[Question #11775] Follow up on [Question #11677] - Please help me clear this mess

12 months ago

Follow up on [Question #11677] - Please help me clear this mess

1-Dr. H called combined negative AgAb & RNA tests @ 29d solid proof against HIV in similar Q#10968. My AgAb & RNA HIV1 were @30d. Are mine solid? Conclusive?

2-Drs here say tests are positive within few days AFTER the start of ARS symptoms. Q#10968 tests were BEFORE symptoms started. My tests @30d were only 1d AFTER symptoms started @29d. Do tests remain solid even though they were not several days before the symptoms started? Should I forget about symptoms if mine started 1-2d after tests?

3-Would RNA alone not be 100% @30d to not worry?

4- With tests negative @30d, do results overrule symptoms & history, even with all ARS symptoms? Whatever symptoms I have don't matter?

5- Dr. H said symptoms started too late @29d but other answers have 10-20 days, 1-3 weeks, 1-4 weeks. Other experts say 2-6 weeks after. Could mine @29d (maybe 28d?) not be considered 4 weeks, and withing ARS window?

5-My female partner did combo & RNA negative@ my 33d mark, not sure if meaningful because I don't know what her hypothetical exposure date would be. We had sex 1d after my protected encounter.

Thank you! I have another question about my big mess but will ask after your responses for clarity.

Edward W. Hook M.D.

12 months ago

Welcome back to the Forum although I'm sorry you felt the need. On this occasion, I'll be answering your question. In preparing to do so I reviewed your earlier interaction with Dr. Handsfield and agree with all he said.

I do not see a mess. These questions are rather repetitive.

1-Dr. H called combined negative AgAb & RNA tests @ 29d solid proof against HIV in similar Q#10968. My AgAb & RNA HIV1 were @30d. Are mine solid? Conclusive?

It seems obvious that if 28 you results were conclusive at 29 days, it would also be conclusive at 30. Once tests are positive, they remain positive. FYI, 4th generation, combination HIV antigen/antibody tests are at least 99% conclusive at 28 days although not entirely- the last 1% of positive tests occur between 28 and 42 days. When combined with HIV PCR tests as you have done however the results are conclusive

The symptoms of the ARS are due to the presence of HIV virus and antibodies to infection. When persons have symptoms, tests are virtually always positive. The symptoms you are concerned above occurred AFTER you already had CONCLUSIVE HIV test results so there was no reason for concern that they might be due to HIV

3-Would RNA alone not be 100% @30d to not worry?

yes

4- With tests negative @30d, do results overrule symptoms & history, even with all ARS symptoms? Whatever symptoms I have don't matter?

Correct. Your test results overrule any symptoms that you might experience, no matter what the symptoms

The ARS does not occur after 30 days. In your case, with your already conclusive test results, you've proven that your symptoms were not the ARS. Test results always overrule the presence of symptoms- ALWAYS!!!

5-My female partner did combo & RNA negative@ my 33d mark, not sure if meaningful because I don't know what her hypothetical exposure date would be. We had sex 1d after my protected encounter.

I don't understand the question. You don't have HIV- you CANNOT have transmitted HIV to your partner

Accept your test results. You have proven you do not have HIV. As Dr. Handsfield said, there is no reason for further testing. The test results will not change. EWH

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12 months ago

Thank you, I need to send a reply but can't. Please don't close the thread.

12 months ago

1-RNA test was HIV1, it'd miss HIV2? @30d, could combined tests miss a % or still conclusive?

2-My @30d tests were 1d AFTER symptoms. Is this enough time?

3-ARS does not occur after 30 days. Mine started @28/29 days, under 30d. Concerned?

12 months ago

Made big mess. AFTER 30d tests (combo & RNA, which are valid), started incorrectly PEP next day (d31), I know it’s unbelievable, I knew about the 72 hours but panicked. Continued 2.5 weeks & stopped, took RNA 1/2 (not just 1) & Combo day after stopping, negative. I assume these tests were worthless? Did PEP suppress Sx?

12 months ago

Thank you! Please help with my two follow up questions, you can delete the one for "Thank you, I need to send a reply but can't. Please don't close the thread."

Edward W. Hook M.D.

12 months ago

Straight to your follow up questions:

1. The RNAPCR tests only test for HIV-1. On the other hand in North America there is virtually no chance of you acquiring HIV-2 unless your sex partner is from West Africa. Even then it would be extraordinarily rare. Please don’t worry about HIV-2.

