(in cases where the diagnosis is already established and known to the patient) is permissible or whether it is a breach of confidentiality.

This is a difficult question.

Even if the person knows it, still the prescription is likely to be seen by others and unless accepted by the patient it would mean breach of confidentiality. Unless warranted due to issues such as employer's policy and accepted by the person and with full understanding of the consequences, I would suggest you not write it on a prescription.

I also do not understand why should we write anything on a prescription? If it is a shortcut for not keeping appropriate records it might be a risky shortcut especially in medico-legal matters.

On the other hand I feel that documents such as discharge cards, death certificates, insurance related papers etc should reflect the truth. However, I would still inform the person to understand the consequences of uncontrolled disclosure and take care of keeping records confidential.

---Vinay Kulkarni

(1) I am 40 years old and tested positive in 2006. My CD4 count was 12 and I started ART (consisting of Zidovudine 300mg, Lamivudine 150mg, Nevirapine 200mg) since February 2007. Now my CD4 count is 17 and viral load not detected. Should I continue with the same regime?

(2) I am 29 years old and tested positive on March 2010. My CD4 count is 375 and my viral load is 26155 copies/ml. I am planning to have a child. Should I start ART?

(1) Yes. If viral load is undetectable and your health is fine, you may continue with the same regimen. There are some patients who have little or late immunological recovery. However, I would suggest you keep following your treatment with both CD4 counts and viral loads done every six months.

(2) If your CD4 counts are above 350 then you need not start ART for your own treatment. You may plan pregnancy after giving due consideration to all pros and cons. You may start ARV for prophylaxis from 14 weeks onwards. What to take as prophylaxis could be decided in consultation with your physician. There are 2 options - using Zidovudine alone or using triple drug ART for the period of pregnancy. However, if at the time of conception your CD4 counts are less than 350, you will be required to start ART for your own sake. Follow your physician's instructions.

---Vinay Kulkarni

I also have continuous fever and sometimes diarrhoea. I went for PCR DNA HIV test after 15 days. It came back as not detected, and after two months I went for the western blot HIV test. It too came back as not detected for all GP, and after three months I got the HIV Elisa test done that also came back negative, ie, the value came back as 0.38.

I still have swollen lymph nodes and pain in my chest, groin and neck area. Should I re-test again after six months? How reliable is 0.38 HIV negative in Elisa test? I am very worried and not getting sleep at all.

Who has diagnosed all those lymph nodes in all those places - yourself or a doctor? Have you recorded the temperatures or had a feeling of warmth? Was your sexual contact protected with a condom or not? All these questions are relevant. If your ELISA test after three months is reported as negative (please ignore the cut off value of 0.38 as it is scaring you even further), you can be reasonably sure that you are not infected with HIV and should consult someone for ruling out other causes of lymphadenitis and fever. There are many causes for it apart from HIV, so do not worry only about HIV. In fact, some other causes may require more urgent attention than HIV.  

Just to confirm that you are definitely not infected with HIV, repeat a rapid HIV test at the end of maybe six months. But remember not to keep worrying till then as a person having symptoms but negative test at the end of three months is most unlikely to be HIV infected.

---Vinay Kulkarni

f you have had no exposure since your last HIV test in 2002, there is no need for any further HIV testing.

--Editor, hivaidsonline.in

I felt some moisture though. My PCR DNA HIV test done at 52 days came as ‘Not Detected’. The test was done at Super Religare Lab. The 70 days ELISA (RAPID) done at Super Religare came ‘non reactive’. Are the above two tests reliable and conclusive. Do I need to go for additional testing at the 3 month mark?

No, you do not have to go for additional testing.

--Editor, hivaidsonline.in

I got the result in 4-5 hours and it says Index level = 0.12 Conclusion = Non Reactive. They charged me Rs 380 for the test. I want to know whether the test performed was only for HIV antibodies detection or for p24 antigen also, as I don't see anything regarding p24 antigen in the test result.

Please do not split hairs on this. When the lab has reported that the test is negative, it is negative for both antibodies and p24 antigen. It is intrinsic part of the test, the way it is performed. If it is reported as positive, it may still not be possible to know whether it is because of the presence of antibodies or p24 antigen. But one is interested in knowing whether the person is infected or not, and that can be seen from the result. ONLY PLEASE BE SURE THAT YOU HAVE DONE THE TEST AFTER THE WINDOW PERIOD WAS OVER. If not, repeat after three months of the possible date of risk.

--Vinay Kulkarni

Thank you for your comments. We hope to start an online forum for immediate feedback. Regarding your question about the different types of tests, we will carry a detailed comment on this later. In the meantime, you may wish to go through our FAQs (frequently asked questions) and other information on the site hivaidsonline.in

--Editor, hivaidsonline.in

A lymph (I think it is lymph) at the back of my head above hair layer immediately to the right side of the centre line, not very big, which I can only feel by touching it, and little bigger than a black pepper. Ii is not tender nor is there any headache. My doctor told me there was no need for further tests and I am okay and I can move on. My question is: what is the chance of turning positive after the 12 week test. Please help me.

There is no need to worry if the test is negative. If you are very worried then get yourself tested once again (as the previous test was exactly after 3 months), and if the test is still negative, just forget about it. Please do not surf the internet for this. The more you search the more confused you will get. Believe us and get going.

--Vinay Kulkarni

You are not infected so please do not worry and please do not get tested repeatedly. You say you are noticing symptoms but there are no symptoms of HIV infection at this stage. You may have symptoms of another sexually transmitted infection. Please visit a government clinic and describe your problem clearly to the doctor in charge. Unprotected sex with a person who has multiple partners puts you at risk of HIV infection.

--Editor, hivaidsonline.in

No, this cannot cause HIV infection. You can check our website hivaidsonline.in for information on HIV/AIDS.

--Editor, hivaidsonline.in