[Question #7903] Dr Handsfield—different perspectives/ideas?

50 months ago

Dr Handsfield, I’m hoping you can give me your perspective. I won’t repeat my prior post as you can look into if you like.long story short. Last exposure 11/2017. , I’ve been experiencing bad symptoms of various types for over three years and then some. I’ve had many many tests and all have come back negative. I’ve had RNA, as well as 3rd/4th generation with The last third and RNA being in late March and the 4th generation this past December. All negative. I have bad abdominal discomfort as does members of my household. We have all given blood with for Covid antibody and the 3rd gen//rna have been negative.

1)could hiv of some strange sort evade all my tests over the years?

2)with the slew of various molecular/serological tests, could I have false negatives for over three years.

3)should I worry about hiv in regards to my family members? (Wife, others) they all have similar symptoms.

4)I know certain types of hiv are difficult to detect, if I had, how would science/a doctor be able to diagnose in the setting of ALL negative tests?

I’m sure I will have some follow-up questions but wanted just another perspective possibly. Thank you

Edward W. Hook M.D.

50 months ago

Welcome back to the Forum although it saddens me that you appear unable to accept the information and advice I offered. I can assure you that Dr. Handsfield’s assessment would not differ from mine. We’ve worked together now for nearly four decades and have never differed in the facts of our assessment. In part for that reason clients are not allowed to choose who answers their questions. As I said before, your tests are conclusive and your symptoms are concerning BUT they are NOT due to HIV. It’s time for you to accept this and work with your doctor to address the real cause of your difficulties. Thus:

1. NO!

2. NO!

3. NO!

4. Get over this idea. Your tests would not miss ANY form of HIV.

EWH

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H. Hunter Handsfield, MD

50 months ago

Hoping it will reassure you, I agree entirely with Dr. Hook, both his comments above and all he said in your previous discussions with him.

Best wishes— HHH, MD

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50 months ago

Dr Handsfield, thank you for injecting your comments. It’s nice to hear from you as well. Dr Handsfield, may you please take a moment to address some things I don’t know.

So I wanted to ask another non-mentioned point. You always say that if you hit six weeks you’re conclusive for new infections.

1)On the other hand, what about if maybe you’ve been infected for sometime? Does the sensitivity decrease and have more chance of false negative?

2)could you lose the ability to make antibodies and giving one a false negative?

3)my wife and I are having increased cold sores. I know this can be a sign of advanced infection. What’s the chance that either of us could actually have hiv and the 3rd/4th generation tests along with RNA aren’t picking it up because of test sensitivity or unable to detect an odd subtype/crf/strain.?

4)when you talk about conclusive test results, Is there any difference in your thinking on test validity and needed repeating between 6,12 weeks versus 1,2,3 years?

5)with the tests I’ve had(many 4ths, 3rds, hiv-1/2 DNA/RNA, is there any instance where you would not believe all the tests and investigate more with kinds of tests? If so, what?

Thank you

Edward W. Hook M.D.

50 months ago

As noted above, Dr. Handsfield added his statement as a courtesy as we do not allow clients to choose who responds as noted above. He will not respond further as part of this thread. In response to your follow up questions:

1. No, the sensitivity of the test does not decrease over time in persons with longstanding infections. Nor does the likelihood of a false negative test decrease over time.

2. No, this is a biological impossibility.

3. This is a repetitive questions. This is not a possibility.

4. Repetitive. The answer is not going to change, no.

5. No.

We have done our best to assure you that you do not have HIV. You repeated testing using multiple types of tests proves this. Please be aware that you have one more follow-up question as part of this thread. After that, further repetitive, anxiety driven questions to this forum may be deleted without a response and without return of your posting fee. EWH

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50 months ago

Hello Sir. Dr Handsfield replied to someone’s post yesterday when he said that the current tests may not pick up hiv 2 with the stand alone tests.(question 7928). Although he said it’s rare and should not worry about. But it’s still serious when your exposure was with someone from outside the US.

1)I wanted your thoughts on that comment please, and could it be that all variety of my tests over three years could miss hiv-2?

2)What’s the chance that IF dealing with a type that is uncommon, that a test(s) years after could miss?

3)With all sorts of symptoms thst ARE NOT ANXIETY, can I still be completely certain that im not dealing with hiv no matter what symptoms I exhibit?

4)You always speak of NEW infections, but is your advice the same for an exposure that say was years prior but are having symptoms? Is the work up different?

5)Can it be Harder to dx hiv if in latter stages with both combo and RNA and may have missed early opportunity to test/find infection?

6)How sure are you, that I have eliminated hiv of ANY SORT with all my testing?

7)is there ever a point/situation besides pep, where you would believe the symptoms OVER the tests and dive further into testing with other methods? If so, what?

8) is there any value to me seeing an ID specialist regarding hiv and having them order any additional tests? If so, what?

I really want to, after 3 1/2 years, MOVE ON. The recurrent abdominal pain, anemia, oral sores are preventing me from doing so.

9) should I COMPLETELY DROP this and focus on other causes?

Thank you

Edward W. Hook M.D.

50 months ago

Straight to your questions:

1. An HIV-2 infection would not have been missed by the tests you describe. HIV-2 may rarely be missed by antibody-only tests with the tests you have described early (in the first month or two) in the course of infection. Over time, HIV-2 antibodies are developed and picked up.

2. Zero chance of the testing you have had missing HIV (1 or-2)

3. Yes, any symptoms you are experiencing at this time are absolutely NOT due to HIV.

4. If anything, longstanding infections are easier to detect than newer infections. Your testing would not have missed an infection.

5. No

6. Absolutely sure from the testing you have described

7. No

8. No

9. Yes, PLEASE put your concerns about HIV aside and work with your doctor to determine the real cause of your symptoms.

This completes this thread. A word of warning. Repetitive, anxiety-driven questions may be deleted without a response. Any question you might have at this time about symptoms or your test result would fall into that category. Please work with your doctor to determine what is causing your problems. Take care. EWH

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50 months ago

Thank you for your time /patience.

50 months ago

I knew there was one thing. With the testing I described in my prior posts, is that a very extensive/reliable battery of tests with many well after 1 year or longer? Sorry for the additional. Be safe and again thank you for your explanations