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Positive PCR for HIV and negative EIAs

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I was getting screened after having two encounters with the same male - on the first encounter we kissed, mutually masturbated each other, and I received oral sex for a few seconds. On the second encounter we kissed and mutually masturbated each other.

I am a healthy 24-year-old male with no health problems. I tested negative for all STIs and I have never had any STIs. He says that he has never had any STIs either and tested negative for all STIs and HIV upon my request.

At 69 and 42 days respectively from both encounters I had a rapid and an EIA test done - negative for both.

At 99 and 72 days respectively from both encounters I had a rapid test done - negative again.

I was getting anxious and ignorantly requested at 104 and 77 days respectively from both encounters to have a PCR test done - the doctor was inexperienced and ordered it. There was nothing to suggest I needed it in the first place, the doctor did not think I needed it, and I never had any ARS symptoms. It came back positive with a viral load at 415. An infectious disease doctor dismissed this as a false positive.

At 114 and 87 days respectively from both encounters I then had a rapid and an EIA test done - negative for both.

At 121 and 94 days respectively from both encounters I had a rapid and an EIA test done - negative for both.

I'm just worried and confused - do I need further testing or was this just a false positive? I know that PCR tests are not recommended for routine screening and provide a high rate of false positives.

Category: HIV- AIDS Specialist

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Category: HIV- AIDS Specialist
 23 Doctors Online

Hello,

Thank you for choosing DoctorSpring.

I assume that all tests are done in a accredited laboratory using standard protocol.
Just to confirm there was only 1 positive result - a positive PCR among all the tests done, right.
Also no history of penetrative anal sex (that mean low pre test probability)

This result is a false positive result. There is NO reason to worry. Ideally there is no need for any repeat test, you can just carry on with out worrying about it.

Hope this helps
Feel free to ask follouwp questions.
Thank you


Patient replied :

Hello Dr. Sebastian -

Yes, I had only 1 positive result which was the Versant (R) HIV-1 RNA 3.0 Assay (bDNA) kit by Siemens. It says:

Copies/mL H 415 <75 copies/mL
Log Copies/ML 2.62 <1.88 log cps/mL

This test was done at 104 and 77 days respectively past my two sexual encounters. And again, right after that test, at 114 and 87 days respectively from both encounters I then had a rapid and an EIA test done - negative for both. At 121 and 94 days respectively from both encounters I had a rapid and an EIA test done - negative for both. (And I had had previous negative tests as well - see above.)

And no, there was no penetrative anal sex in either encounter at all. In the first one we kissed, mutually masturbated each other (he and I touching each other's penises), and I inserted my penis into his mouth for a few seconds. In the second encounter we just kissed and mutually masturbated each other.

I am just concerned about the PCR test. Do my negative rapid and negative EIA tests at 114/87 days post the exposures and negative rapid and negative EIA tests at 121/94 days post the exposures disprove the PCR test?


Hello,

Do not worry. The viral load has to be atleast 10,000 or more to be significant in case of acuter sero conversion. RNA PCR can have upto 5% false positive rate. The test should not have been done and these trouble could have been avoided. Again no worries. None of the tests are suggestive of HIV infection.

You can do 1 more EIA / Western blot test after 6 months from the latest encounter just to be sure and officially close the chapter. There is no need for any other tests.

Hope this helps
Feel free to ask followups.
Thank you


Patient replied :

Hello Dr. Sebastian,

I just had a few final questions just to be thorough. So just to clarify:

1. At 6 months I can just get another rapid and EIA test done together? Or do I have to have a Western blot test as well?

2. You do not recommend any more tests except the final one at 6 months?

3. I should not worry further about this?


1. You just need to get Western bloat done. ( or any one test. WB preferred ) . Hope by now you would understand that too many tests only will lead to confusion.

2. No others tests are required in between.


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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