[Question #4957] HIB testing

24 months ago
Hello doctors,
I have written before and followed your recommendations. It had been suggested that I repeat my 4th generation test and put this all behind me. I followed this advice last spring and results for non reactive and I moved on to get pregnant with my husband.  My prenatal testing also came back non reactive.

I am now in a panick as my baby was born small for gestational age and after an emergency c section, my incision is infected.

My exposure was 4 years ago - unprotected sex with bisexual male unknown status handful of times.

Symptoms that are all very convincing of hiv - elevated Ana, dry eyes/irritation, persistent rash on back for past year, incision infection, and baby born small for gestational age.

Testing- 3 negative 4th gen tests, 7 weeks, 3 years, and 3.5 years after exposure, and multiple oraquick tests.

Would you recommend that I face
My worst fears and have my doctor directly test for hiv? I feel as though I have too many contradictory symptoms despite my 4th generation tests.

I sincerely appreciate your knowledge and advice as I have no where else to turn and need to get my life back on track. This has been absolutely hell.

Thank you 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Welcome back, but sorry you found it necessary. That the situation "has been absolutely hell" has no rational basis. Don't get me wrong:  I understand your concerns; unexplained symptoms can be very disconcerting. However, you have offered no information not provided and answered in your distant past discussions with Dr. Hook. Among other things, one of his statements (in your first thread) was "Everything you had told me earlier indicates that you have conclusive test results which prove that you do not have HIV and did not get HIV from your exposure to a bisexual partner years ago.  There are many other processes that can cause a positive ANA including in some cases, non-HIV, non sexually transmitted viral infections.  You have no need to worry that your chronic eye inflammation or positive ANA are related to HIV."

That remains true. The HIV blood tests, including the ones you had, are among the most reliable diagnostic tests ever developed, for any medical condition. When done sufficiently long after the last possible exposure, they always overrule symptoms, no matter how typical for HIV, and exposure history, no matter how high risk. False negative 4th generation tests in particular simply do not occur. And  these symptoms and positive ANA aren't typcial for HIV anyway. Among persons with postiive ANA plus your symptoms, even among people whose HIV risks were far higher than yours, I'll bet that fewer than one in a thousand would have HIV as the cause. Looked at another way, if HIV testing were done in 1000 people each, with and without these findings, the frequency of HIV in the two groups would be identical (and probably zero unless both groups included persons at true HIV risk.)

Whatever the cause of your ANA and other symptoms, it isn't HIV.

Stepping beyond the details of testing etc, I believe you would beneift from professional counseling about all this. It simply is not normal to remain so frightened and worried in the face of the overwhelming evidence and repeated, science-based expert advice you have had on this forum and probably from your own doctors. Although I'm no psychologist, all this has earmarks of unresolved anxiety and guilt over a sexual decision you regret. You may have to deal with that in order to accept the plain fact that you do not have HIV. I suggest counseling from compassion, not criticism.

I hope this information finally helps you move along. Let me know if anything isn't clear.

HHH, MD
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