[Question #12504] [Question #11972] Follow up
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7 months ago
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Hello again, I’m asking a new question as the last one was closed without a follow up. Firstly, thank you for your answer, it was helpful but I can’t seem to move on with my life due to these symptoms that are still there. After all of my tests I did a PROVIRAL ADN PCR for HIV1/2 with undetectable results, at 11 months after exposure another 4gen test (architect abott) which was neg with 0,13 index (but previous ones had 0,08 index). And an inmunoblot (similar to a western blot) in which none antigen/ab was detected. In 31 dec, almost a year after exposure I did a 3gen rapid test in another lab with blood from vein which was neg. But I’m more worried than ever cause: my bf still has swelled lymph nodes : one in neck (less swollen than before), one in groin (visible but small), and I think maybe one behind his ear. He has this rash on his chest that comes and goes with little red dots and his eyes are usually red for these lasts months (before it was never the case). He also had some mouth ulcers recently. He don’t want to test cause he says that if I’m neg he’s neg.1/ What could be happening? 2/What is the minimal “peak viral load” needed to generate enough antibodies to be detected on a test? Would I had detectable antibodies if my max viral load during acute infection was 1500 copies? 3/ I have read some papers speaking about exceptional élite controllers with undetectable rna and proviral dna. How can I know I’m not one of them? 4/ please help me :(
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H. Hunter Handsfield, MD
7 months ago
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Welcome back, but I'm sorry you found it necessary. As for closure of your previous discussion, threads are closed after 4 weeks or two follow-up comments and replies, whichever comes first.
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The only problem I see here is your vastly exaggerated fears of HIV. Your symptoms mean nothing in regard to HIV: it is not possible to have symptoms of HIV and test negative. There are no exceptions to this.
You were at zero risk of HIV from the cosmetic procedure you had. All the test results you describe were reliable. Changing index values means nothing: as long as the index is below the positive cut-off (usually 0.9 or thereabouts), the test is negative. The same specimen tested 10 times would give 10 different numbers, which might vary far more than your different index values. Your and your partner's symptoms are not possibly due to HIV. You also misunderstand HIV symptoms: a few slightly enlarged lymph nodes never would be the only symptoms. Such nodes and mouth ulcers occur all the time in entirely healthy people.
1. "What could be happening?" Probably nothing of any serious health consequence and for sure not HIV. Beyond that I cannot say. See a doctor if the symptoms continue to be bothersome or to worry you.
2. I don't know the peak viral load that determines test positivity. I only know that it is impossible to have HIV with the negative test results you have mentioned.
3. Elite controllers test positive on the standard antibody tests, and usually on the more sophisticated tests you describe. How do you know you are not an elite controller? From a) not having an exposure that could have infected you with HIV and b) your negative test results.
4. "Please help me": Your worries are frankly irrational, indicating disordered thinking. I have to suspect there may be underlying psychological issues (OCD? anxiety disorder?) that might benefit from professional counseling. You should consider at least an exploratory initial professional psychological evaluation. Please understand I suggest this from compassion, not criticism of any kind.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD