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Developed Rash, Sore Throat And Lymph Node On Neck. Concerned If Hiv 2 Dna Pcr Missed Virus Detection
Question:
Doctor,
I was in a relationship 2yrsa go, developed rash,sorethraot 3 wks after exposure. Got tested multiple times HIV EIA 1/2 2nd generation from quest and ICMA 1/2/0 from labcorp , last test 2 yrs after high risk expsoure. Also got tested for hiv-1 dna pcr, qualitative hiv 1 rna pcr, hiv 2 dna pcr. I am concerned abt hiv 2 as i tested in usa, labcorp and the lower limit of detection is 350-500 copies. i heard abt seronegative hiv 2 in india and also type 2 replicates very slowly and i am scared the hiv 2 dna pcr missed virus detection. i also developed a neck lymphnode 30 mons after last expsoure. Pls help. I also concerned as my new partner developed fever 103 3 wks after expsoure.
Doctor,
I was in a relationship 2yrsa go, developed rash,sorethraot 3 wks after exposure. Got tested multiple times HIV EIA 1/2 2nd generation from quest and ICMA 1/2/0 from labcorp , last test 2 yrs after high risk expsoure. Also got tested for hiv-1 dna pcr, qualitative hiv 1 rna pcr, hiv 2 dna pcr. I am concerned abt hiv 2 as i tested in usa, labcorp and the lower limit of detection is 350-500 copies. i heard abt seronegative hiv 2 in india and also type 2 replicates very slowly and i am scared the hiv 2 dna pcr missed virus detection. i also developed a neck lymphnode 30 mons after last expsoure. Pls help. I also concerned as my new partner developed fever 103 3 wks after expsoure.
Hi XXXXXXX,
thanks for writing in.
First of all I want assure you that 2nd and 3rd generation ELISA are very effective in finding out HIV 2 infection.
Also PCR is a golden test to determine infection even in very low titre of HIV2.
After 2 years of exposure RNA PCR can determine HIV 2 infection upto 100% sensitivity.
Indeed there are few patients who have very latent infection and go symptom less for years together, but they have detectable antibodies in blood and also viral particles enough to give positive test results.So there is no way that you can get negative tests after 2 years of exposure.
Also I would like to know do you have any other HIV related symptoms like weight loss/diarrhea/cough/fever for long duration?
Any oral thrush/genital oral ulcers/long lasting respiratory or skin infections?
Any enlarged lymph glands in more than 2 body sites?
The further testing is viral culture on culture media.It is the only way to detect seronegative cases.It is costly and available only in few centres.
Answer the questions above and we can continue the discussion here.
As of now it does not appear that you have HIV infection.
Hope this helps.
I will be available for regards.
DrSudarshan
MD
HIV and STD specialist
thanks for writing in.
First of all I want assure you that 2nd and 3rd generation ELISA are very effective in finding out HIV 2 infection.
Also PCR is a golden test to determine infection even in very low titre of HIV2.
After 2 years of exposure RNA PCR can determine HIV 2 infection upto 100% sensitivity.
Indeed there are few patients who have very latent infection and go symptom less for years together, but they have detectable antibodies in blood and also viral particles enough to give positive test results.So there is no way that you can get negative tests after 2 years of exposure.
Also I would like to know do you have any other HIV related symptoms like weight loss/diarrhea/cough/fever for long duration?
Any oral thrush/genital oral ulcers/long lasting respiratory or skin infections?
Any enlarged lymph glands in more than 2 body sites?
The further testing is viral culture on culture media.It is the only way to detect seronegative cases.It is costly and available only in few centres.
Answer the questions above and we can continue the discussion here.
As of now it does not appear that you have HIV infection.
Hope this helps.
I will be available for regards.
DrSudarshan
MD
HIV and STD specialist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I do not have more than 1 lymphnode swelling, no oral thrush/weightloss/diarrhea/skin/respiratory infections. CD4 count 2 yrs after expsoure was 780. My concern is hiv 2 as there is no documentation of window period and for type 2 I had HIV 2 DNA pcr which has 500 copies as lower limit detection. The only problems I have is constant peeling of iiner side cheeks and one single lymph node in neck. I heard that people take years to develop detectable antibodies in blood.
Thank you
Thank you
Hi again XXXXXXX,
single lymph node is not to be worried as it reactive lymphadenopathy to any bacterial infection of upper respiratory tract.
Peeling of inner side of thigh can be tinea cruris a fungal infection or intertrigo which occurs due to friction of thighs.
As you know HIV 2 cannot be exactly detected by available tests you can monitor CD4 count on every 3 months.Any significant fall in titre of CD4 count or change in CD4 to CD 8 ratio can be suggestive of infection.
As you dont have any HIV related illness till now there is nothing to be worried about.
It is unlikely in your case to have HIV 2 infection .
The internet can produce phobia as it can highlight the rarest of rare cases.
Hope this helps.
I will be available for follow up.
Regards
single lymph node is not to be worried as it reactive lymphadenopathy to any bacterial infection of upper respiratory tract.
Peeling of inner side of thigh can be tinea cruris a fungal infection or intertrigo which occurs due to friction of thighs.
As you know HIV 2 cannot be exactly detected by available tests you can monitor CD4 count on every 3 months.Any significant fall in titre of CD4 count or change in CD4 to CD 8 ratio can be suggestive of infection.
As you dont have any HIV related illness till now there is nothing to be worried about.
It is unlikely in your case to have HIV 2 infection .
The internet can produce phobia as it can highlight the rarest of rare cases.
Hope this helps.
I will be available for follow up.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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