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Dear Drs can I have your advice please

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  • Dear Drs can I have your advice please

    Dear Drs,
    Could I have your advice please.
    I am a heterosexual male and one year ago I had a brief sexual relationship with a female who it subsequently materlised is HIV positive and not on anti viral medication.
    Two weeks after the relationship I became ill with chronic stomach ache and rumbling, swollen lymph under my armpits, nausea and general fatigue - the severe stomach issues and periodic swelling under my armpits still continues to date over one year later and I have noted vascular changes in my eyes and lids with dark circles under the eyes and developed joint pain.
    I tested for HIV using 4th generation at 4 weeks , three months , six months and twelve months post exposure , a cephid HIV 1 qualitative point of care PCR was also carried out at seven months - all tests were non reactive / not detected. I have also undertaken a full STI test panel for more common infections and these were all negative outside of the relevant window periods.
    I have a genetic immune deficiency called IGA deficiency meaning I am not able to produce this particular antibody against infections - could this existing immune condition in any way be affecting the validity of my negative HIV test results, especially in view of my ongoing symptoms and my previous partners status?

    With thanks.

  • #2
    Hi Pilot,

    In theory it should not affect the validity of the tests that you have done so far. HIV 4th Generation tests checks for both Antigen and Antibody and the antibodies that are checked are IgM/IgG instead of IgA. You also have a negative PCR test which I assume is for HIV RNA PCR. There will also not be affected by any immunodeficiency.

    I would say that all your tests are accurate and you do not HIV.

    Regards

    Comment


    • #3
      Many thanks for your response Dr.
      Correct , the Cephid xpert HIV-1 Qual provides a total nucleic acid based test for RNA and proviral DNA in one fully integrated cartridge LOD is 278 cp/mL , 95% sensitivity when referenced to Abbott M2000.
      I understand that antigen is not detected in the case of HIV 2 , do you feel a PCR test to cover HIV2 infection would be prudent given my ongoing symptoms?

      Thank you

      Comment


      • #4
        Hi Pilot,

        HIV-2 is actually rare out of Sub-saharan Africa. I think if it puts your mind at ease you could ask your healthcare provider for it, although RNA/DNA tests for HIV-2 are more rare.

        Personally, I do not think your symptoms are HIV related, given the multiple negative antibody tests you had so far.

        Regards

        Comment


        • #5
          Many thanks for your help Dr , it is greatly appreciated.

          Comment


          • #6
            Hello Dr ,
            My apologies for troubling you again but I would really appreciate some additional advice please.
            My many symptoms still persist including chronic stomach pain , loose stool , eye problems , fatigue and swollen armpit lymph and now my body hair has begun shedding rapidly.
            I understand my testing to date should be conclusive however in view that my Drs are unable to reach a diagnosis I was considering taking a course of PrEP to see if my symptoms improve or resolve, if they did then this would surely point to seronegative HIV and get me to a point of receiving suitable treatment?

            Comment


            • #7
              Hi Pilot,

              I would strongly advise against taking PrEP for treatment for presumptive sero-negative HIV.

              HAART (Highly active Anti-Retroviral Treatment) is a cocktail of 3 medications for HIV treatment and control.

              PrEP on the other hand is only 2 out of 3 of the medications needed to control HIV. It's not good enough for treatment but good enough for prevention.

              If you take PrEP instead of HAART, in the event of sero-negative HIV there would be rapid development of drug-resistance, leading to multi-drug resistance HIV.

              You do not have HIV, the HIV Pro-Viral DNA/HIV RNA PCR has proved that conclusively. You should still see your doctor for accurate diagnosis of your conditions.

              Regards

              Comment


              • #8
                Thank you for your help Dr , it's greatly appreciated. It has been a very difficult time to get my condition followed up due to the many cases of covid19 here, prednisolone seems to be starting to help .

                kind regards

                Comment


                • #9
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