Dr. Ravinder K. Sachdeva
HIV/AIDS specialist
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,
I had unprotected intercourse once with CSW(Community Sex Worker) last year. I tested for rapid ICT(Indirect Coombs Test) and PA methods after six weeks of exposure. HIV (Ag/Ab) CMIA test after eight weeks, both negative. I started getting chronic diarrhea for the past six months. A viral Marker test was done (16 months later), which reported negative for hepatitis A, B, and HIV. Is it possible that HIV has reached an advanced stage that is why antibodies are not showing in the test anymore? My lymphocytes were also low 8, 14, 16 when tested before five months. I also observed whitish tongue since after the exposure, ARS (Acute Retroviral Syndrome) symptoms also.
Hi, Welcome to icliniq.com.
Your test results are negative for HIV. If there had been no further exposure, these would be considered conclusive. However, if there is any doubt about the same or test result, there is no harm in getting a repeat HIV antibody test. This will allay your anxiety. Symptoms could be due to various reasons and do not necessarily mean HIV. In fact there are no symptoms through which HIV can be diagnosed. Getting an HIV test is the only answer. From the description, it is unlikely for advanced disease manifestations.
Patient's Query
Thank you doctor,
After your advice, I took a full panel STD test and tested negative on all, including HIV (p24 antigen and antibody test). My problems are, why do you think my lymphocytes have been reporting lower than standard, consistently (8,14 and 16) and WBCs were raised? There were three tests done. The first test showed 8, which then increased to 14 and 16. Why did it go so low? I have been having a chronic problem with soft stool for the last four months now. The frequency is once or twice a day, but the stool does not have integrity and is soft. Although I am asthmatic, I feel more breathless now, and there is a whistle-like sound when I breathe from my nostrils. Even if the Antibody test is negative, how to ascertain that this is not an advanced infection stage where body antibodies may not be detectable? Should I get CD4 tests are done to be sure, or the antibody test is sufficient? Have you seen cases where the infection has reached an advanced stage in only 16 months, and antibody tests start showing negative results?
Hello, Welcome back to icliniq.com.
Good. Your tests are negative. I could not find any hemogram, blood counts, lymphocyte report attached in the query. So I cannot comment. If it is persistent, get stool routine examination for three consecutive days for ova/cysts. Maintain food hygiene. You can send the report so that adequate treatment can be given. For chest wheeze, I suggest getting a chest x-ray and pulmonary function tests. Do let me know the medications taken by you for asthma. I again want to emphasize that these symptoms are quite common in normal populations and do not mean HIV. Getting a fourth-generation HIV rapid test and a qualitative HIV DNA (Deoxyribonucleic acid) PCR(Polymerase Chain Reaction) will help to diagnose infection if it is there. CD4 is not a diagnostic test. It is used to monitor the response of antiretroviral therapy. Such a scenario I have not witnessed in my practice.
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HIV/AIDS specialist
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