2. As I have already said, the ARS is not a concern for you. Your tests prove that you do not have HIV. Your symptoms could not have been due to HIV. Put those fears aside.

3. Starting PEP was a waste of time and resources. You had already proven you did not have HIV. Taking PEP only wasted resources and does not in anyway invalidate the test results. You already have which proven that you do not have HIV.

You have one follow up remaining. After that, there should be no need for further questions regarding your test results or your symptoms. EWH.

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12 months ago

Thanks Doc for info and patience!

No West Africa connection, both white.

1-I know D30 tests are valid but is my latest batch of combination tests 48d after exposure (and 1d after 17 days of PEP) valid or does PEP nullify it?

2-Especially latest RNA HIV1/HIV2 @48d tested also for HIV2, is it valid & conclusive for HIV2 or does PEP nullify it?

3-Would incorrect PEP starting 31d after exposure but 1d after Sx, suppress symptoms? Is it possible for those suppressed Sx to show up now?

4-Is this correct: If you were exposed and took PEP incorrectly (after 72h), your RNA & Ag & Ab results would show whether you were infected in the same amount of time as if you had not taken PEP?

5-I still have HIV specific symptoms 3 weeks after start, first week of Sx was severe and acute. Any suggestion?

6-When should I test again for for conclusive results for HIV1 & HIV2?

7-When should my partner test with combo & RNA HIV1 & HIV2 for conclusive results?

Edward W. Hook M.D.

12 months ago

These follow-up questions are highly repetitive. The answers are not going to change.

1. As I said above, you wasted your time taking PEP, however, that you took PEP in no waynullifies or invalidates your conclusive test results. As I have already said repeatedly, you do not have HIV and your test results are not going to change.

2. If you had an HIV 2RNAPCR test at day 48, those results are conclusive and just as your HIV-1 test results. You do not need to repeat these tests.

3. This is another repetitive question. Please stop repeating yourself. As I have already told you, the PEP that you took would have no effect on your test results or your symptoms if they were due to HIV, which is an impossibility.

4. Yes. When persons fail PEP their tests quickly become positive.

5. Need to look for a cause other than HIV as causing your symptoms. I suggest you talk to your doctor regarding this.

6. As I have already told you several times, further testing is a waste of time and resources. There is no need for additional testing.

7. You do not have HIV. Therefore, you cannot have infected your partner. Therefore, there is no need for your regular partner to test for HIV in any way

This is your second question as part of this thread. In your questions you have repeated questions that were already answered by Dr. Handsfield. You have one follow up remaining. If you follow up with repetitive questions, they will not be answered. Need to accept that you do not have HIV, that you cannot have infected your partner. And that there is no need for additional testing. EWH

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12 months ago

Thank you Dr. Hook & Dr. HHH, I can't tell you how much I appreciate both of you. I also deeply apologize for the repetitive questions, which is due to excessive stress and lack of knowledge on the topic. There's nothing I want to do more right now than accept your suggestions and forget about this nightmare. Your feedback is the most important factor in my favor and I truly value it.

Unfortunately, my concerns stem from going from 100% healthy to acute symptoms accurately matching ARS under 30d following what I now think might have been a high risk, no testing for HIV2 @d30, CDC and other medical sources not talking about combination tests but sticking with at least 3 months, and most importantly not understanding how bad PEP started d31 and taken for 17 days affects the 48d results. So, I mostly don't understand how all these pieces fit together in my favor and a simple summary explanation would help me understand.

I believe you said this useless PEP does not change the validity of the 48d combination tests (RNA HIV1/HIV2 @48d tested also for HIV2) and (Combo 4th gen Ag/Ab HIV1/HIV2). If you say "Yes, the 48d combination tests are absolutely valid from my vast experience", I will take it and leave. It would mean a lot to me if you're able to say "the 48d tests are valid and PEP didn't affect them" because it'll reassure me.

If you leave this thread open, I can give you an update but will not ask any questions. Thank you Drs.!

Edward W. Hook M.D.

12 months ago

Yes, the 48d combination tests are absolutely valid from my vast experience

The thread will be open for up to 30 days or until you provide an update, whichever comes first. There will be no more answers or replies. ANY UPDATE or further comment will result in the thread being closed. EWH

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