[Question #2421] Are hiv and syphilis in the rear view mirror?

43 months ago

Dear Doctors...I hope one of you can clear some issues up..



I will try and make this as brief as possible but kind of complicated.  Startting back around 2008 I was having relations out of marriage.  Some of these were unprotected episodes.  At some point in around 2010 I started having strange  symptoms---many to list, and therefore went and had a full panel of std tests done...All were negative.  At that time I also stopped this behavior(2010).  So no exposures since 2010.  Through the last 7 years, I have had MANY MANY hiv tests(hiv antibody, hiv RNA/DNA, western blot, hiv 4th generation) and ALL have been negative.  My last one was back in March of this last year and it was a 4th generation test.  I have also had MANY syphilis tests only because the symptoms are so strange and i know it can be an intimidator.  I have had many RPR, TPPA, FTA-ABS, and TREP-antibodies up until 2015 and ALL WERE NEGATIVE.  Then in 2015 I tested again because i just was unsure and all the others were correctly negative.  At that test time I got a negative RPR, negative TPPA, but POSITIVE FTA-ABS.  I was shocked and went and saw and ID specialist.  He said it had to be a false positive because of all the other tests before it as well as the negative RPR, and TPPA that accompanied this particular blood draw.  He said that I never had syphilis based on ALL the prior tests.  Nervous I have had just the FTA-ABS, RPR, and TP antibody, but NOT the TPPA repeated at 1 week, 6 weeks, 9 months, and 1 yea, 2 years after that positive and ALL have been negative.  I am so overwhelmed that these two particular diseases may have been missed somehow.  I am hoping you can give me clarity on a few things.  My wife is experiencing very odd symptoms and I am afraid I may have given here something.


1)Can I ABSOLUTELY be sure that I in NO WAY have HIV?

2)Can there be ANY way that SO many HIV tests have been done over the years, but given false negatives?

3)Could there be a subtype or something ever so strange that it would not get detected?

4)What do you make of the syphilis tests and that one positive followed by 5 subsequent negatives over two years?

5)Is there any way that I could have syphilis but the tests not picking it up?

6)Can serology be wrong that many times?

7)Can you ever take too long to detect syphilis and blood tests are wrong and the only way is by CSF?


Do you think I have put my wife in harms way regarding these two diseases, is there anything else I should do to make sure.

I look forward to your insight.

Thank you

Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
 Welcome to our forum. I happen to be on the site when your question came in so you are getting a response much more quickly than is typical.   Let me quickly give you the main part of my response and then address your questions on a step-by-step basis. My important message to you is that you do not have HIV or syphilis and that you need to stop testing. Your positive FTA ABS reflects the fact that you have tested too many times and as a chance  occurrence had a false positive FTA-ABS.    The FTA ABS test is interpreted subjectively. The test is performed by looking for florescence and tests with only slight florescence should be interpreted to be negative. My suspicion is that the FTA ABS that you had that was reported as positive had slight florescence that was  over interpreted. 

 Now onto your specific questions. 
1.   You do not have HIV. If you do not have further High risk exposures you should not test further. Instead you should believe the test results you have. Just as for syphilis, the more you test the more likely you are to have a false positive test result on the basis of chance alone. 

2.   No, once again believe your test results. 

3.  NO!!!!

4.   Please see my explanation above. You do not have syphilis! 

5.  No.

6.   You are repeating the same question using different words. This will not change the answer. No! You do not have syphilis. 

7.  No!

 The nature of your question suggests that you continue to be guilty about you're missteps many years ago. You need to get over it. You do not need more testing. If you cannot stop worrying, you need to speak with a counselor who can help you work through your guilt and anxiety. 



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43 months ago
Thank you so much for expanding on that. I understand that with all those tests I should be comforted, but it is the unknown possibility that somehow the tests failed to detect either of these. My wife is definitely having some health issues and her doctor has ordered a hiv test to rule it out which she did yesterday. She has never had any outside marriage episodes so I feel I should be good. It does worry me though.  These next few questions are just regarding her and i relationship. 
1)can I feel 100% confident that I didn't give anything to her?
2)is there any way that she could test positive as it relates to me on either test?
3)can you ever have it where both people could be positive(say for years) but only one of you shows positive on a test where  Yother one is indeed positive but for some reason test negative ?
4)if she did test positive, would you at all question my prior results?
5)it seems impossible that I could have hiv with ALL those prior tests.  Do you agree?

She should have her results in a few days and if so, I would like to relay them to you for my last reply that is allowed . I hope that is ok

Thank you



Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Current tests are among the best tests available and should be believed.  If your wife is tested, her tests will be negative as well.  I am confident of this.  Her health problems should be evaluated for other, non-STI causes.  In answer to your questions:
1.  Yes.
2.  See above, no, not related to the encounter you have described.
3.  This is a "what if" question.  The answer is no, not to my knowledge.
4.  No
5.  Yes.

I hope you will now be able to move forward.  EWH
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43 months ago
So, my wife's results came back today and they were negative just as you said it would be.  The only thing that is high is the persistent elevated eosinophils(REALLY HIGH).  She did not get a syphilis test as I thought she would.  I am confident now that there is no hiv.  I am hoping you can help close this out for me.
1)Does high eosinophils mean much when regarding STDs?  Appears its more allery/parasitic infection.
2)She did not get tested for syphilis.  Would you advise she does in regards to her exposure to me?
3)Could she have syphilis by me giving it to her somehow?
3)I have never been treated for syphilis, but have taken various antibiotics over the years.  Can I conclude with all my testing that I have never had it syphilis?

I thank you for all your time and attention to this matter.

43 months ago
So, my wife's results came back today and they were negative just as you said it would be.  The only thing that is high is the persistent elevated eosinophils(REALLY HIGH, about 2200).  She did not get a syphilis test as I thought she would.  I am confident now that there is no hiv.  I am hoping you can help close this out for me.
1)Does high eosinophils mean much when regarding STDs, Especially syphilis?  Appears its more allery/parasitic infection from what i have read and syphilis would be a rare cause.
2)She did not get tested for syphilis.  Would you advise she does in regards to her exposure to me?
3)Could she have syphilis by me giving it to her somehow?
3)I have never been treated for syphilis, but have taken various antibiotics over the years.  Can I conclude with all my testing that I have never had it syphilis?

I thank you for all your time and attention to this matter.
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Elevated eosinophils are a non-specific finding which certainly do not suggest HIV or other STIs.  Your wife should discuss this with her doctor and you should not be concerned that this is a sign that you have given her an STI.  Answers to your specific questions below:
1)Does high eosinophils mean much when regarding STDs, Especially syphilis?  Appears its more allery/parasitic infection from what i have read and syphilis would be a rare cause.
See my comment above.  Increased eosinophils are a non-specific fining with a long list of possible causes, nearly all of which are not STIs.  Increased eosinophils are not a sign of syphilis.  She should work with her doctor to understand why they occurred.

2)She did not get tested for syphilis.  Would you advise she does in regards to her exposure to me?
You do not have syphilis.  Thus, unless he has other partners, she does not need a syphilis test.

3)Could she have syphilis by me giving it to her somehow?
sigh, give it up.  You do not have syphilis!!!

3)I have never been treated for syphilis, but have taken various antibiotics over the years.  Can I conclude with all my testing that I have never had it syphilis?
Yes.

Our Forum permits up to 3 three responses to questions.  this is my third response.  thus this thread will be closed shortly.  I hope my comments have been helpful. EWH
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