Can I Trust My Test Results? Persistent Symptoms and Diagnosis

Q: Can I Trust My Test Results? Persistent Symptoms and Diagnosis

Dear Mr. <br>A-Kai：<br>1. <br>HIV RT-PCR is primarily used in the early stages of HIV infection, approximately around 7 days post-exposure. <br>If infection has occurred, the viral load is very low, so PCR is utilized in the laboratory to amplify the viral quantity, allowing for

Can it be confirmed or not?

Doctor, I am from Tainan.
On October 7th, I was at high risk.
On October 14th, I experienced abdominal pain and diarrhea.
On October 18th, I went to a testing facility for an RTPCR test (negative), and the P24 test was also (negative).
On November 2nd, I took another P24 antigen-antibody combination test, which was also (negative).
However, I have swollen lymph nodes in my neck, and the diarrhea has not improved.
On November 9th, I underwent another RTPCR test (negative) and antigen-antibody test (negative).
On November 30th, I developed white patches and sores in my mouth.
Two days later, at eight weeks, I did the P24 antigen-antibody test again (negative).
Currently, I have swollen lymph nodes in my neck and groin, and all RTPCR tests were sent to Liren for analysis.
I am unsure whether I can trust these reports.
Aside from not having a fever, night sweats, or rashes, I have all other symptoms.
Given that I have undergone RTPCR testing at 10 days and 33 days, along with these antigen-antibody tests, can I rule out any infections? This is very frustrating...
The lymph nodes continue to spread, and I have also been screened for syphilis.
Am I experiencing these issues due to a sexually transmitted infection? Please advise, doctor.

A-Kai, 20~29 year old female. Ask Date: 2017/12/03

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
A-Kai:
1.
HIV RT-PCR is primarily used in the early stages of HIV infection, approximately around 7 days post-exposure.
If infection has occurred, the viral load is very low, so PCR is utilized in the laboratory to amplify the viral quantity, allowing for the detection of the HIV virus.
2.
The P24 antigen-antibody response typically occurs between 4 to 8 weeks.
This method detects the presence of HIV antigens directly through immune response, regardless of whether the body has produced antibodies.
3.
In our country, the diagnosis of HIV is currently performed using ELISA screening, followed by confirmation with Western Blot.
4.
In fact, you are currently experiencing abdominal pain, diarrhea, and lymphadenopathy in the neck and groin.
In addition to considering HIV, there are many other diseases that must be taken into account and investigated.
Therefore, I recommend that you seek consultation at an infectious disease clinic at a medical center as soon as possible; it is not advisable to speculate on your condition or delay treatment.

Reply Date: 2017/12/03

More Info

When it comes to understanding the reliability of your test results, especially in the context of potential HIV infection and persistent symptoms, it's essential to consider several factors, including the types of tests performed, the timing of those tests, and the nature of your symptoms.

From your description, it appears that you have undergone multiple tests, including RT-PCR and P24 antigen/antibody tests, all of which returned negative results. The RT-PCR test is highly sensitive and is typically used to detect the presence of the virus itself, while the P24 antigen test detects the viral protein that appears shortly after infection. The combination of these tests is generally reliable, especially when they are negative.

However, it's important to note that HIV has a window period during which tests may not detect the virus, even if a person is infected. The window period can vary depending on the type of test used. For instance, the P24 antigen test can typically detect HIV within 2 to 4 weeks after exposure, while antibody tests may take longer. Given that your last test was conducted approximately eight weeks after your high-risk exposure, it is likely that you are outside the window period for these tests, and the negative results are reassuring.

Your persistent symptoms, including swollen lymph nodes and gastrointestinal issues, are understandably concerning. While these symptoms can be associated with HIV, they can also be indicative of other infections or conditions. It's crucial to consider that many other infections (such as viral infections, bacterial infections, or even non-infectious conditions) can cause similar symptoms. Therefore, the presence of these symptoms does not automatically indicate an HIV infection, especially in light of your negative test results.

You mentioned that you have also been tested for syphilis, which is a good practice given your concerns about sexually transmitted infections (STIs). It's essential to continue monitoring your health and to seek further evaluation if your symptoms persist or worsen. Consulting with a healthcare provider who specializes in infectious diseases may provide additional insights and help rule out other potential causes of your symptoms.

In summary, based on the information provided, it seems that your test results are reliable, and the likelihood of an HIV infection is low given the negative results from multiple tests conducted after the window period. However, persistent symptoms warrant further investigation. It is advisable to maintain open communication with your healthcare provider, who can help you navigate your concerns and determine if additional testing or referrals to specialists are necessary. Remember, taking care of your mental health is just as important as addressing physical symptoms, so consider seeking support if anxiety about your health is affecting your well-being.

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