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Old 06-19-2010, 10:12 PM   #1
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Testing algorithm

www.aphl.org/aphlprograms/infectious/hiv/Documents/StatusReportFINAL.pdf

I'm in Canada so our algorithm(s) here may be different some countrys don't allow HIV pcr for diagnosis even with an initial positive or reactive result and a follow up one. If the doctor who ordered mine Didnt specifiy clearly I was having acute or initial HIV symptoms they may have only ordered the pcr as an option if I had a positive antibody immunoassay. Not to mention compared with 3rd gen or 4th gen antibody tests pcr only picks up a small amount of later seroconverters. So ya factoring in my country they may not even use pcr for diagnosis that may add incentive to discount that part of the test on top of the test being more costly. It could happen to have that portion of the test only as an option to a positive antibody test.

From what I understand if plasma isn't stored transported or drawn properly it could be tainted, also the pcr is far from a simple test and it can be easily contaminated during testing leading someone to strongly
considering a false postive result especially with a non reactive antibody immunoassay.

I can't help but remember how severe my acute symptoms were and what in all triggered or shortly proceeded them a sexual risk. One of these girls is a prostitute or was engaging in high risk behaviors aka anal.assuming you read my other recent thread you can factor in how I'm still feeling not well and you get the picture. Some of my symptoms were and are too specific to HIV aka OHL,severe loss of appetite, peripheral neuropathy, sebborhea I already had before much more inflammed I could go on and on with other ones. I'm really aware of my body especially feeling this much different.

Don't get me wrong the pcr should have been ordered especially since my results were sent off to another province likely because they didn't do pcr in the one I live in. Not to mention my results took longer than they should have to come back.

Last edited by missingyou; 06-24-2010 at 11:30 PM.

 
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Old 06-19-2010, 11:01 PM   #2
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Re: Testing algorithm

I'm alsoin Canada, what province are you in? Have you tested positive or negative and how far after exposure?

 
Old 06-19-2010, 11:40 PM   #3
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Re: Testing algorithm

I'd rather not tell you which province it's not a province that does naat testing provincially.

My most recent test was done just over 6 weeks post exposure and it came back negative.

 
Old 06-20-2010, 12:54 AM   #4
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Re: Testing algorithm

Congrats! Then you are fine.

Perhaps what you and I have is a new HIV. A disease not known
to doctors yet. HIV had it's infancy stage I'm sure it won't be the last new and deadly
sexually transmitted disease.

 
Old 06-20-2010, 01:32 AM   #5
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Re: Testing algorithm

Can you get a copy of the lab report from your doctor's office, and if the PCR was done, it will say so, along with the detected viral load (such as <75 copies, or whatever the lower limit is there), and if the PCR was not done, the lab report should say it wasn't indicated (or whatever the lab would put if they chose not to run it for some reason.)
It seems to me if you could get copies of your results, you could find out which tests the lab actually ran.
btw if you had unprotected sex with a prostitute, you were more likely to have contracted a different STD (if you contracted anything.) So hope you were tested for all STDs after 4 weeks?
If so, I am sure you are fine. I personally would feel good about a 6 week negative test.
Good luck and peace.

Last edited by pfe; 06-20-2010 at 01:32 AM. Reason: typos

 
Old 06-20-2010, 11:53 AM   #6
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Re: Testing algorithm

Quote:
Originally Posted by peacefullearth View Post
Can you get a copy of the lab report from your doctor's office, and if the PCR was done, it will say so, along with the detected viral load (such as <75 copies, or whatever the lower limit is there), and if the PCR was not done, the lab report should say it wasn't indicated (or whatever the lab would put if they chose not to run it for some reason.)
It seems to me if you could get copies of your results, you could find out which tests the lab actually ran.
btw if you had unprotected sex with a prostitute, you were more likely to have contracted a different STD (if you contracted anything.) So hope you were tested for all STDs after 4 weeks?
If so, I am sure you are fine. I personally would feel good about a 6 week negative test.
Good luck and peace.
I saw the piece of paper with my results at the top it said hiv pcr and negative beside it. I wondered why it didn't specify a viral load number like you mentioned.

