[Question #10146] Is Further HIV Testing needed?

25 months ago

Hello, male living in United States had unprotected vaginal. I took the HIV 4th gen lab tests at 27 days and 16 hours, then I took an HIV RNA at 37 days. Both results came back negative and I have a few questions for you.

1. Do I need anymore follow up testing?

2. The RNA test only tested for HIV-1. I understand HIV-2 rates are low in the United States, but should I take another 4th gen to rule out HIV-2 or is it uneccessary?

3. Is it possible to get hiv symptoms(coughing and runny nose) 39 days post potential exposure?

4. Who is at risk for hiv-2 infection in the United States?

Thank you!

Edward W. Hook M.D.

25 months ago

Welcome to the Forum. Thanks for your questions. You do not mention the nature of your risk but, irrespective, I can tell you that your test results conclusively prove that you did not acquire HIV in the timeintervals describe. Your HIV RNA PCR combined with each of your nearly 28 day 4th generation tests are entirely conclusive. In respnse to your specific questions:

1. Do I need anymore follow up testing?

2. The RNA test only tested for HIV-1. I understand HIV-2 rates are low in the United States, but should I take another 4th gen to rule out HIV-2 or is it uneccessary?

You are correct that the PCR test tests only for HIV-1 however there are fewer than 50 cases of HIV-2 annually in the U.S. and they occur in persons who have traveled to or from West Africa or Southeast Asia . This is not a realistic concern.

3. Is it possible to get hiv symptoms(coughing and runny nose) 39 days post potential exposure?

No. First cough and runny nose are signs of a cold or other respiratory tract infection but HIV does not cause these symptoms. Secondly, the ARS does not occur that long after an exposure.

4. Who is at risk for hiv-2 infection in the United States?

See above.

I hope that this information is helpful. Please don't worry. EWH

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25 months ago

Okay great, I thought I mentioned it but my exposure was oral and vaginal sex with a woman I don’t know her status, but it’s not a complete stranger I randomly met.

I’m glad that you think my results are conclusive, I got my results in and immediately got paranoid about the chance that I could have hiv-2, but neither I nor her have traveled to those regions, or anywhere outside of the United States for that matter. Just to recap:

1. I am at no risk for hiv-2, I know it’s rare but it can still spread from individuals who bring it over here as far as I understand.

2. My results are considered conclusive. I know rna tests are useful in early detection, but would the efficacy of the test decrease if I took it too long after for example my 37 days post potential exposure?

3. For the future, does receiving oral as a male pose any risk to getting hiv? I see some people say it’s very rare, and I see some say that it’s a theoretical risk, but hasn’t been observed in the real world

Edward W. Hook M.D.

25 months ago

Thanks for the details of the exposure. Overall this exposure, which has now proven to not result in infection for you, was relatively low risk. Far fewer than 1% of women in the U.S. have HIV and even if she did, the risk for infection following a single vaginal exposure (there is no known risk from receipt of oral sex from an untreated HIV infected person) leads to infection in fewer than 1 person in more than 1000 exposures. Thus :

1. Again, this infection has only been seen in the U.S. in persons who had sex with partners from Southeast Asia or West Africa and your test is negative and should be believed.

2. Correct- your results are conclusive. The efficacy of the test does not decrease once infected and you are substantially beyond when the test would be positive.

3. No, as I said above.

EWH

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25 months ago

Thanks a lot Dr. Hook. You saved me a lot of time, anxiety, and money. I really appreciate it

Edward W. Hook M.D.

25 months ago

Thanks for your thanks. We'll close this thread now. EWH---