Anonymous
This question maybe beyond the scope of this service, but hopefully you may be able to point me in the right direction.
I’ve just had a biopsy on a red lesion/nodule on my cheek/nasal crease that I've had for 7 weeks which was diagnosed as Kaposi Sarcoma by a Private Consultant Dermatologist, who is now writing to my GP to inform them of the result of the biopsy. I don't understand what's going on as I have tested negative by a 4th generation Ag/Ab HIV 1 & 2 test at 6 weeks, 14 weeks and 24 weeks post a risk with a female sex worker in Africa where the condom broke, I have also had a PCR RNA Hiv 1 & 2 at around 20 weeks, Not Detected. I have read numerous reports online that says the 4th generation test may not detect rare groups or strains such as O,N,P and CRF’s/URF’s, but the reports don't offer advice what to do if you have been exposed to these rare strains, (which I may have). I have other highly suspicious/suggestive symptoms besides KS that also causes me to be concerned. I didn't have the red nodule last time I was tested, but the clinic have previously said trust the tests and they won’t test me again. Additionally I paid for a CD4 count around 18 weeks, which was 491.

Have you any advice, other testing options, I don't know what to do, would a genotyping/resistance testing be an option?
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Anonymous
Hello,

Thank you for contacting the AIDS Vancouver Helpline as your source for HIV/AIDS related information. I am sorry to hear about your recent diagnosis. Your question is beyond our scope here at the helpline but I will try to help you the best I can.

[Kaposi's Sarcoma](http://www.aidsmap.com/Kaposis-sarcoma/page/1044692/) (KS) is a common presentation in people living with HIV/AIDS. However, KS can also occur in people without HIV/AIDS as there are different types of KS. Since you have been tested for HIV at the clinic multiple times and have been found to be negative, your form of KS is most likely unrelated to HIV.

With regards to your symptoms, I would like to say that HIV vary from person to person. For this reason, symptoms are not used to diagnose HIV. The only way to know if you have HIV is to get tested.

Having said that, it is wonderful that you have had the 4th generation and PCR tests. These tests are very accurate and will detect HIV if present in the body. Specifically, the 4th generation test is a test that detects both HIV antigens and antibodies. On the other hand, the PCR test detects the genetic material of HIV itself. Using the guidelines AIDS Vancouver follows (as per the BC Center for Disease Control), all HIV tests are considered conclusive at 12 weeks or 3 months after your last high risk exposure. Both the 4th generation and PCR tests are over 99% accurate at the conclusive time period. Since your tests are done after this time, I would agree with the clinic when they say your tests are trustworthy. If you would like to read more about HIV testing, you may go to this [webpage ](http://www.avert.org/hiv-testing/whats-involved) for more information.

In light of your diagnosis and questions, I would encourage you to collaborate with your local medical professional and continue to ask questions to further inform you.

I hope this has helped. Please feel free to contact us if you have anymore questions.

Best wishes,

Mary


AIDS Vancouver Helpline/Online

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