Below it also said HIV 1 negative and HIV 2 negative. When I was asking one of these girls about her test results she read some off like the ones I just stated and she mentioned pcr which given how I was feeling was and is strange. I didn't pay for the sex but that doesn't mean either wasn't a prostitute if that makes sense.

The negative test result is a good sign but I do have an igg deficiency so my antibody response could likely be blunted. Also my symptoms are still there something has to be causing them you need to listen to your body.

I was far from the healthiest person before despite having muscles working out consistetly and having a very healthy diet. It's just too weird how I don't
even get hungry anymore on top of the other symptoms
I metioned in my OP and other threads

Last edited by missingyou; 06-20-2010 at 11:55 AM.

 
Old 06-20-2010, 12:18 PM   #7
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Re: Testing algorithm

one of these girls who was into unprotected anal lost alot of weight looking at pics around Christmas and then others a few months later. I know she wasn't into working out, diet or cardio not to mention all of the above.

I have super low HDL gentically(not from diet or lack of exercise) which means I have
less myelin tissue protecting my nerves hence why I'd be alot more prone to neurological symptoms.

 
Old 06-20-2010, 12:42 PM   #8
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Re: Testing algorithm

Quote:
Originally Posted by missingyou View Post
one of these girls who was into unprotected anal lost alot of weight looking at pics around Christmas and then others a few months later. I know she wasn't into working out, diet or cardio not to mention all of the above.

I have super low HDL gentically(not from diet or lack of exercise) which means I have
less myelin tissue protecting my nerves hence why I'd be alot more prone to neurological symptoms.

Keep us posted on your findings because I'm in the same boat as you... Exposure, symptoms, negative test at 5 weeks 1 day and not hungry anymore.... I usually eat a snack in the morning and dinner...

It's unlike me eat this little

 
Old 06-20-2010, 03:40 PM   #9
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Re: Testing algorithm

Loss of appetite is a common symptom of anxiety. I think the most common mistake that people make on HIV forums is that they forget that anxiety can make a person physically ill.

 
Old 06-20-2010, 05:25 PM   #10
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Re: Testing algorithm

Quote:
Originally Posted by joggen View Post
Loss of appetite is a common symptom of anxiety. I think the most common mistake that people make on HIV forums is that they forget that anxiety can make a person physically ill.
Yes anxiety can cause symptoms but trust me on this one theirs something seriously wrong with me that's the cause of my physical symptoms. Also when someone has severe symptoms because their is something seriously wrong
with them that can cause anxiety even further compounding the base problem.

It's not just a loss of appetite I don't even feel hungry anymore and eating properly is very important to me for muscle building and overall health and well being.

 
Old 06-20-2010, 05:36 PM   #11
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Re: Testing algorithm

I would think that at 6 weeks I should have gotten an inderminate HIV test result if I was going to seroconvert in the next few weeks, although their are alot of subtypes and mutations.

Along the lines of anxiety keep in mind with CFS or CFIDS some doctors who are usually more old school think this is just a psychological condition because their is no test for it so to speak and alot of the symptoms are similar to depression headaches fatigue etc although some are quite different like lymph node pain neuropathy post exertional fatigue etc..

 
Old 06-21-2010, 01:24 PM   #12
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Re: Testing algorithm

So the lab did do a PCR then. They did a qualitative PCR. And it was negative.
Keep this in mind, missingyou!

How are you feeling lately? Are you able to go out and enjoy life?

 
Old 06-21-2010, 10:45 PM   #13
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Re: Testing algorithm

Quote:
Originally Posted by peacefullearth View Post
So the lab did do a PCR then. They did a qualitative PCR. And it was negative.
Keep this in mind, missingyou!

How are you feeling lately? Are you able to go out and enjoy life?
yes I will keep the negative results in mind but I can't not notice my symptoms. Yes it appears to have been a qualitative pcr, after quick research its suggested that a low lymphocyte count can cause a false
negative so HIV infection cannot be excluded, also my antibody test was 6 weeks and a day and a bit later far from the 3 month conclusive test result timeframe. Also my igg deficiency like I stated could give me a blunted immune response meaning more like 8-13 weeks before detectable
antibodys

I'm not feeling well I don't get hungry anymore I'm still having alot of fatigue
my skin is still more inflammed than it should be and the neuropathy is quite noticeable and annoying. So no I'm not really able to do much not to mention other issues and circumstances.

