Dr. Goswami Parth Rajendragiri
Pathology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
After exposure, I got tested for HIV(Human Immunodeficiency Virus) (the condom covered half of the penis after ejaculating inside). All tests were conducted after seven months of exposure. Most of them are rapid tests, and two are CMIA (Chemiluminescent Microparticle Immuno Assay) tests from a diagnostic center. My query is, are these test results reliable? They say it is a fully automated test. Does it mean there are no chances of error? I heard that the diagnostic centers employ freshers who have no experience in testing. I have attached a copy of the results below. So can the results be trusted?
Hello, Welcome to icliniq.com.
Following is my opinion for your asked question. I have seen the attached reports (attachments removed to protect the patient's identity). All your HIV (human immunodeficiency virus) test reports with different methods are negative for HIV. Diagnostic centers are usually well-reputed pathology laboratories, and their reports are reliable, as per my opinion. I have seen many reports from many patients, and they are good with standard reference ranges. I do not know their recruitment process. But you had tested many times with different methods. So clerical or technical error chance is almost zero. After six weeks, HIV can be excluded by CMIA (chemiluminescence microparticle immunoassay). So, now you need not worry about HIV if you have no further exposure. Hope I have answered your question. Let me know if I can assist you further.
Best regards.
Patient's Query
Hello doctor,
Thanks for the reply. All these tests were done after seven months of exposure. Is this CMIA (Chemiluminescent Microparticle Immuno Assay) test third generation? By fully automated, does it mean the machine itself processes the serum sample? Those rapid tests were taken by myself with a finger prick, and I was not satisfied with them. So I took a lab-based rapid card test and two TRI-DOT tests followed by two CMIA tests from the diagnostic center.
Hello, Welcome back to icliniq.com.
Following are my answers to your questions. Yes, it seems to be a third-generation CMIA test detecting all antibodies against HIV. After three months, any antibody test can detect HIV (Human Immunodeficiency Virus) antibodies if a patient is infected with HIV. So, you can consider CMIA reliable for testing after three months of exposure. Yes, it was an automated testing procedure for HIV. Most of the current tests are automated instruments that avoid human errors and are more accurate and reliable. You have done rapid card testing perfectly, and it is a valid test. Presence of band in control indicates that you had done the perfect rapid card test testing procedure. So, you should forget that incidence and consider yourself free from HIV. Do not worry.
Best regards.
Patient's Query
Hello doctor,
Thanks for the reply.
I do not remember if I had this before. But I feel small bean-sized jelly-like movable nodes behind both my knees. I can feel it on both the bones or ligaments behind both knees. Is it normal to feel them with fingers? I do not think it is swollen or it is painful.
Hello,
Welcome back to icliniq.com.
Your attached reports are negative for HIV. So, you do not need to worry about HIV. Diagnostic centers are well-reputed laboratories, and you can consider their report valid. Automation in testing, especially CMIA, reduces human error and reports lack error if automation is used. Every laboratory gives induction training to newly appointed staff and only allows them to work. So you may need not worry about staff ability in running samples in the instrument.
Hope I have answered your question.
Best regards.
Patient's Query
Hello doctor, Thank you for the reply. As mentioned before, I feel small bean-sized jelly-like movable nodes behind both my knees. It is not swollen or painful. I can feel it on both the bones or ligaments behind both knees. Is it normal to feel them with fingers, doctor? Can small bean-shaped lymph nodes be felt on various body parts like the jaw, chin, etc., by touching them with fingers? Many people have persistent symptoms despite testing negative after six months. Have you seen any of them testing positive later?
Hello,
Welcome back to icliniq.com.
A jelly-like soft lesion behind the knee could be a ganglion or lipoma-like benign soft tissue lesion. You can get it removed by the surgeon if needed. Suppose you have an enlarged node of more than one cm in the cervical, jaw, or neck area. In that case, it needs further investigation in USG (ultrasonography) and FNAC (fine-needle aspiration cytology) of the enlarged node. They are not the symptoms of HIV. I have not seen any case which turns positive after six months of exposure. So, you can forget that incidence and consider yourself free from HIV if you have no further exposure.
Hope this helps.
Best regards.
Patient's Query
Hello doctor,
Thank you for the reply. I do not have an enlarged node. I can feel only one small bean size node with my finger. It is not noticeable from the outside. Also, I cannot tell if it is one complete round piece because I cannot move it around. I can only feel its presence by touching it from the bottom of my chin. It is located under the chin, slightly to the right from the middle. In the case of positive people, do they get reactive results with just one test or have to test repeatedly until they test positive?
Hello, Welcome back to icliniq.com.
An enlarged node less than one cm does not have much significance. The enlarged node does not indicate HIV. Reactive node enlargement could be due to many causes. It is not a sure sign of HIV. HIV can be diagnosed by the end of three months and maximum at six months of exposure. After which, there is no need for further testing. I am assuming that you had no other sexual exposure after that incident. You can consider yourself free from HIV, as I said in my previous answers. I hope I have answered your question. Let me know if I can assist you further.
Best regards.
Patient's Query
Hello doctor,
Recently I have had pain near the gum part of my last wisdom tooth on both sides of the mouth. Now I have three very small lymph nodes, one below the other less than 1 cm on the right side of the neck. Does it cause swelling in the neck or jaw?
Hello,
Welcome back to icliniq.com.
Gum infection or inflammation might be responsible for enlarged nodes in the cervical area. So, you might need not worry about that. However, you can start an antibiotic course for a week as per my opinion. I suggest you consult an otorhinolaryngologist (ENT doctor) for examination of enlarged node and get an antibiotic prescription accordingly.
Best regards.
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Pathology
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