[Question #4859] False Negative from receiving oral and fingering

27 months ago
My apologies doctor but I have returned from a previous Question (4477).

If you remember correctly, I saw my PCM and was tested by her with the Oraquick test and it was negative.   The issue that I am having is,  I have gained all of my lost weight back and now taking an antidepressant/anxiety medication.  How reliable was my Oraquick test?  My wife continues to have a dry cough and my daughter is failing to gain weight while always being sick with a stomach virus of some sort.  She is 1 Years old and doesn’t weigh what she should.  She continues to have severe congestion, vomiting and severe diarrhea every few weeks plus she has a white coating on her tongue.  I’m afraid that I truly passed the virus to my wife and she gave it to my daughter by breastfeeding.  I also still have white coating on my tongue, a super severe back ache that resembles sciatica and the brown line in my fingernail is getting darker and I still have the night sweats, burning sensation in my legs and black bags under my eyes .  I understand that receiving oral sex and fingering a streetwalker with multiple fingers is low risk but things aren’t adding up for me and I am going insane.  My backache has gotten progressively worse since the onset of my initial symptoms.  Is it possible that I have HIV and had a false negative with the test?  Should I retest and this time go for blood draw?  I am simply in need of some direction and feel that I may have ruined my families lives.   Please help! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome back to the forum, but I'm sorry you found it necessary. I scanned your previous thread and agree exactly with the reasoned, science based reassuriance you had from Dr. Hook. I suggest you re-read that discussion carefully, because my reply here will be very brief -- the answers are in your previous thread.

You were at no signficiant risk of HIV, and the symptoms you described then did not suggest a new HIV infection. That remains the case here, both for your own symptoms and and your daughter's. And HIV test results always overrule symptoks and exposure history. Even if you had a high risk exposure (as you correctly undertand, you did not) of if you or your daughter's symptoms were typical for HIV/AIDS (they are not), your test result proves there is no possiblity you have HIV (assuming no new high risk exposures). And anyway, both your symptoms and your daughter's have very many potential explanations other than HIV.

So my advice, as above, is that you re-read your last thread with Dr. Hook; and that you and your daughter see your doctor(s) for proper medical evaluation to determine the cause of your symptoms. In the meantime, you should be having no worries at all about HIV. For sure neither you, nor wife, nor your daughter have HIV.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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27 months ago
Good evening Dr. HHH and thank you for the timely reply.  The reason for my visit  again is that  I spoke with an infectious Diseases doctor and he told told me that you can have ARS symptoms at 9 weeks in which I did.   My symptoms started with fever, diarrhea, vomiting and a wollen lymph nodes in which he swore could be symptoms of ARS. I understand the level of risk with these instances but can’t help but to believe that I am the worlds first to be infected in this manner.   He also told me that Oraquick is utilized and sometimes has false negatives.  This scared me pretty bad and this is why I am back. Pleas reply with your thoughts and thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
I've never heard of ARS starting any later than 2-3 weeks after exposure. And it is IMPOSSIBLE to have ARS for more than a few days and also have a negative blood test:  there are no exceptions. Finally, your symptoms are NOT suggestive or ARS, despite what you think you learned, probably online. And as I said above, even if they were, blood test results always overrule symptoms.

In other words, these comments do not change my evaluation or advice.
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27 months ago
Thank you Doctor but please forgive me for maybe not specifying that this was not a blood test, it was the mouth swab test.  Does this change anything that you have said?  Thanks
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Thanks for clarifying that. Oraquick makes both an oral fluids test, which you had, and a blood test. The oral fluids test is very good, but not quite as good as the various blood tests available. The oral fluids test misses up to 2-3% of HIV infected persons and is not the recommended test in circumstances like yours. You should have a laboratory-based blood test. Given the low risk of your expousre and lack of symptoms typical for ARS, you can still count on a negative result. I'm surprised your ID doctor didn't recommend it; but s/he probably is the best person to contact to arrange for another test. Stay mellow in the meantime. It will be negative.

Threads normally are closed after two follow-up comments and replies. However, I'll leave this thread open for a couple of weeks, so you will have the opportunity to let me know the result of an addtional test if you have one. However, I will have no further comments until then. And please plan on this being your last question about this exposure and your HIV concerns. Repeated anxiety driven questions are discouraged. OK?
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