 
Old 06-22-2010, 12:34 AM   #14
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Re: Testing algorithm

Quote:
Originally Posted by missingyou View Post
yes I will keep the negative results in mind but I can't not notice my symptoms. Yes it appears to have been a qualitative pcr, after quick research its suggested that a low lymphocyte count can cause a false
negative so HIV infection cannot be excluded, also my antibody test was 6 weeks and a day and a bit later far from the 3 month conclusive test result timeframe. Also my igg deficiency like I stated could give me a blunted immune response meaning more like 8-13 weeks before detectable
antibodys

I'm not feeling well I don't get hungry anymore I'm still having alot of fatigue
my skin is still more inflammed than it should be and the neuropathy is quite noticeable and annoying. So no I'm not really able to do much not to mention other issues and circumstances.


Well I guess at this point there's not much else to do but to occupy your time differently, maybe take a break from here and do something to take your mind off of it considerin you're probably going to have to wait a week or two to take another antibody test because of your immune problems.

I feel different, I've occupied myself doing other things that have managed to stop me from thinkig and worrying about the possibilities. It's probably a good idea to move on because if you do test positive (and I don't think you will) I can't imagine what you're going to be like if you're like this right now. Take a break, occupy yourself, workout, go for a run because if you are positive it's a step in the right direction you've already had taken instead of dwelling on it.

Trust me I know, I had every symptom, I dwelled on it. Got a negative 5 week and although that's nowhere near conclusive by the CDC's standards it gave me some peace of mind and I've moved on and I have to say I've enjoyed my life since that test result even though I know I'm still not in the clear, occupying my time, moving on has helped me physically in so many ways and of course mentally.... I'm such a different person now than I was before my 5 week test result.

Good luck and let us know your test results in a few weeks?

 
Old 06-22-2010, 08:00 PM   #15
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Re: Testing algorithm

I'll see what I can do with future updates.

I should note HIV and AIDS itself cause low CD4 counts their are CD4 and CD8 lymphocyte cells as well as T cells that make up the lymphocyte count.

False negatives are a real possibility albeit qualitative PCR's have a higher sensitivity than quantitative as in they can detect alot fewer copies of the virus but they only give a negative or positive result making a quantitative better in that aspect as it gives a viral load number. I read of a false positive in the 100,000 range but that must be rare when refering to PCR's false positives, your more likely to get a false positive in the 5,000-10,000 range.

It's also stated that proviral HIV DNA PCR's should be used with care in non sub type b HIV infections. From what I understand subtype B is the most common so maybe the proviral HIV DNA PCR is geared towards this subtype and is less accurate for other types. I've read similar data on other assays relating to them being more geared towards subtype B but still their overall very accurate maybe it just takes a bit longer to detect the more rare subtypes with one of the more common assays. I read using HIV DNA qualitative proviral PCR one patient had seroconverted yet was having a false negative on this test. I'm assuming the seroconversion was determined through antibody testing and facotring in the time of the patients symptom/exposure.

Initial CD4 lymphocyte counts were studied in 244 patients with human immunodeficiency virus (HIV) seroconversion. The CD4 cell counts at initial presentation after seroconversion were normally distributed (mean, 579/mm3; SD, 252). The mean percentage of CD4 cells was 26.1% (SD, 5.6). CD4 cell counts were < 500/mm3 in 41% and < 200/mm3 in 4%. The mean calculated duration of HIV infection was 7.7 months, which was not significantly different between the highest and lowest CD4 count quartiles (8.1 vs. 7.9).

In other words by the mean of 8 months 4% of newly diagnosed HIV patients had a cd4 count in the greater than 200 but less than 300 aka 200-299 thats my interpretation anyways. Obviously these patients would benefit from HAART right away.

Last edited by missingyou; 06-23-2010 at 11:49 AM.

 
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