[Question #5556] Hiv 2

21 months ago
Hello I took a hiv 2 test QPCR  the test came back. Not  detected. But there was comment saying lower limit of detection  is 500 copies and they are saying to retake the test in 3 weeks. My doctor  told me  no need to retake since I took 4th generation for hiv1 and hiv2. Do you suggest  I need to retake. Is it possible to have viral load under 500 copies for hiv 2 ?and  is it possible to have undectabale  anitbodies for hiv 2?Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
I'm sorry these issues continue to concern you. HIV2 is very rare in the US, and in all countries outside tropical east Africa. Last I heard, there had been only a couple hundred HIV2 infections documented in the US, almost all in persons who acquired the virus in east Africa; and few if any cases even in their sex partners. So i agree with your doctor:  there probably was no reason to test  you for HIV2 (or maybe even HIV1 -- you don't say the nature of the exposure you are concerned about). It is not possible to have undetectable antibodies to HIV2 useing the standard AgAb (duo, 4th generation) blood tests if done more than 6 weeks after exposure. And probably not to have HIV2 with under 500 virus copies.

If you'd like to provide information about the exposure you are concerned about, I might be able to give you even stronger rreassurance. But if you didn't have unprotected sex with someone from Africa, probably there was no risk for HIV2.

HHH, MD
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21 months ago
I had unprotected vaginal  sex in the USA. About six weeks later I had a sore throat for 10 weeks. Most recently  I have night sweats and I noticed more veins in my lower legs and have muscle pain and muscle twitching  in my lower legs. Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
Sounds like a very low risk exposure. Even among the most sexually active women in the US, on average only 1 in 1,000 has HIV. And the average stransmission risk, if the woman is infected, is once for every 2,500 episodes of unprotected vaginal sex. So your risk of catching HIV was in the range of 1 in 2.5 million. As for your symptoms, the sore throat started too late:  if caused by HIV from that exposure, it would have started within 2 weeks. and the other symptoms are very nonspecific and really do not suggest HIV at all. And you cannot have HIV symptoms with a negative antibody test. (The symptoms of recently acquired HIV are due to the immune response, including antibody -- not to the virus itself.)

Given all this, you have been seriously overtested. Please don't have any more HIV tests of any kind.
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21 months ago
Hello doc, I just dont feel good my pant size has gone down 2 inches and I've lost a lot of muscle mass on my legs.are you sure it can be lipoatrophy?
I understand  you said antibodies have to be present  if hiv in your body. Is it possible to have  false negative  4th gen test at all. Both viral test had LOD 500, I have read hiv 2 has lower limits of detection  but is that common or would you have to be on treatment  to get it below 500 for both viruses?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
In two threads, I have been doing my best to reassure you with thoughtful, science based advice. You keep rejecting it. Would you feel better if I said your concerns are correct, that you have HIV2? Sorry, I'm not going to do that. As discussed repeatedly in your previous thread and above, with the negative HIV tests you have had you cannot have HIV symptoms -- including weight loss or "I just don't feel good". (If in theory you had HIV with low viral load, that would also mean no symptoms:  nobody with HIV and an undetectable VL is likely to have symptoms due to HIV.)

See your doctor if you remain concerned about your symptoms or anything else. But it isn't HIV, either HIV1 or 2. Believe it and move on. Also please note the forum does not permit repeated questions on the same topic. This being your second, it will have to be your last one; future new questions about this exposure, testing, and your fears about HIV will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding. 

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