All too often, teenagers are going to their doctor’s office with flu-like symptoms, aches and pains, etc.- having some routine blood work done – and when everything comes back negative they are sent home with no-questions-asked. A few weeks later (symptoms still persistent) the teens return to have more blood work. This time the HIV test comes back positive. “What caused this,” or “how did this happen” are often the response that doctors get.
Most often the tests used to detect HIV are antibody tests. The antibodies they are trying to detect usually do not fully develop for several weeks in most people, so if someone were to try to take this test only a week or two after infection chances are they would receive a false negative.
Allison Agwu, M.D., a pediatric infectious disease specialist at John Hopkins Children’s Center, explains that these false negatives usually occur during the most contagious stage of HIV infection – the earliest one. If teenagers are engaging in risky sexual behavior, their need for more extensive testing is increased. Often doctors will ignore these possibilities because of the age of the patients.
If the teen is at high risk they should consider the use of a polymerase chain reaction (PCR) test, which detects genetic markers instead of antibodies. These tests have significantly smaller window periods than antibody tests. While they are more expensive than the standard antibody test, PCR tests allow us to get accurate results at around two or three weeks.
Doctors should consider using a PCR if the patient has used injectible drugs or has two or more of the following symptoms: enlarged lymph nodes, night sweats, malaise/fatigue/headaches or rash, fever/chills, or a persistent sore throat or cough.
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