[Question #11777] HIV RNA Test
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12 months ago
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Hello Doctor, I recently had unprotected vaginal sex with a female and her husband. For context, the couple are in their late 30s and early 40s. The female is a BSN nurse and the male is a relatively successful business owner. They said they get tested every 6 - 12 months & the husband and I had no interaction/anal insertion.
About a week after the interaction, I started to have an assortment of different symptoms including persistent fever (99 to 101), pressurized headache (near temples), ED/drastic decrease in sperm volume, chills, nausea after eating, tingling in hands/feet, and swollen lymph nodes. Fast forward, it's been about 18 days exposure and I still have the persistent fevers, swollen lymph nodes (near neck/ear), and a constant headache.
After my initial symptoms, I decided to take an HIV RNA test at 11 days and it came back negative. I also took another HIV RNA test at 15 days, and it recently came back negative as well. After hearing about my symptoms, the female also went to get a full STD panel test and received a negative on her HIV Ag/Ab test 10 days after our interaction. I also took a full panel STD test at 7 days after exposure and everything came back negative. I know that the nature of the event may be considered low exposure, however, I do have ezcema which causes my penis skin to dry/create open sores from scratching. Does this highly affect the nature of the risk?
The couple claims that they don't do this often and I was the first person in over a year that they had interactions with. So, in conclusion, how accurate are my two HIV RNA tests and could I be somewhat rest assured that I do not have HIV? Thank you.
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Edward W. Hook M.D.
12 months ago
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Welcome to our Forum. Thanks for your questions and the implied confidence in our service. I can assure you that your symptoms are not due to HIV. The evidence that this is not HIV is incontrovertible:
1. If you had acquired HIV from her, her 4th generation, combination HIV antigen/antibody test taken 10 days after the encounter would definitely have been positive.
2. Yourtwo negative HIV RNA PCR tests at 11 and 15 days would have been positive. These results are conclusively negative at times when they would be positive. Further, if your symptoms were the HIV ARS, tests would have been positive as well.
I cannot tell you what might be causing your symptoms but I can assure you they are not due to HIV or any other STI.
I hope that this assessment is helpful. EWH
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12 months ago
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Thank you for the diagnosis Doctor Hook. I guess I'm just worried that the woman might've lied about her test results since she is a stranger after all.
I understand that my symptoms may not be related to HIV due to the test results coming back negative (guessing viral load would've been high enough to detect if these were HIV symptoms). However, is it possible that these symptoms were something else and I still have HIV? What is the likelihood that another 4th gen HIV ag/ab test + HIV RNA test at 28 days will come back positive even after testing negative twice? Would a negative result 15 days post exposure be considered highly conclusive?
Thank you.
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Edward W. Hook M.D.
12 months ago
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Even if you were a female partner lied about her HIV test results which quite frankly is unlikely. Your HIVPCR test results remain absolutely conclusive and would have been positive if you had HIV or if your symptoms were due to HIV. It is not scientifically possible that you have HIV.
When I said that your HIVRNAPCR test results were inclusive that means they will not change. In other words, there is no way that later test would be positive as a result of the encounter you have described.
Further testing would be a waste of resources and emotional energy. You need to accept that you do not have HIV. That is a fact. EWH.
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12 months ago
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Hi Doctor,
I appreciate your assurance. It's certainly great to know that I am most likely HIV negative. However, I did want to ask if I should get re-tested again at 28 days due to the HIV possibly not being detected? Is there any chance that the HIV could've had low viral loads and therefore undetectable due to being tested only at 15 days post exposure? Currently, I am sitting at 21 days post possible exposure and my symptoms have started to get a little better.
Should I get tested again now, wait till the 28 days, or is everything 100% conclusive? I guess I wanted to know if there were any possible cases in which a person was tested negative for a HIV RNA test at 15 days and later turned out to be positive by an ag/ab test (supposedly the only test to 100% confirm if you have HIV or not?).
Thank you so much.
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Edward W. Hook M.D.
12 months ago
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Apparently, you and I interpret your test results differently. As I mentioned in my reply above, there is no question at all that you do not have HIV. as I mentioned in my initial reply, HIVRNAPCR tests are virtually conclusive anytime 11 or more days following an exposure. You have not one but two conclusive test results. As I also mentioned earlier, additional testing is a waste of time and money. These test results are not going to change. Your symptoms are due to something other than HIV.
I am not aware of any case in which a person with a negative HIV RNAPCR test at 11 or more days following an encounter went on to have a positive test for HIV of any kind.
As you know, we provide up to three responses to each clients question. This is my third response. Therefore, this thread will be closed shortly without further replies. I urge you to accept your test results. EWH.
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