[Question #3375] Testing vs Clinical findings
90 months ago
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Hello. I have returned as there is a little more to my story and I have a few follow up questions.
This is my background:
Unprotected sex handful of times with bisexual male a little over 3 years ago. Ejaculation 1x.
Duo 7 weeks after exposure
Oraquick 11 weeks after exposure
Oraquick 4x 3 years after exposure
I had put HIV behind me after 11 week oraquick. In the meantime had gotten married. HIV fears resurfaced as I have had ongoing eye inflammation for months. The eye doctor said it looks autoimmune in nature. My PCP ran some tests and ANA was high. I also noticed that my protein level was high, 8.4. According to google, could be indication of hiv. The rheumatologist ran more tests and said it was a false positive. I did notice complement testing was high, which is indicative of infection, according to google (naturally). At the time I was pregnant but have miscarried. I had chalked up my off lab work to pregnancy and was trying to move on. I saw my PCP Friday and she said that she had never seen ANA with such high titer 1:320 come back as nothing. This got me worried again. Does any of this lab work suggest to you that I had false negative tests?
I also came across this:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167641/ the guy had multiple false negatives. How does that happen?
In a recent post, Dr Handsfield had stated that oraquick misses about 1% of infections. Is it at all possible for there to have been a false negative/lab error with the duo and 4 false negative oraquick tests after 3 years?
I am hoping to avoid the blood test if at all possible but worried about trying to conceive again if I am unsure of my status.
I value your medical experience and advice. Thank you so much for your help.
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Edward W. Hook M.D.
90 months ago
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Welcome back to the forum. I'll be glad to comment. There is a lesson here- for health-related issues, and particularly for HIV, Google is not your friend. Much of what is found there is subject to misinterpretation, taken out of context, or is just plain wrong. The study you mention evaluated persons a single time. You have had multiple negative tests taken long after exposure. The OraQuick tests can have occasional problems relatively soon after acquisition of infection but in your case with multiple negative tests taken long after exposure to a partner of unknown HIV status (and who is statistically unlikely to be infected), I would urge you to have complete confidence in your results. There is no need for additional testing related to the exposures you mention above.
Parenthetically, I would add that I have seen many persons with ANA values of 1:320 who have not had infection or identifiable serious problems.
I hope my comments are helpful. Please don't worry. EWH
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89 months ago
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Thank you so much for your response. I’m sure you are very busy.
I was hoping to ask you about the eye inflammation. Is it possible for eye inflammation to be the only symptom of hiv?
I have read that elite controllers are more prone to inflammation due to immune system working in overdrive.
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Edward W. Hook M.D.
89 months ago
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Isolated inflammation of the eye would be a most unusual indication of recently acquired HIV and is not something I would worry about.
With respect to elite controllers, they still have positive tests which you do not. I am confident that this is not HIV from the exposure you mentioned above. EWH.
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89 months ago
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Thanks!!
However, you mentioned eye inflammation not being an indication of newly acquired infection. The exposure I am concerned about was a little over 3 years ago. Do you see eye inflammation at later points in infection?
89 months ago
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Do you see eye inflammation as the ONLY symptom of progressed hiv?
It just seems too coincidental to have the bloodwork come back indicative of hiv and having symptoms indicative of hiv.
If I had a low risk exposure I would be able to move on much more easily, but I will point out that my risk was high.
Thanks again for your time and knowledge.
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Edward W. Hook M.D.
89 months ago
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I think you are over reacting.
No, visible inflammation of the eye is no a recognized clinical feature of HIV.
The blood tests that you have mentioned, a high protein and a reactive ANA, are non-specific and do not suggest HIV, particularly with your 11 week negative Oraquick. Further, the term "high" risk is a in the eye of the interpreter. Statistically, it was unlikely that your prior bi-sexual partner had HIV, less than 8% of such persons to and then, if he was, the risk of acquiring HIV per act of unprotected intercourse is less than 1 infection per 1,000 sex acts. Thus your per sex act risk from your prior encounter is less than 1 in 10,000, even before your Oraquick results are considered.
If you cannot move forward based on what you know now, then my strong advice would be to repeat your HIV blood test. The result will resolve things once and for all and it appears that your are worrying a lot about this.
As you know, this is my 3rd reply to your questions. Thus, as per Forum guidelines, this thread will be closed later today. Take care. I hope my comments are helpful. EWH
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89 months ago
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Thank you so much for taking the time to answer my questions!