[Question #123] My apologies. Please read. Not a repetitive question.

37 months ago
First off I would like to appologize to you Dr. Hansfield and ASHA. I realize my questions were repetitive and that you are a very busy man. For that I am sorry.  I do have information to convey in regards to my original question #107. 
I went to MUSC today to  Internal Medicine. I discussed with him the same information that I included in my original post. He asked me " were you fine before the incident  in April 2014?" I told him yes. He said that I have had alot of HIV testing since the incident. He said that Humira could affect HIV antibody production and that the RNA PCR tests that I had done at 5 weeks and 12 months were basically invalid because not everyone infected will have detectable viral loads at those times. He said he was going to confer with an HIV Specialist at MUSC about my situation to see if HIV can be ruled out based on the testing that ive done or if special tests should be ordered because of delayed or no antibody response due to Humira. What is your professional assessment based on this new information? Thank you Dr. Hansfield. I do appoligize for my earlier repetitive posts.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
I'll take this one and provide a single brief answer.  If you "doctor shop" sooner or later you will find someone who will provide an answer that feeds your unwarranted fears.  While Humira and related drugs can impair Immune response, they would have no effect on tests that check for the HIV virus such as the PCR tests you have needlessly taken.  If you had acquired HIV, your PCR tests would have been positive.

I agree completely with Dr. Handsfield in his suggestion/urging you to seek mental health support to help,you address your unwarranted guilt and anxiety stemming from your recent exposure.  You did not get HIV or other STIs.. You need to move on.  EWH
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37 months ago
Thank you Dr. Hook for your reply. I realize Iam very stressed out. I will take your advice and seek counseling to help me deal with my anxiety. I'm just having a hard time dealing with the fact that I was a healthy person before the incident April 2014. Then my health took a turn and it was symptom after symptom, including  muscle atrophy. Im trying to understand what you are saying about the RNA PCR tests that I took at 5 weeks and 12 months. I admit I've researched every possible sight for RNA PCR testing. My understanding is that the RNA PCR test is only good within the first few weeks of an acute infection, and even then it's not a conclusive result. Other than that it's used to monitor viral loads, which may no be even be detectable at 5 weeks or 12 months. So I'm very confused. 
1. How long after stopping the Humira could it affect Hiv antibody test? 
2. I'm confused about my RNA PCR tests at 5 weeks and 12 months. My understanding is that the DNA PCR test is the test I should have taken, that I could of had undetectable viral loads at those times and still be infected.
3. Could Humira affect antibody testing at 16 months post exposure? I stopped the Humira after the exposure and didn't take it again until 2 weeks before my 12 month RNA PCR test. So I did antibody testing out to 8 months after exposure, after stopping the Humira. My last test was a Gen 4 duo at 16 months post exposure. I took the Gen 4 test because I had another risky exposure on August 3 2015. I took it 29 days after that possible exposure which put it 16 months post first exposure. 
4. Could Humira affect the Antigen testing?
5. Is there any research on the effects of Humira on HIV testing? 
6.Have yoy ever seen or heard of someone testing negative like I have and still be infected. That meds caused false negative results for so long? 
Thanks for your time.




Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Repetitive question.  Your tests do show conclusively you do not have HIV.  Humira related failure to produce antibodies would end within a few weeks (4-6 max) of your last dose of medication.  Further,HIV RNA would be present if you had HIV and were untreated throughout the course of u treated infection.  You need to believe your test results and stop worrying, as well as stop testing.  

Your persistent, redundant questions are a misuse of the Forum and it's intended use.  EWH
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37 months ago
Dr. Hook..I do appoligize for repetitive questions. I ask out of concern, as well as some confusion. I'm the type of person that wants to be told the facts/truth. I don't like things to be sugar coated. 
The reason I've been so persistent is because I'm worried my tests have been false negatives because of the Humira.
1. I've read that TNF alpha blockers(Humira) do effect the body's immune response to all infections.
2. Humira has a half life of 10 to 20 days, meaning it can stay in your system for 3 months.
I did alot of research on TNF alpha blockers and there effect on antibody production and HIV. There is something called Immune Reconstitution Inflammatory Syndrome which I'm concerned that is exactly what I've been going through.
I was on Humira before incident, as well as Prednisone. I believe that my immune system was immunosuppressed and I did in fact contract it. I started having symptoms within a couple of weeks, but at the time the Humira should of worn off the symptoms got alot worse. That's when the muscle atrophy started. That makes complete sense to me based off my symptoms, what I've read and the explanation of IRIS.
I came to this forum to seek the professional advice of yourself or Dr. Hansfield. If I had never taken Humira, I would have accepted my results a long time ago. 
1. Have you ever seen or heard of a situation  where medicines like Humira could cause false negative results for so long? 
2. Could Humira mask HIV antibodies? I took a Gen 4 test at 16 months post exposure, but I took 2 doses of Humira a couple months before the test?
3. Could Humira interfere with the RNA/Antigen test?
Why is there so much confusion about RNA PCR testing? That's another reason I'm having a hard time with this.
1.RNA PCR testing is not a stand alone test.
2. RNA PCR test is a viral load test. I've read and was told that it is used for early detection and to monitor patients. I was told by an ID Doctor at MUSC that my 5 week and 12 month RNA tests didn't mean anything. He said that by 5 weeks that the HIV has left the blood stream and entered the actual cells themselves, making it undetectable with RNA PCR testing. I read at 
12 months not everyone will have a detectable viral load, even people that are not taking treatment. That DNA PCR would detect at those times, not RNA PCR. So Iam very confused.
That's why I've turned to you and Dr. Hansfield. You are 2 world renowned experts. Honestly Dr. Hook, with all the symptoms and sicknesses that I've experienced since the incident I am physically a shell of my former self. I look and feel very sick. My eye sockets are sunken in, I ve lost 50% of my muscle and what's left has no tone. It's soft and squishy. I've been symptomatic for the last 4 weeks and I'm fighting Upper Respiratory and Bronchitis right now. The muscles spasms are going crazy too. 
Hard to believe test results when I was  healthy beforehand. It's like the floodgates opened after the incident. 
If I wanted to do anymore testing, what would be the best test to have done other than an antibody test? I've read a DNA PCR.
Please repsond. My questions and concerns are legitimate? You're the expert. And I promise I won't post anything else unless I end up testing positive after all is said and done. 
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago

Final reply.  Dr. Handsfield and I have independently come to the same conclusion.  You do not have HIV, you do not need further testing.  You have been told this repeatedly yet keep repeating the question.  I cannot help you further.  This thread must end now.

In my opinion, your anxiety-fueled research and doctor shopping has only fed your anxieties.  I urge you to print out this thread, as well as our earlier responses to you and take them to a mental health professional who can help you try to overcome your pathological fear and anxiety and not to waste your time with further questions on this Forum (if you do, they will be deleted).  I say this out of concern for you, nothing more and will not contribute to your anxieties further by replying further.  EWH

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