[Question #309] False Positive or NEG Conclusive???

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105 months ago
I got a positive HIV test last year on a routine health check on August 6, 2015 ; repeatedly reactive >1.44 index, Abs Abnormal and NEGATIVE's supplemental test/Multispot HIV1 and HIV2. I'm a heterosexual male. The recommendation from the LAb was for me to get an RNA test on a new sample. Since I was out of the country I couldn't get an RNA test. Instead I got an ECLIA HIV test and was Negative (Aug 14, 2015). Then in October 15, I went and did two more HIV tests (ICMA 3rd Gen and a 4th Gen test) both NEGATIVE. Then I did an RNA test in December 18, 2015, which the result was <20 copies/ml. Then in January 8, 9 & 19 I did a Home Oraquick Saliva test, all NEgative. Then in April 2015 I did another Oraquick Home Test, NEgative and then in June 2015 I did an ECLIA blood test again NEGATIVE. I got food poisoned or a Virus before the first Positive test while I was in vacation in the Caribbean, do you  think this has something to do with the first POS test?  

Can I trust the Home Oraquick Tests? Can I trust the RNA test? I'm I NEGATIVE? Can I forget about this forever? This has been a nightmare. I did have painful lymph nodes on my neck (not swollen or noticeable) that lasted for 5 moths and that started in October 2014. Also a feel like hair in my mouth all the time. Also a noticeable and painful node in the inside of my leg by the ball sack area, that happened right after hitting my knee with a door frame (December 2014 and lasted for a week).  All kind of symptoms during the first 6 months after knowing about the first POS test. What is your view on this? Thanks.
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Edward W. Hook M.D.
105 months ago

Welcome to the Forum.  I'll try to help.  Give the series of tests that you have had since your initial positive test I would presume that you are not infected and do not see the need for repeated testing related to your earlier exposure.  Should you continue to be exposed you  may want to continue to be tested but I see no need for further testing to sort out your earlier test- it was falsely positive.  HIV tests are rarely falsely positive but it does occur. When it occurs the false positive result may be transient (i.e. resolve with time) or lasting and may occur with one kind of test but not others.  In your case, given the subsequent tests with tests for HIV antibodies, HIV p24 antigen (in the 4th generation test) and viral RNA, you can be confident you are not infected.  The symptoms you describe are due to some other process which you should evaluate with your own physician but without further concern about HIV


I hope this comment is helpful. EWH

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105 months ago
Good Morning and Thanks for answering Dr. Hook.

Why some people said that the RNA test is no good after 4 weeks (since I did mine at almost 5 months after the first POS test) ? Also what is your take on the Oraquick Home Test? Are they reliable?

Thanks.
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Edward W. Hook M.D.
105 months ago

In untreated person who have HIV the RNA test is the first test positive and stays positive until successful therapy is being given.  People who state that this test is no good after 4 weeks are mis-informed.

The oraquick home test has to pass the same FDA criteria and specifications as all other HIV tests.  Believe the results.  EWH

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Terri Warren, RN, Nurse Practitioner
105 months ago
Joe, just to add some credibility to Dr. Hook's response, I will tell you that I had a false positive HIV test many many years ago.  Scared the bejesus out of me!  All subsequent tests were negative but it took me a while to believe the negatives.  I had had a needle stick from an HIV positive patient so went through the routine protocol of testing.  It's tough, I know, but I so agree with Dr Hook that this is a false positive.  They do happen - even to STD professionals.

Terri Warren, NP
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