[Question #11895] HIV Test Conclusive?
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11 months ago
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Hello,
I had a high risk exposure by having unprotected vaginal and oral sex with a female. This was a hookup with a stranger in southern california. After I started developing symptoms, I reached out to her and she said she gets tested every 6 - 12 months and has never had an STD. She then had a HIV ag/ab/ test at 10 days after our exposure and it was negative (pic showed two negatives, one for HIV ag/ab and one for rapid test, stated as "capillary skin puncture without incident".
From this incident, I tested for the following (all performed by LabCorp):
- Negative HIV RNA at 16, 24, and 38 days from possible exposure
- Negative 4th gen HIV (HIV Ab/p24 Ag with Reflex) at 32 days from possible exposure
I also had unprotected sex with my ex 32 days ago and she started to develop flu like symptoms. She said that it was not one of the worst flus that she's had but has a fever, nasal congestion, and sore throat. My symptoms have been fever, mild sore throat, dry mouth/tongue, nausea, and night sweats.
Is it possible that all my test results have been false negatives? Thank you.
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Edward W. Hook M.D.
11 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment, reassuring you that you can be entirely confident that you did not get HIV from the encounter you describe. I could point out all of the statistics and facts which make this a very low risk encounter but there's no need - your test results, as well as those of your partner prove that you were not infected.
1. Persons with negative tests do not transmit HIV. Her test results 10 days after the encounter, which are beyond the so-called testing "window" prove that she could not have transmitted HIV to you.
2. Each of your HIV RNA PCR tests at 16, 24, and 38 days are virtually conclusive and need not be repeated.
3. Your 32 day 4th generation test is more than 98% conclusive.
You do not have HIV and need to look for another cause of your current symptoms. Please don't worry about the possibility of HIV, there is all of these different tests could be falsely negative. There is no need for further testing. EWH
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11 months ago
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Thank you for the info Doctor. But to confirm, did you mean to say “Please don’t worry about the possibility of HIV, there is all of these different tests could be falsely negative”? Meaning that all my tests could be falsely negative?
Also, the partner had a capillary skin puncture, which I’m worried has a higher window period (90 days?) than a 4th gen hiv test from vein?
Is it virtually possible for someone who was exposed to HIV have a negative HIV rna test at 38 days from possible exposure? While also showing symptoms?
I’m super anxious that I might’ve passed it to on my ex if I was potentially positive.
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11 months ago
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Also I saw that the CDC states the window period for HIV RNA test is 10-33 days. Does this mean that since my test result from day 38 is negative, it is 99% confident that I don’t have HIV? I know that a 4th gen hiv is required at 6 weeks to be conclusive by official standards.
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11 months ago
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I saw that Dr. Handsfield believes that a hiv rna taken at 2+ weeks plus a 4th gen hiv taken at 4+ weeks is 100% conclusive? Is that right? Have you guys seen any cases in which a person is negative for both tests at the required timeline and still later tested positive? Thank you so much
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Edward W. Hook M.D.
11 months ago
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Sorry for the typo. I left out the words “no way” . To repeat- there is absolutely no way that all of these tests could be falsely negative. You need to move on.
Sigh- 4th generation tests perform equally whether using capillary or venous blood.
Correct, no one who acquires HIV will have a negative HIV RNA PCR at 38 days. Particularly those who are symptomatic
The CDC’s estimates are overly conservative.
Dr. Handsfield's statement agrees with my summary.
You need to put your unwarranted anxiety aside and move forward. You have one follow up remaining. E WH
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11 months ago
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I see, thank you Dr. Hook. If i wanted 100% conclusive results that I did not acquire HIV from this interaction, would a 4th gen HIV Ab/p24 Ag with Reflex at 42 days (6 weeks) be considered 100% conclusive? or would I have to wait for the actual 45 day window to test for 100% accurate results?
Also given that my ex started to develop flu like symptoms (similar to that of acute hiv) after 32 days since our interaction. Would she test positive for a 4th gen hiv if she were to go get tested right now and was indeed positive?
I just don't seem to understand that if a HIV RNA at 2+ weeks & 4th gen hiv test at 4+ weeks is considered conclusive by experts like yourself, why is there still a need to wait 3 months for absolute results? Seems like most people will be able to have relief (whether they are positive or not) if they just used this as a standard protocol. Nonetheless, I really appreciate your help.
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11 months ago
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I also did have COVID about 3 weeks from the initial interaction with the stranger. Please let me know if this can affect either the HIV RNA or 4th gen HIV test results? thank you.
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11 months ago
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My ex just confirmed that her flu was caused by covid-19. This does bring somewhat of relief to me. Can this somewhat help in confirming that I don’t have HIV?
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Edward W. Hook M.D.
11 months ago
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As you know, we provide up to three responses to each clients questions. This is my third response, and therefore this thread will be closed shortly after this response. That should be sufficient given that I have already informed you that you can be confident you do not have HIV and do not need further testing. No matter how much additional testing you do your results are not going to change.
If you choose to waste time and resources with additional testing, the answer is that at 42 days, your test test results using a fourth generation combination HIV antigen/antibody test will be conclusive, just as your PCR tests already are.
I’m not sure who has recommended a three month follow-up test. It sounds like another example of Internet based misinformation. You do not need additional testing of any sort, including follow-up testing at three months.
Having COVID-19 has no effect on the reliability of tests for HIV
This completes this thread. I hope that you will now be able to move forward with confidence that you do not have HIV. EWH.
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