[Question #10356] Follow up to Question #10169

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23 months ago
Hello,

I am following up to my previous question #10169. I am also immensely thankful for your reassurance and service you provide.

For a summary, here is the timeline of events:

1. Potential exposure on 7/10. Broken condom with a female massage therapist/CSW. Exposed for roughly 3-4 minutes before changing condoms.

2. Started PEP on 7/12 (about 50 hours after the encounter).

3. Took 10-panel STD test. All negative except for HSV-1.

4. Took another gonorrhea and chlamydia test on 7/27. Negative for both.

5. Completed PEP on 8/10.

6. Took HIV RNA test on 8/28. Negative.

My questions are:

1. Is my negative test result for HIV conclusive? I understand completing PEP reset the clock on reliable testing, but anxiety got the best of me and I opted for the HIV RNA test instead of waiting 6 weeks for the 4th Gen Ab/Ag test. The STDcheck website stated this test can be used 9-11 days after exposure, so I counted 8/10 as my “exposure” date due to PEP.

2. Is it advisable to take another 10 panel STD test in about a month or so? 

Thank you for your help!
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Edward W. Hook M.D.
23 months ago
Welcome back to our Forum.  On this occasion I happened to be assigned your follow-up questions.  FYI, Dr. Handsfield and I have worked together for more than 40 years and while our communication styles vary, the facts and substance of our advice never do.  In preparing to answer these questions I reviewed your prior interaction and it should be no surprise that  agree with all that he said.  Thus, in response to your specific questions:

1. Is my negative test result for HIV conclusive? I understand completing PEP reset the clock on reliable testing, but anxiety got the best of me and I opted for the HIV RNA test instead of waiting 6 weeks for the 4th Gen Ab/Ag test. The STDcheck website stated this test can be used 9-11 days after exposure, so I counted 8/10 as my “exposure” date due to PEP.
I agree with the website that HIV RNA PCR tests any time more than 11 days following an exposure are conclusive.  While some experts suggest follow-up testing  with a 4th generation, combination HIV antigen/antibody test 4 following a negative PCR test "just to be sure", we have never seen nor heard of such a test becoming positive.  I would consider your results conclusive.  

2. Is it advisable to take another 10 panel STD test in about a month or so? 
No, I see no need whatsoever for further testing.  Your results are conclusive and will not change.   You can be confident in the results.

Please don't worry.  EWH
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