[Question #11914] Hiv test

11 months ago

I need to ask the doctor a question again. After doing some research, I found that the body can produce antibodies late, which can cause test times to be extended. When I received the hepatitis B vaccine, my body did not produce antibodies. After the childhood vaccination, I had a dose later on, but my doctor said I needed three doses. Still, my body did not produce antibodies, so my concerns are not alleviated. It's been 35 days since a potential exposure; would an HIV RNA PCR test be reliable even if my body does not produce antibodies? Should I get this test done, or is it necessary? (Do I need to rewrite my situation and previous tests in detail below?)

Edward W. Hook M.D.

11 months ago

Welcome back to the Forum although I'm sorry you felt the need. I note that in his reply Dr. Handsfield said "Indeed your current HIV tests are conclusive." I agree with this assessment. PCR tests detect the virus, not antibodies. FYI, about 5-10% of persons who receive hepatitis B vaccination do not respond to initial vaccination. More than half of persons who do not respond then respond to a second series of vaccinations of the sort your doctor recommended. In contract, virtually everyone who acquires HIV develops antibodies and has positive PCR tests demonstrating the presence of the virus ion their blood.

As Dr. Handsfield said, your results are conclusive. You are not infected with HIV. EWH

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11 months ago

Doctor, first of all, I am very sorry for asking questions again. I am a dentist and feel very unhappy about being so anxious and uninformed in the healthcare field. I have been reading old questions and answers on this forum for a long time and wanted to ask you some questions again.

Why is it that while previously a negative antigen-antibody test after 28 days was considered conclusive, now 45 days is regarded as conclusive? Has there been a case in the literature where a test was negative at 28 days but became positive after 45 days? If so, what disease or physiological event caused this situation?
If I contracted gonorrhea from unprotected oral sex, could this situation have been caused by protected vaginal intercourse instead?
It has been 38 days now, and I have symptoms such as diarrhea, sore throat, and swollen lymph nodes in my head and neck area, according to an expert doctor's examination. Could my body be responding late and creating antibodies later for HIV infection? (I had a negative HIV duo test result at 35 days.)

Edward W. Hook M.D.

11 months ago

Thanks for your follow-up. I'm sorry that you remain unnecessarily concerned. I'll try to provide further clarification. FYI, we provide up to 3 responses to each client's questions. In our experience, there is little value to either the client or us with more than 2 series of questions. You have 1 follow-up and then the thread will be closed. After than, should your return your question may be closed without a respnse and without return of your posting fee.. As a reminder, you have already PROVEN that you do not have HIV.

On to your questions:

1. The previous recommendation was made to remain in agreement with the CDC. Apparently the CDC has seen a VERY small number of cases in which a person with a negative combination HIV antigen/antibody test went on to become positive between 4 and 6 weeks. We have never seen or heard to cases. Test conversion after a negative test at 28 days or beyo nd is VERY, VERY rare.

2. While in science you can never say never, it is far, far more likely that IF you acquired gonorrhea, it would be from receipt of oral sex rather than from condom protected sex when the condom was worn throughout the exposure and did not break

3. No. Your symptoms are due to something other than HIV. Further testing for HIV will be negative.

EWH

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11 months ago

Hello Doctor, I have one last follow-up question. I have already ruled out HIV. About 45 days ago, I visited a doctor due to discharge and burning during urination. I was given a Novosef injection and a box of Tetradox pills. The discharge stopped after the injection. Now, I am experiencing burning during urination and a sensation of residual urine on my penis after urination. Today, I visited the doctor again, who said it was a prostatitis issue and prescribed 5 Gentamicin injections and a box of Biteral antibiotics. Could this condition be related to a previous gonorrhea infection? And what do you think of the treatment plan given by the doctor? In the country I live in (Turkey), doctors are not very knowledgeable about sexually transmitted diseases, and frankly, I am worried about having chronic prostatitis. What treatment plan would be appropriate, and should I get a prostatic fluid test or an antibiogram test?

Edward W. Hook M.D.

11 months ago

Your symptoms could certainly be due to prostatitis The treatment with Novosef and tetradox would be expected to cure gonorrhea. The medications you have been prescribed are not the medications we typically use for prostatitis. My suggestion would be to consult with a urologist. There is much more we can offer from this site.

This is the 3rd reply and completes this thread. I wish you the best. EWH

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