Dr. Vedprakash Verma
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had an unprotected relation two months ago, which led to urethritis three days after that was treated with a 10 days course of Levaquin. The urethritis disappeared, but at the end of the treatment, I started to feel neurological symptoms, numbness, tingling burning sensation in my arms and allodynia in my foot. Then a few weeks later, I began to experience diarrhea (muddy stools) after digestion (mainly in the morning, sometimes at night or the end of the afternoon). I lost a lot of weight (nearly 10 kg). I got an MRI (cerebral and medular) and an EMG that came back normal. I got STD (hepatitis, syphilis, HIV, gonorrhea, chlamydia) lab test 43 days after exposure, which came back negative. As I was worried about all these symptoms, I got multiple HIV fourth-generation testing at 21 days, 28, 35, 43, and 51 days that all came back negative.
My doctor gave me this week a complete blood test, and everything came back healthy except slightly high albumin level (53g/L) probably due to dehydration but also a somewhat low gamma globulin with a level of 7.4g/L while the lab norms range from 8 to 13.5 g/L. The conclusion stated hypogammaglobulinemia. Now I am worried because I read that hypogammaglobulinemia can delay the seroconversion and then give false negative antibody results. Do you know if such level of gamma globulin can indeed affect HIV testing?
Hello,
Welcome to icliniq.com.
As you have done all the test which came normal. Hiv antibodies while detecting in initial phase generally came negative, as it is in window period for three months. So have to recheck HIV antibody test post three months of exposure. And if it comes negative after then no need to worry. As you explained, you have hypogammaglobulinemia, As lab report showing lower level, but the value not that much decreased. You go for thyroid profile testing also and connect me if you have further questions.
Patient's Query
Thank you doctor,
My question was regarding the gamma globulin level (7.4g/L) and HIV 4th antibody accuracy. Can this level affect the accuracy of the test? Because in my place, the window period for a fourth-generation lab test is six weeks only (42 days).
Hello,
Welcome back to icliniq.com.
As we have 4th generations HIV test which detects both HIV antibodies and p24 antigen, which appears within two weeks in your blood. Any research shows 4th generation HIV test more than 95 % reliable and valid after one month of exposure. In your case with the condition you have now you have two-month exposure and test came negative. So it is highly unlikely in your case, about hypogammaglobulinemia, I do not think it will play a significant role in delay appearance as per evidence.
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General Practitioner
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