[Question #2974] Follow Up

93 months ago

Hello doctors, I have a few follow up questions as my last post was mostly anxiety and now I’ve had time to think clearly.

1) I feel obligated to repeat a 9.7 week test in January as my GP says this is the only way to be 100% certain I have not caught HIV. Is this medically necessary?

2) I was on the depo shot when I was tested, would that effect results?

3) I was diagnosed with fibromyalgia several years ago by a doctor poking my joints. Since then I’ve not had symptoms nor have I taken medication for the condition. I’ve always never had labs drawn for this. Can fibromyalgia effect HIV results?

4) lastly, I’m having my wisdom teeth pulled tomorrow, bc of smoking (in a clinical cessation program now) will any antibiotics I may be given effect my final test in January.

Dr. Hook provided excellent advice last time and it is my own need to cover all bases that is sending me back. I have such anxiety that I will test positive in January bc of the above mentioned issues. I desperately want to move on from all this and continue living my life.

H. Hunter Handsfield, MD

93 months ago

Welcome back to the forum. I'll be taking your question this time. I read your previous discussion with Dr. Hook.

I'm afraid your GP is misinformed. The standard antigen-antibody ("4th generation") HIV blood tests are conclusive at 6 weeks or more after the last exposure. It is never necessary to wait 3 months for conclusive testing: that's left over from the recommendation for older ("2nd generation") HIV antibody tests that now are rarely used. Your current result at almost 10 weeks proves for sure you did not catch HIV and you don't need any further testing. If you nevertheless decide to follow your doctor's advice, you can be sure another test at 3 months will remain negative. To your specific questions:

1) As just discussed, the answer is no: an additional test is not medically necessary.

2-4) There are no medications or drugs of any kind that have any effect on HIV test reliability. Even strong immune suppressive treatments (e.g. cancer chemotherapy), which used to be a concern, do not affect the Ag-Ab tests. This includes injectable contraceptives. The same is true for other medical condtions: there are none that have any effect on HIV test reliability, including fibromyalgia or recent surgical procedures or antibiotics.

So for sure you can now move on without worry! I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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93 months ago

Dr. H,

You and Doctor Hook have provided me with such comfort and reassurance. I don't want to knock my GP at all, but the fact that I'm sure I'm not the only one getting such outdated advice from him is truly disturbing. I have learned A LOT from this experience and feel very lucky that I found you and Dr. Hook seeing as how you're no longer on the site I learned of you all on in the first place. Seeing that there is no way this thing is going to turn around on me per the advice of two doctors who specialize in these diseases is such a huge breath of relief. I do have two more questions if you have time to answer. Thank you from the very bottom of one worried person's heart!

1) I have read the CDC's updated guidelines per the strong persuasion of my therapist. My question is, how are doctors supposed to relay these to their patients? Mine seemed to be lacking education on this matter in a big way, and I'm sure this is leading to A LOT of unnecessary anxiety among his patients.

2) Do you believe or have knowledge of any plans by the CDC or Department of Health here in the US for better education for physicians?

I know my last questions are not related to my episode, but I'm sure I'm not the only person out there thinking this. Once again, Thank you so much!

H. Hunter Handsfield, MD

93 months ago

Thanks for the additional comments. But I wouldn't call your doctor's advice "deeply disturbing". It's very common, and you can't blame practicing physicians for not instantaneously changing their many years' practices. And some doctors routinely take conservative stances on such things.

There is no formal system to for these things. CDC is not a regulatory agency, i.e. nothing they advise has the force of law, just common sense recommendations. CDC puts out media releases when there are major changes, and many state and local health departments amplify those or develop their own guidelines (mirroring CDC's) and make them available to providers (online, sometimes by mailing, sponsoring continuing education courses, etc). All in all, these systems do a very good job. But that doesn't mean that all or even most physicians immediately modify their practices.

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93 months ago

Thank you for the clarification, that does make sense. I think I have taken this fear and anxiety to an extreme, and feel at this point as though it's time to let go. No doctor or professional would let a patient think they're not infected if they truly are. I happen to work at the same hospital my GP practices in and we had lunch together earlier. He told me that while he believes I have nothing to worry about, his recommendation to retest at the six month mark (January) is simply due to network guidelines. They're conservative because not everyone is an open book with their medical history like I am. It would be very unfortunate to tell a patient they're not infected only to find out they are. So, in conclusion, because it is policy, I will retest in January just to get the final all clear. But at least now I can go into it knowing that neither you, Dr. Hook, or my GP think I have anything to worry about. I have been abstinent since this all started in June, and besides all that, facts are facts, you can't have something that isn't there. Thank you for your kind words and sound advice, it has done wonders for my anxiety, and I will continue to see my therapist in the meantime. Keep up the great work, I don't think you or Dr. Hook realize what a wonderful thing you're doing for anxiety ridden people like me.

H. Hunter Handsfield, MD

93 months ago

Sounds like you're very much on top of things now. Thanks for the thanks about our services.---