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Paiful lymphnodes under neck after sex, negative ORAQUICK test.

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Please, I need your take on my situation;

Around 6 months ago I have a one time unprotected sex with a girl of unknown HIV status (one night stand). I did a routine health check and this results came out;

Last Unprotected sexual exposure Sept 9, 2014

1) Routine Screening HIV test ; Oct 7, 2014 (28 days after exposure) – ICMA HIV Test Repeatedly Reactive >1.45: then, they reflex to an HIV 1 and 2 Differentiation Test for confirmation (Results were HIV 1 Non-Reactive and HIV 2 Non-Reactive): The results were giving to me via phone since I was out of the USA at that time. The lab recommendation was for me to get an RNA test on a new specimen. Since I was out of the country I couldn’t find a place to do this RNA test, so I went to a private Lab in the country I was and they performed the following test;

2) Oct 15, 2014 (36 days after exposure): COBAS E-411 ECLIA: NEGATIVE (they performed the test twice with the same blood sample just to make sure). The Lady at the lab told me that this was a 4th Generation Test (test for Abs and Antigens), but I don’t have a way to confirmed since the results document only says “HIV COBAS E-411 ECLIA: NEGATIVE”

Then, back in the USA, I performed the following HIV tests;
3) Dec 09, 2014 (98 days after exposure): I went again and did the same original test (same lab but different state): HIV 1/O/2 Abs-ICMA; Non-Reactive

4) Dec 09, 2014 (98 days after exposure): With the Same blood Sample above I requested a 4th Generation HIV test: Non-Reactive

5) Feb 03, 2015 (160 days after exposure): I request a RT PCR RNA Test and the result was Negative <20copies/ml

6) Feb 24, 2015 (180 days after exposure): I went and bought an In Home Oraquick HIV Test and was Negative (only a C line visible)

7) Feb 25, 2015 (181 days after exposure): I went and bought an In Home Oraquick HIV Test and was Negative (only a C line visible)

8) Mar 01, 2015 (188 days after exposure): I went and bought another In Home Oraquick HIV Test and was Negative (only a C line visible)

My questions are the following;

1) Does my first test was a false positive?
2) Can I trust my later Negative Results?
3) I have being having painful lymph nodes under my neck, arm and one leg and weird sensations all over my body.
4) Should I take the last tests (after the first positive) as Conclusive Negative?

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 22 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I can understand your concern.
You have taken a number of tests following the first test, which is understandable. Since, at the end of 6 months, the tests are negative, the first test was definitely a false positive. Yes, you took so many tests, and they definitely show that there is no sign of HIV in your serum, so you can trust the tests.
Regarding your lymph nodes, if they are enlarged at various sites, you need to get it physically examined by a physician and get blood tests done such as CBC with ESR. This will indicate any active infection.
Yes, you can take the last tests as conclusive negative.
Feel free to discuss further,
Regards.


Patient replied :

What is your opinion on the RT-PCR-RNA test <20 copies at 5 months?
The tests at 6 months were the home oraquick oral fluid test. What do you think about this test?


Besides the 4th generation antigen antibody test, HIV RNA test is one of the most sensitive test used, and the RNA is the first viral product found in human serum. Since it was negative at the end of 6 months, you need not worry.
Also, the Oraquick test is sensitive, but the 4th generation and the RNA tests are more specific.
Regards.


Patient replied :

Thanks for your answers.
What causes false positives? Does the first positive number (1.45) means that it was a low positive? Im glad that all the other tests were negative. I was very depress and with a lots of stress with this situation. I took the Oraquick ORal test 3 times during the six months period so I make sure there were no false negatives.
1) Have you seen people that are positive HIV, not in treatment and with a NEGATIVE <20 copies/ml RT-PCR-RNA test? Can I trust this test?
2) What is your experience with the Oraquick Oral Test? Can I trust this test?
Thanks


Hello,
Yes you can trust the other tests.
The first one was an isolated false positive, must be some kind of error in reporting in the lab.
As I mentioned, RT-PCR-RNA is very sensitive, so you can definitely trust this test.
Oraquick though not as sensitive as RT-PCR-RNA, it is 95 % sensitive, so repeated negative tests confirm you do not have the disease.
Regards.


Patient replied :

Ok. THanks.
Just for your information. A week and half before I took the first test (first false positive) I was in vacation in Dominican Republic and I eate something that got me some kind of bad bacteria because I have this crhonic diarrheas for almost 4 days.
You never answered my question above; here is again.
1) Have you seen people that are positive HIV, not in treatment and with a NEGATIVE <20 copies/ml RT-PCR-RNA test? This test was taken at 5 months and not 6 month.
Thanks


Hello,
The very fact that your RT-PCR-RNA test is negative at the end of 6 months, completely rules out HIV. In you case the first test was an error, and such errors are highly uncommon.
In my practise, I have never come across a case like that, but there have been false positives.
Please do not worry. I can assure you, that the RNA test is the most specific and it being negatives, rules out HIV completely.
Hope this was helpful,
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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