[Question #6006] Hiv negative antibodies but pcr POSITIVE

17 months ago
From 7 months i bought a new anal plug from store . It was not sealed. I washed it by hot water and soup then used it for 2 second . Next day i felt pain in my throat . And after 1 month i got one cold sore on my lower lip which persisted for 5 weeks and after 6 months from exposure i got oral thrush on my tongue and take floconozal but thrush didn't go away till now.  I did 7 hiv antibodies tests over 7 months at 3 different labs and all back negative. Then i did cd4/cd8 raito it back 0.78 and total lymphocytes: 1.9 cd4 : 460  and cd8 : 570 . So i did pcr qualitative  and it back POSITIVE.  I'm so confused.  What should i do now ? I think I'm POSITIVE due to pcr result and low cd4/cd8 ratio 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Welcome to the Forum.  I'll be glad to comment.  You do not provide additional information regarding past sexual activity other than your purchase of the anal plug.  Additional information regarding numbers of sexual partners and exposures would help me to comment.  My preliminary comments will be based on the information you have provided thus far.

1.  If you have acquired HIV, I am confident that you did not acquire it from than anal plug.  Unless they are passed and used immediately by more than one person, HIV is not transmitted through shared inanimate objects such as sex toys.  

2.  You have had 7 tests for HIV antibodies (were any of these 4th generation, combination HIV antigen/antibody tests?) over 7 months performed at three labs and apparently just a single PCR test.  I would believe the antibody tests which have been repeatedly positive.  As we have said on this Forum many times, the rate at which PCR tests are falsely positive is far higher than the rate for antibody or antibody/antigen tests.  If you choose to repeat your test, I would suggest a quantitative PCR test as well.  My suspicion is that, unless you have had HIV for many years, which I doubt, the PCR test is falsely positive and would ignore it.

3.  The CD4/CD8 ratio has not been used in diagnosis of HIV for over 20 years and can be affected by many other illnesses.  When persons have HIV detected, sometimes the total CD4 concentration is determined to guide management decisions.  I would ignore your CD 4/CD 8 ratio and not repeat this test.

I hope that this initial information is helpful to you.  EWH


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17 months ago
I didn't make any sex activities  except use this anal plug once for 2 second . Maybe it was used in the store before i bought it . But i washed it by hot water and soup before i try it . And all antibodies test is 3d generation antibodies only . I'm married  and don't have another sexual partner.  I tested my wife after my POSITIVE pcr and she was negative pcr and negative antibodies test
17 months ago
The time between purchased the anal plug and use it after cleaning around 1 hour . Can you pleace advise me  about which test i need to do now P24 or western plot or pcr ? And what do you think about my strange exposure? I think i have very bad luck 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
I can completely assure you that you were not infected by using the plug.  This does not happen.  HIV does NOT survive and continue to be infectious immediately upon exposure to the environment.    I would not repeat the PCR test.  I would have a combination HIV p24 antigen/antibody test, sometimes called 4th generation tests.  I am confident the result will be negative.  Your ba luck is to have had a falsely positive PCR test.  EWH ---
17 months ago
I'm from Egypt . We don't have 4th generation tests . But we have p24 test .
So i will get p24 test alone and i think i don't need to make antibodies test because the last antibodies test i did was from 5 days . Is that enough or i need to make western plot ?
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
A p24 test is all that you need.  I anticipate that it will be negative.  I agree with you that there is no need for antibody testing again if your last test was five days ago.

Our Forum provides up to three responses to each client's questions.  This is my third reply.  therefore this thread will be closed shortly without further responses.  Take care.  EWH
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