[Question #13061] At wits end!!! HIV still possible?

2 months ago

Hello Doctors. I will try and be brief. 7-8 years ago and before i acted without regard and did some foolish acts that put me at risk. Over the last 7 years I have had NUMEROUS hiv tests including rapids, 4th gen, pcr qual/quant, with the last of all these tests being in August/2023, although I did use an insti test last august 2024. All have been negative. from 2018 and up until now. I still have DAILY abdominal pain and GI issues. I am worried that I could have a type of HIV that isnt picked up. My exposures were in the states but at massage parlors with foreign asian women. Apparently, there is an asian strain that is more difficult to find?

1)Do i need more hiv testing? if so, would it be genotyping?

2)Can many tests(oraquick, insti, DBS,surecheck,4th gen consisting of architect/bayer advia,gen,5th gen bio-rad, roche qualitative for hiv 1/2 and aptima and roche for HIV1) all produce a FALSE NEG RESULT? Some were qualitative and quantitative)and the last of all these were in 2022-2023.

3)Can hiv of some sort hide from all these tests because of improper primers and therefore target detected?

4)Is there enough cross-reactivity in HIV that some if not all tests would pick up something?

5)Is there any doubt from an expert like yourself that my case is a rock solid true negative, or do i need to continue to work with my doctors to consider the possibility that I(it would be rare) am that unlucky one that slipped by.

I really want to believe the tests but all my symptoms including GI, oral sores, muscle loss, are making me doubt.

Please let me know your thoughts.

Edward W. Hook M.D.

2 months ago

Welcome to our Forum. Thanks for your questions. I'll try to help. You do not say much about your exposure history but irrespective, it is now time to accept your test results and move forward. The tests you have described would have detected any and all possible strains and variants. You need to move on. To continue to worry about HIV will distract you from evaluation of what is actually causing your abdominal pain and GI issues. I should add that the statement "Apparently, there is an asian strain that is more difficult to find? " sounds like something you may have heard on the internet. There are no forms of HIV that would not have been detected by the testing that you have had. In response to your specific questions:

1)Do i need more hiv testing? if so, would it be genotyping?

There is no further testing for HIV needed here. Further testing would be a waste of time and resources.

Absolutely not!!!

3)Can hiv of some sort hide from all these tests because of improper primers and therefore target detected?

No.

4)Is there enough cross-reactivity in HIV that some if not all tests would pick up something?

I have no doubt whatsoever that your results prove, belong a shadow of a doubt that you DO NOT have HIV.

I do have several suggestions:

1. Stay off the internet. There is no way to determine what is correct and what is not. Much of what is found there is taken out of context, misinterpretation, out of date, or just plain wrong.

2. Find a good doctor, possibly an internist who you feel you can talk to and work with him/her to determine what is causing your symptoms.

I hope this perspective is helpful. EWH

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2 months ago

Thank you for your reply. It just worries me for my health but also my daughters health as she is having chronic GI issues. I worry that somehow I could have passed it to her in recent years or from birth as she is now 20 years old and just started having symptoms. As I mentioned, my tests have been taken since before 2010 up until 2024 now with not a single positive.

1)I took HIV PCR RNA/DNA 3 weeks after incident in 2018 and multiple since then, with the latest 8/2024. How accurate are the tests early on and does the accuracy fade over time if in fact have HIV but not treated?

2)As i said prior and you may have mistaken question-"Is there enough cross-reactivity/similarities between types of HIV, that many if not all the tests would have came back positive, if in fact truly have HIV?

3)Many antibody as well as antibody/antigen tests since before 2010 up until now. Could they all fail me because of sort of HIV or not making AB specifically for HIV, because of biological reasons or hiv subtype? I make AB to other entities when labs are done(Covid, Hep,HSV)

4)How can I be any more sure that healthwise I am not infected with a rogue strain, and if so, how would a diagnosis come about when all modern tests i have done have come up negative?

5)If a qualitative test Roche HIV1/2 was done 8/2024 and negative, is there any chance that without new exposure it would ever change to positive?

6)I am so frustrated every day as to why i hurt and have seen so many doctors without a resolution and so disappointed. I know it is not the doctors fault, but somehow modern medicine should be able to figure out whats wrong with me. I just want to make sure its not HIV of ANY SORT!!!! Thoughts?

Thank you

Edward W. Hook M.D.

2 months ago

Sigh. These are implausible "but what if" questions that do not help you and serve no purpose but demonstrate your continuing unjustified anxiety

1. HIV PCR tests are conclusive at any time more than 11 days after an exposure. Believe your results.

2. I understood the question. If you had HIV most, if not all of these tests would have been positive.

3. This repeats question 1 using slightly different verbiage. You have been test not only for antibodies but also for the virus itself (2 ways- as an antigen test and by PCR). Believe the negative results. (and the likelihood that you do not make antibodies normally is vanishingly rare).

4. This is fanciful. You could have been attacked by aliens from space to cause your symptoms as well. The two are equally likely.

5. No chance whatsoever.

6. You do not have HIV. My recommendations are above. Stay off the internet and find a doctor you can work with to address your ongoing concerns. EWH

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