[Question #230] Testing with low igm level

37 months ago
Doctors,

In June on 2014 while on a business trip to Boston I visited a strip club and a dancer performed privately in front of me.  I remained fully clothed and did not touch the vaginal area of the dancer but I  had a 1/2 to 1 cm wound on the back of my hand that had happened the day before (I am not certain as to if the wound was scabbed over or not. The wound was from blunt trauma while working and basically caused a scooped out wound but not sure of the depth) and  I became concerned that the dancer may have touched her vagina and then touched my wound.  I could not put this incident out of my mind so I decided to be tested for hiv. I had several oraquick tests up to three months,  a 12 week antibody only test blood test, a 4th generation test from labcorp at 5 months and a 4th generation test at 11 months from labcorp. All have been negative/non reactive. My concern is that in November 2014 I had my antibody levels tested due to recurrent sinus problems and was informed that I have a slightly low igm level (my igm numbers were 36, at the first test in November 2014, 37 in March 2015, and 40 in August 2015). The lower end of the reference range is 48 as I am sure you know. My immunologist says we will have to continue testing to determine if I am immunocompromised or not.  My question is are my negative tests completely conclusive or should I try to peruse RNA/DNA NAAT testing .  

Thanks for any help
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum. Thanks for your question.

First, there is absolutely no risk of HIV from the events you have described, even if the stripper had HIV -- and it is statistically unlikely that she did. Nobody gets HIV without direct sexual contact (intercourse) or shared drug injection equipment.

Second, even if there was risk, your test results are conclusive, regardless of any IgM antibody levels. That kind of problem would not have any effect at all on HIV antibody testting. Further, the 4th generation test includes evaluation for the virus itself, not just antibody. If somehow your IgM issue impaired antibody production, the antigen component of the 4th gen test would be MORE likely to be positive.

So the answer to your specific questions is that your negative tests indeed are completely conclusive and you should not have any further tests of any kind. On top of which, you could not have caught HIV anyway.

I hope this has helped. Best wishes--  HHH, MD


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37 months ago
Dr. HHH

THANK YOU VERY MUCH FOR YOUR RESPONSE!!!

It has taken a load off my mind!  By the way, if my internet research is correct, you are a pilot(as am I) and use this skill to help others.  If I am correct, happy flying, smooth air, and high clouds!  You may never know how valuable answering this type of question is,but it is a jewel in your crown.

All the best
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Thanks for the thanks and the kind words. I'm glad to have helped. Yes, you correctly scoped me out!


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