[Question #6932] After TWO years of tests....Can i be 1000% certain I don't have HIV of ANY sort?

9 months ago
Hello, I am hoping Dr. Hook will have a moment.  I am returning to ask a couple of questions.  My risk goes back to NOV 2017 and also there were risk exposures BEFORE that(2009 +).  After 11/2017 episode i came down with nasusea, night sweats, abdominal pain.  To this day the abdominal pain persists with other symptoms including easy bruising, muscle loss, joint ache, and periodic mouth sores which go away in a few days.  I have read that NO MATTER THE SYMPTOMS, THE TESTS SHOULD BE TRUSTED.  I have my doubts though.  I will list types of tests/timeframe done.  A) LAbcorp Advia done at 7,18,26,41,52 wks B)Quest architect 10,13,25,45,74,126 wks ), C) HIV1/2 Prism(3rd generation with HIV-1 RNA blood donation 68,83,92,100,110 wks D)Bio-Plex 5th gen @ 54,100 wks, E)COBAS HIV-1 RNA 16,45,126 wks, F)Roche Qualitative HIV-1 RNA @16,126 wks G)Quest HIV-2 Proviral DNA @ 7,45,126 wks. H)Aptima HIV-1 RNA@4,7 wks I)INSTI 25,37,96 wks, J)sure check 35 wks K) Alere Determine rapid 117 wks.  ALL of my tests have been negative or non-reactive. What bothers me is the possibility that even with all the tests, it is somehow being missed, which is still causing my symptoms which began a week afterwards.  My son( who I tested with ALERE rapid(neg)at MY 117 wk mark, and wife who also went for blood donation at MY 110 week mark(neg).--they have these symptoms too.To my questions:
1)Any way that from years ago exposure(therefore more advanced and could have lost AB) or last one NOV 2017, that HIV of SOME SORT could be missed with all the testing?
2)Could HIV-2 be missed?
3)My doctor still says its safe to give blood, do you agree?
4)With the above tests(extensive), is there ANY BETTER test to do or others to do and at what timeframe? (Abbott REAltime??, I heard equivalent to ROCHE COBAS)
5)Is it possible that I cannot create antibodies to a certain strain, or have detectable RNA because of strain, subtype, or immune problem?
6)Can I take with 1000%  confidence that I don't have HIV?
Thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
9 months ago
I'm sorry, but these questions have been answered repeatedly over two years. Nothing has changed in the 16 months since our most recent discussion. As has been stated and reemphasized, symptoms never are a useful predictor of HIV infection compared with laboratory testing. Something other than HIV explains your symptoms. Please note that I'm not denying your symptoms. But you have not only my and Dr. Hook's reasoned, science based opinions and advice, but that of your doctor as well. And anyway, the symptoms you describe are not at all suggestive of HIV anyway. To your specific questions, with very succinct replies and no follow-up discussion:

1,4) No new test types have become available over the two years of your career on this forum and no additional tests of any kind are necessary or recommended.
2) HIV2 would have been detected if you had it.
3) Your doctor is right.
5) We discussed this in at least one of your previous threads. If somehow you didn't make antibody, the antigen component of your AgAb tests and your PCR tests would still be positive.
6) Yes.

Your last thread concluded with the following statement:  Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV may 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. 

This time, please substitute will for may:  Future repeat of these questions, no matter how long in the future, will be deleted without comment. But I do hope this final reply contributes to your final acceptance you don't have HIV. If it does not, perhaps professional counseling is something for you to discuss with your doctor. Good luck.

HHH, MD
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