[Question #6764] Plz help

13 months ago
Hi my last exposure was on 22/01/20 with a csw , my symptoms started two weeks after mainly swollen tonsils few white spots on them and sore throat  and on / off diarrhoea  I’ve had several antibiotics and they are not working I’ve been to an ent and he said it’s acute tonsiltis , my wife had come to see me from abroad and she has today got a swollen eyelid could this be part of ars and she has a rash on one elbow which is bumpy , I have two round bumps on my tongue which are enlarged but not swollen on either side , what’s worrying me is my diarhoea and sore throat aren’t getting better been over a month the list of tests are below my.                           1/ hiv combo fourth gen (alinity s by abbot ) 16,21,25,28,34,49,50,54 days past last exposure the results of test were from 0.05-0.09  I’m getting worried it’s going up in value ,                2/genexpert total qualitative  hiv 1 25 and 41 days past exposure both (not detected ).                 3/abbot pcr quantative 26 days past exposure not detected                                                                               4/genexpert viralload assay 47 days past exposure  not detected                                                   My questions for you plz.                                               1  /if viral load was below the threshold of 40 rna copies in the pcr test will they still mention it In the report ?                                               2 / what are the chances of me being positive now after all these tests and I am scared thinking I’ve missed the vital windows for these tests ,                                                                             3/what tests should I do now and  and what should be the viral load of a person who’s infected  in the last 3 months etc it should be picked up by the pcr ?
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Welcome to our Forum and thanks for your questions.  I'll be glad to comment.  Your test results now prove that you did not get HIV from your encounter on 22 Jan..  The tests you have test for HIV infection three different ways- looking for antibodies, looking for viral protein, and looking for viral RNA.  Each of your results has been conclusive on more than one occasion.  It is time to stop testing and wait for these troublesome symptoms to go away.  From the sound of things, the diarrhea may be most troublesome and I would suggest working with your own doctor to make sure that there is not a treatable cause of the diarrhea.  If there is not, I'm afraid you are going to need to wait for these problems to go away on their own.   In answer to your specific questions:

1  /if viral load was below the threshold of 40 rna copies in the pcr test will they still mention it In the report ?    

Every test has a limit of detection,.  When persons acquire HIV the have tens of thousands of virus in every drop of blood.  The quantitative tests are used not bfor diagnosis but to make sure treatment of persons known to be infected are working and to evaluate how well therapy is working.  Your test results PROVE you do not have HIV.                                        

2 / what are the chances of me being positive now after all these tests and I am scared thinking I’ve missed the vital windows for these tests ,  

You are well beyond the window and have now proven that you are not infected.  Please review my comments above.

3/what tests should I do now and  and what should be the viral load of a person who’s infected  in the last 3 months etc it should be picked up by the pcr ?  

further testing is a waste of time, energy and money.  You have proven you do not have HIV.  There is no need for further testing related to your January exposure.

I hope that this information is helpful.  Please don't worry.  You did not get HIV in January.  EWH 

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13 months ago
Thanks for your prompt reply , I’m just scared because exactly two weeks after my last exposure I’ve got acute tonsiltis with a sore throat dry mouth and swollen tonsils , white tongue and swollen circumvate papillae  on the back of my tongue , and my diarrhoea , Also I have a dry cough from swallowing sputum from my tongue , in your vast experience of many years can you tell me if you have  ever came across anyone come positive afte 6-7 weeks combo test and how long do ars symptoms last for ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

I completely understand your concern over the persistence of your symptoms.  I hope the following information will be both helpful and reassuring:

1. When persons become symptomatic with recently acquired HIV, they are typically ill for a week-10 days.   Your lingering illness is not consistent with HIV.

2.  When persons have symptoms consistent with recently acquired HIV (the so-called ARS [acute retroviral syndrome]) seek care, less than 1% of them turn out to have HIV.  Put another way, a coincidental lingering sore throat or flu-like illness is far more common than the ARS.

3.  Neither Dr. Handsfield not I have ever seen, or even heard of a person with multiple negative tests for HIV of the sort you have had go on to find that the tests had missed an HIV infection.  Not ever!!

Please don't worry.  This is not HIV.  EWH

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13 months ago
Thanks dr , the reason I am getting stressed is because my throat is bad , also it’s this conflicting information on the net where people are saying wait for a confirmation combo at 3 month and some even say just to make sure again do it at 6 months ! As you can understand this makes life hell ,  the combo test I’ve been having is a alinity s assay on a alinity ci series machine by abbot , I’m living in Pakistan. At the moment so even the testing spooks me out here can you check the spec of the test plz 


Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

I'm sorry your throat continues to worry you and I encourage you to work with your doctor to explore other causes.  I am well aware of the Abbott assay and can assure you that it works very well.  Believe the results.

Also, please stay off of the internet- it will mislead you.  Much of what is said there is out of date, taken out of context or incorrect.

This is my 3rd response.  Therefore, as per Forum guidelines, this thread will be closed shortly without further responses.  EWH

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