Although sorry to learn you acquired chlamydia, I'm glad it was promptly diagnosed and treated. The azithromycin was unnecessary following doxycycline and did not improve your chances of cure, which is 100% certain with doxycycline for 7 days. But the extra treatment did no harm.

Thirty-one days is much too long for onset of acute retroviral syndrome (ARS, i.e. initial HIV infection). In addition, it is not possible to have ARS symptoms and not have positive results on any and all types of HIV tests. Even if you had the most typical symptoms of ARS, the combination of timing plus your test results is 100% proof you do not have ARS. And your later tests (negative AgAb/4th generation at 44 and 52 days is further proof you did not acquire HIV.

Those comments answers many of your numbered questions, but to assure no uncertainty:

1. No further testing is needed; your results are conclusive for HIV-1 and probably HIV-2, since it is so rare.

2. On rare occasions, PCR tests are not positive by 2 weeks. But the combination of PCR at 2 weeks and AgAb at 4+ weeks is conclusive.

3. No further testing is needed for any STD.

4. No, I have not seen or heard of such late onset of ARS symptoms. It doesn't happen, except maybe in people who take post-exposure prophylaxis with HIV drugs that doesn't work.

5. Symptoms of ARS are caused not by the virus, but by the immune response -- which is indicated by antibody. It is not possible to have ARS symptoms without HIV antibody. This applies equally to HIV-1 and -2.

6. There are no medications or medical conditions that alter the timing or reliability of the tests you had. Your immunoglobulin treatment a few months earlier is irrelevant. People with "weak" immune systems probably are MORE likely to have accurate HIV test results, not less accurate.

7. To my knowledge, HIV-2 is exceedingly rare in east Asia. But you'd need to check with authorities in those regions to know for certain.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

1. You mentioned my results are conclusive for hiv1 and "probably" for hiv2. What would make you determine conclusively for hiv2?

2. Could you please shed some insight on how many days it takes after onset of symptoms antibodies are detecable? For example when p24 arrives do symptoms start then how many days after that antibodies or so symptoms start when antibodies start?

3. My pcr results were from "139825 Qualitative RNA" which is from labcorp. I purchased it through stdcheck.com. the results have 2 lines hiv 1 not detected and hiv 2 not detected.  I asked stdcheck does this test include hiv 2 as well because I've heard pcr tests only test for hiv1 and the lady said yes only for hiv1 then i asked her why did my test results say not detected for hiv2 she then changed her answer and said probably it did include hiv 2.. my question to you is do you know if the 139825 Qualitative pcr test from labcorp years tests both hiv 1 and 2? I assume if they didn't test hiv 2 it wouldn't show up as not detected right? Just confused.

3. I read a post from Dr Hook (#10146) that said hiv2 is primarily an issue for people that have traveled to west Africa or South East Asia,  should i be concerned because they are from the Philippines?

4. What is my percentage odds for acquiring hiv 2? If you could factor in all we've discussed I'd really appreciate it. 

5. You mention 31 days is too far out,  what window period would you say 95% of people experience ARS symptoms if they do?

6. Can I resume have sex with my partner or should i wait for conclusive hiv2?

Also thank you for this forum and your responses have given much comfort and clarity. Merry Christmas. 

2. Antibodies are present the same time as onset of symptoms. If symptoms are due to HIV, antibody testing always is positive.

3a. In the last year or two, some commercially produced HIV RNA PCR tests check for both HIV-1 and HIV-2. You apparently were tested with one that detects both types.

3b. I don't recall that HIV-2 is frequent in SE Asia. It is exceedingly rare world wide except in parts of Africa and ini migrants from those parts of Africa.

4. To the best of my knowledge, zero chance.

5. ARS symptoms usually start around 8-10 days after infection and rarely if ever beyond 3 weeks.

6. If I were in your situation, I already would have resumed sex with my wife, confident I could not infect her with either type of HIV.

Thanks for the thanks. I'm glad to have helped!

1.Is there any data or research papers available that shows antibodies are detecable at the onset of symptoms? From this article it says "Current tests typically become positive within 3–6 weeks of infection and 1–3 weeks after the onset of acute HIV symptoms [1].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144168/#:~:text=Current%20tests%20typically%20become%20positive,acute%20HIV%20symptoms%20%5B1%5D.

 I saw this paper was published in 2011, but I believe at that time testing was still used with 4th gen tests? if you could shed some more insight on how you absolutely know that a positive hiv test would occur if the symptoms were ars I would greatly appreciate it. Because from reading this it seems it may take 1-3 weeks for antibodies to show up on a test or am i reading this wrong?

 thank you. 

I took an rna hiv 1 and 2 test on day 60 and another 4th gen test on day 60 both came negative.  Can I conclusively rule out hiv 2 now? 

Also if you can resound to my previous question I would really appreciate that too.

Thank you so much you have given me much comfort. 

That concludes this thread. Thanks for the thanks -- I've very glad to have helped. Happy new year.