an abnormal situation. This is an immunology issue, yes, but I have also had risky situations regarding HIV and I still have paranoia.

Also this is not my first topic, it is a continuation of question #11034. Could you please read this interaction again?

My question about HPV: I had anal warts 1 year ago. After cryotherapy, they all fell out, but the doctor also asked for a colonoscopy, so I didn't go. A year has passed and when I checked with my finger, I couldn't find anything outside the anus and a little inside, but that area has been itching for the last few weeks, maybe it's due to my hemorrhoids. Do you think I should go for an examination? More importantly, is a colonoscopy necessary? Because I don't want this done. This is a conservative country and they view this negatively.

16 months ago

Last little question: I shouldn't worry about HIV anymore, right? When I touch my lymph nodes, I think of HIV.

Edward W. Hook M.D.

16 months ago

Thanks for the additional information.

Regarding colonoscopy- persons who participate in receptive rectal intercourse may well have internal rectal HPV infection which would not otherwise be seen externally. For this reason sigmoidoscopy but not an entire colonoscopy is sometimes performed. Rectal HPV (internal of external) is typically asymptomatic and may not be able to be felt with your fingers.. Follow-up is reasonable but unless there is another reason for it, I see no reason for a full colonoscopy. You should discuss this with your doctor.

You are correct, HIV is not a concern. No need for additional testing at this time. EWH

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16 months ago

Thank you sir, I have a few more questions.

16 months ago

1) How long should follow-up take for anal HPV? I know that the virus is eliminated from the body in 24 months.
2) Does smoking prevent HPV from being eliminated from the body to a significant extent?
3) Does it make sense for me to get the HPV vaccine?
4) I have palpable lymph nodes in my groin. Does HPV swell the lymph and can cancer develop due to HPV within 1 year?

5) If the 'HIV' virus mutated and a new subtype emerged, do you think current blood tests would give at least "indeterminate" or "false positive" results, or would the result be negative?
6) You wrote "DNA" for HIV, but I had an "RNA" test. Is it safe again?

That's all my questions, sir. thanks for the answers.

Edward W. Hook M.D.

16 months ago

1) How long should follow-up take for anal HPV? I know that the virus is eliminated from the body in 24 months.

Guidelines for followup for anal HPV are still evolving. I would wait for at least a year following treatment to seek follow-up evaluation.

2) Does smoking prevent HPV from being eliminated from the body to a significant extent?

There are no data to suggest that this is the case.

3) Does it make sense for me to get the HPV vaccine?

If there are no barriers, vaccination makes sense. Vaccination would virtually eliminate risk for acquistion of additional HPV infections due to HPV that you have not had yet and recent data suggest that the vaccine may enhance/accelerate resolution of HPV when present.

4) I have palpable lymph nodes in my groin. Does HPV swell the lymph and can cancer develop due to HPV within 1 year?

No. This is a non-specific finding. Many of not most people have lymph nodes which can be felt, particularly in the groin

5) If the 'HIV' virus mutated and a new subtype emerged, do you think current blood tests would give at least "indeterminate" or "false positive" results, or would the result be negative?

There are no data to suggest that if a new HIV subtype were to appear, that it would not be detected by currently available tests.

6) You wrote "DNA" for HIV, but I had an "RNA" test. Is it safe again?

That was a typo, sorry. A negative RNA PCR froms that you were not infected.

As you know, we provide up to three responses to each client's questions. As this is my 3rd response, the thread will be closed shortly without further responses. EWH

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16 months ago

Sir, I am sorry, I am asking because you did not close the issue. On the website of the device I used to test for HIV (biomerieux VIDAS), it says that the M and O groups of the virus are tested. But it doesn't say P and N. I knew he would look at them all. I was worried. Even if you don't answer this, thank you for your help.

Edward W. Hook M.D.

16 months ago

Once again, be confident in your results. Closing the thread now. EWH---