‘Do I or don’t I have AIDS?’

Dear Dr. Donohue: I took an AIDS test, and it came back positive. I am a heterosexual male, and I don’t have sex with anyone but my wife, to whom I have been married for 10 years. A second test was done, and that test came back negative. Do I or don’t I have AIDS? — R.T.

Answer: You don’t have AIDS.

The initial screening test for AIDS is the ELISA test. If that test is negative, testing stops. If it is positive, a confirmatory test, the Western blot test, is done. If that second test is negative, then the first test was a false positive.

Immunizations, like a flu shot, can make the first test transiently positive. So can multiple blood transfusions. A woman who has had many children might have a positive first test. Lupus and similar illnesses can also be responsible for a positive ELISA test. And then there are positive ELISA tests that are inexplicable; they just happen.

The doctor who ordered this test for you should explain it to you in detail and in person.

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Dear Dr. Donohue: Is there anything new on chronic fatigue syndrome? We are trying to learn about this disease. — D.P.

Answer: People with chronic fatigue syndrome face many troubling issues. First, they must cope with the symptoms of the syndrome. Second, they have to deal with an illness whose cause remains mystifying. Third, their illness has no specific tests. Fourth, it doesn’t have specific treatment. Chronic fatigue syndrome, therefore, is a great burden to those who have it.

As the name implies, it’s fatigue, not the ordinary tiredness that comes from not sleeping or working too long and too hard. It’s an overwhelming fatigue that makes any effort a gigantic challenge, and it’s a fatigue that rest and sleep do not resolve.

In addition to fatigue, people have disturbed sleep. They might have joint and muscle pain, their memory is often not as good as it was, lymph nodes frequently enlarge and become tender, and headaches are common.

Some experts theorize that the syndrome might come from a disruption of the normal coordination that exists between the pituitary and adrenal glands. Others feel it’s an inappropriate activation of the immune system. No one knows for sure what the cause is.

There has been no breakthrough in treatment. Supervised exercise with a gradual increase in its intensity is important. Chronic fatigue patients find exertion difficult. Therefore, they become deconditioned, and that adds to the problems of the syndrome.

That’s why exercise is important. Medicines like Elavil can restore refreshing sleep to some patients. Patients should not take long naps during the day. Those naps can make nighttime sleep more fragmented. Chronic fatigue syndrome is disruptive, but it is not fatal. That’s one upside to the syndrome.

The booklet on chronic fatigue syndrome discusses the condition at greater length. Readers can obtain a copy by writing: Dr. Donohue — No. 304W, Box 536475, Orlando, FL 38253-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.