[Question #11680] Question 11493 follow up

12 months ago

Hi Great Docs,

Apologies for bothering you again.I require some crucial guidance at the moment. I recently came across this article.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313264/

Look at Table 1 in the referenced literature, where it mentions that the 4th generation Abbott Architect was reactive on day 0, and simultaneously, the next to the Abbott, Biorad stand-alone p24 assay was also reactive, indicating that Abbott's p24 component was reactive. However, from day 7 to day 34, the Abbott Architect remained non-reactive. Subsequently, the abbott architect became reactive from day 34, possibly due to the detection of antibodies. This suggests that Abbott was non-reactive for a period of 34 days.

My inquiry here is, as my tests were with the Abbott Architect from day 18 to day 47, during those 34 days when Abbott was non-reactive in the literature, my tests in those 34 days could have been false negatives? Since my 4th generation tests were also with ABBOTT ARCHITECT.

AND, for your information i have taken two additional 4th generation lab tests with abbott architect on day 83 and 89 after expsoure, (12th week) they were also NEGATIVE.

QUESTION 2:

Have I been infected? Assuming the tests from day 18 to day 47 during the 34-day period of non-reactivity in the article were false negatives, would the tests on day 83 and 89, week 12 of the year, still be positive? Given that Abbott became reactive after day 34 in the article

Regarding your second question, do you believe the NHS UK GUM clinic would still be utilizing the 4th generation Abbott Architect from those times in 2014 when the article was published?

12 months ago

Question 3- i dont know i have feeling of condom breaking during a one-off 4 to 5-minute intercourse. I felt air on the head of my penis upon pulling out, but I couldn't see it due to being drunk and it was dark. Could a one-off vaginal intercourse lead to infection?

My fourth question is whether it's possible that the seven 4th generation tests from day 18 to day 47 (week 7) couldn't detect the infection. Additionally, the two additional 4th generation tests on blood vein in the lab on day 83 and 89 (week 12) might have missed the infection.

My fifth question is about the qualitative RNA PCR rapid test CEPHEID manufacturer's detection limit of 475 copies/ml. Could this test miss the infection on day 18th (3rd week) after exposure? Do you have any insights on this rapid PCR test? Its sensitivity is 99.23% and specificity is 98.91%. Could you email a nationally recognized HIV testing expert to inquire about the accuracy of this rapid PCR test? Can you email nationally renowned HIV testing expert to take info from them about above rapid pcr accuracy?

NOTE: after exposure i had 7 fourth generation lab test with Abbott and 1 Rapid pcr qualitative test on DAY 18 after expsoure.

Many thanks

Edward W. Hook M.D.

12 months ago

Welcome back to the Forum although I'm sorry you felt the need. As I informed you on our prior interaction, the encounter you describe did not put you at risk for HIV. That assessment in unchanged despite the fact that you have found a single, unexplained case report of a prolonged testing window in a person who had acquired HIV. The fact that since that single case report there have been no further reports of this sort of problem should be proof of the fact that, as the authors said, this was an unexplained, unusual event. I urge you to believe your test results. In reply to your specific questions:

1. You have tested far beyond the time frame described in the case report. You need to accept the results . You do not have HIV.

2. I have no idea whether the UK GUM clinics are still using the Architect. Irrespective, if you had acquired HIV, your later, day 83 and 89 day tests would have been positive

3. In theory, a single exposure could have led to infection HOWEVER< you have no evidence that you were even exposed and your repeated negative tests prove that you were not infected

4. No it is not possible that your repeated tests at the times described could have missed infection

5. No the CEPHID test you had confirmed that you do not have HIV.

You need to accept that you were not infected. There is no need to repeat the questions, the results are not going to change. There is also no reason not to accept your negative test results. If you cannot, I recommend you discuss the reasons that you are having trouble accepting that you did not acquire HIV from a trained counselor. EWH

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12 months ago

Thanks for the reply.

Dr. I wanted to ask in the fifth above question. Whether my 18th day (3rd week) rapid pcr qualitative test was conclusive or was it too early?

2nd question: if someone is infected. Usually how many copies/ml can someone expect in their blood by 18th day 3rd week???

3rd: i have seen dr hunter was saying in one of his thread that if i had just one exposure with someone unknown status. I would initially test myself for gonnareha and chlamydia and if its negative i wouldn't worry much about HIV. ??? Whats the logic behind that??

4rth: the whether is hot these days in uk and there is pollen. I get hayfevers. I dont know why since yesterday i feel flu like symptoms. Oneof my nose is blocked. I have headache, Tiredness. It just brings in my head as HIV like symptoms.

Doctor i get so scared as soon as i see any of symptoms in myself. I try my best to influence myself that i am negative but this fever or headache tiredness. Sore throat just makes me crazy

Edward W. Hook M.D.

12 months ago

This will be the fianl response to this question. You should not return. If you do with further repetitive, anxiety-driven questions about the reliability of tests for HIV, your question may be deleted without a response and without return of your posting fee. You need to accept that you do not have HIV from the encounter you have described.

1. As I said above- "...the CEPHID test you had confirmed that you do not have HIV.". It is conclusive, like your other tests

2. The number of HIV copies in persons with recently acquired, untreated HIV is highly variable, ranging from a few thousand to millions of copies. Far above the limit of detection for the Cepheid test.

3. I can only guess bout what Dr. Handsfield said and the context of his reply. Most people do not have HIV and both gonorrhea and chlamydial are hundreds of times more common, on average than HIV. Further, the risk of acquiring HIV from a single genital exposure to a person with untreated HIV is, on average less than 1 in 2000. Thus combining the low likelihood of having sex with an infected partner and the low risk for infection, the odds of acquiring HIV from a single encounter are less than 1 in 200,000 and probably closer to 1 in a million.

4. Your symptoms are non-specific and you have numerous tests which show that you do not have HIV- your symptoms are not due to HIV.

You need to believe your tests. This thread is now complete. EWH

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