[Question #8479] So many tests but symptoms continue

43 months ago

Hello. Over the years Going back to 2002 I have had many exposures, most low risk. In December 2017 (last exposure)I started having health issues so. I went and got tested again. All my tests have been negative. My issue is that most exposures have been with Asian massage parlor and I am afraid of missing subtype/strain. I went to ID doctor recently/ordered tests Abbott hiv-1 qual, bioplex, hiv-1 viral load, and Roche hiv 1/2 qual. ALL negative. Up until then I tested myself and since 2019 “”have had architect, advia centaur, insti, surecheck, alere, hiv-1 viral loads, since 2019 to present, about six different kinds of PCR(Roche, Abbott, procleix), 8-9 different types of serology 4th generation tests(rapid and lab drawn). To this day I still have symptoms and my wife getting increased cold sores and I’m Worried about her health although she has had blood donated fine.

1) is it possible that for tests with multiple types of tests that I’m Getting false negative because of odd strain/Asian subtype?

2)possible to be more advanced and even all these tests miss it?

3)how can I be sure, no matter what symptoms that below tests not missing :

Alere, insti, surecheck,oraquick, architect, centaur, bioplex, prism ab, Abbott real-time qual, Roche hiv 1/2 qual, Roche hiv-1 qual, Roche hiv-1 quant, procleix, quest hiv-2 dna, aptima.

Is there any more you’d suggest? My cd4 was 635 and ratio has remained 2.1-2.9 since 2019 although total has changed down. I know scattered question but really worried.

Thank you

43 months ago

Clarifying: all those tests except for aptima have been done more than two years after last exposure, all negative.

Edward W. Hook M.D.

43 months ago

Welcome to our forum and thanks for your questions. I’ll be glad to comment and hope that my comments will help to redirect you to determining the cause of your symptoms (the nature of which you have not described).

You have tested repeatedly at times when the results provide definitive results with a variety of test for HIV, all of which are negative. Science has provided us with tests for HIV which are amongst the most reliable of all tests and medicine. There is an Internet-fueled myth that subtypes, particularly those arising from Asia, may provide falsely negative tests. This is an urban myth. On those extraordinarily rare occasions when variant strains of HIV have not given clear results on testing, the results have been equivocal bowl which, intern, has led to further tests which provide a diagnosis. This is not been your experience. Had your tests been anything but negative further testing would’ve been performed to evaluate the reason for unexpected results.

My sincere and heartfelt advice is for you to not worry further about the possibility that you have acquired HIV as a result of past sexual encounters. Rather, I would encourage you to carefully describe your symptoms to a qualified physician who can then make determination about other possible causes of your symptoms. Believe your test results. EWH

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43 months ago

Thank you. My symptoms have been many. Three weeks after 2017 exposure I got small rash/(spot) for a day or two. Also have chronic stomach pain that many Dr have tried to figure out without diagnosis.

1)you mentioned Asia strains. Are some extremely tough to diagnose and give you false neg?

2)in Asia do they use a different type of hiv test that cover more strains/subtypes more prevalent there abs therefore better?

3)if strange type of hiv( and tests not designed/primed fo detect), how would doctors be even able to diagnose it?

4)are there any better tests to do here in US than what I’ve done? Sample to CDC or University of Washington (Dr Handsfield)

5)Can ALL of my RNA/DNA, 4th generation/rapid tests since 2017(more than two years after exposure snd multiples up until present give ALL false negative?( 6 diff rna, 5 lab based 4th, six different rapid)

6)are there cases where drs are suspicious of dx but all tests negative? What is the next step?

7)so my cd4 was 1000 back in 2019 but now st 635. Different reference interval but % has stayed constant and ratio 2.1 to now 2.9. Any concerns?

8)how confident should I be that I

100% free of hiv?

9)anything left in my power to exhaust all resources?

Thank you. I appreciate your time

Edward W. Hook M.D.

43 months ago

Brief answers:

1. No they are not more difficult to diagnose but there are internet myths that they are. I mention it because you seem to be getting misled, at least in part, by the Internet

2. No.

3. If you had HIV current tests would diagnose it. Please don’t go down the rabbit hole of zombie strains.

4. No.

5. No!!!

6. This is the sort of “what if” question that really does not help.

7. No concern whatsoever. The CD4 levels and ratios fluctuate.

8. You you be entirely, 100% confident that you do not have HIV

9. You already have.

I urge you to believe your test results. EWH

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43 months ago

Thank you.

1)So both of you mention time for conclusive testing for new infections. Does that advice change for infections that have been there longer say a year, 2,3 or more? Could the rna/4th gen tests become less reliable in testing?

2)it seems that I am having muscle loss/increased fat. I am concerned that somehow this could be, with my low cd4 another part of advanced disease. Thoughts?

3)is there a possibility that all tests for some reason just cannot pick a strain/subtype because of the type of hiv or some biological reason with my body?

4)are there any more specialized tests that are employed (if so, by who)to pick up a rare/strange subtype? Is that genotyping?

5)could ALL the below science fail me well after after 2 years:and give ALL false negative::

-insti,oraquick,surecheck,alere determine,Roche hiv-1 cobas rna quant,Roche hiv 1/2 qual, quest hiv-2 dna,Roche hiv-1 dna, abbot hiv-1 qualitative,MPX HIV, abbot architect, bio-rad bioplex,advia centaur, prism 3rd generation

6)even with bad/strange symptoms that are NOT in my head, should I 0000% forget hiv as a possibility?

7) is there ANYTHING related to/for hiv that I should further consider? I want to FEEL BETTER!!!!’

Thank you for your time.

Edward W. Hook M.D.

43 months ago

As you know, we provide up to three responses to each client’s questions. This will be my 3rd and final response.

1. No, test results do not become less reliable over time. If infection were present, the test would be positive.

2. Your CD 4 count is within the normal range and not a cause for concern. I would look for other reasons for your muscle loss, starting with discussing your concerns with your doctor.

3. No. The topic of undetected strains is an urban myth promulgated on the Internet.

4. No, see above

5. Same answer, no

6. Yes, absolutely

7. No. Your fixation on the possibility of HIV is not healthy. I’d suggest discussing it with a trained counselor

EWH

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43 months ago

Thank you. So one last thing?

1)without additional exposure I do not/should not need to test or test anymore even with any symptoms I have? Thank you. That’s all.

Edward W. Hook M.D.

43 months ago

You do not need further testing for your current concerns. Further testing of any sort for HIV would be a waste of time and money. EWH ---

43 months ago

Thank you