[Question #12222] HIV RNA Test at 20 Days

9 months ago

I’m a gay male and I had a sexual encounter 31 days ago where I bottomed for another man. He said he was HIV Negative and STI free. We used a condom altho I didn’t get to inspect it after the encounter. 10 days later, following some routine bloodwork (WBC, CBC stuff) from my dr, they were concerned about a few things and that got me scared. I have depression/anxiety. After hearing this, within hours I was nauseated, no appetite and had night sweats for a couple nights. I also had thrush (altho, I have a history of that and I’m on probiotics for it). A few days later I was ok. They did an HIV Antigen test on day 12 which came back non-reactive and then an RNA test on day 20 which came back non-reactive. I was put on Augmenten and Prednisone on day 21 for Sinusitis which they discovered from an MRI. That day, I had very high heart rate mowing the lawn (184). I’m 43yo. During and after the meds, I had high blood pressure at two appointments. I did another Antigen test on Friday, as well as all the other STD tests. Everything has come back except the results from the HIV test. All negative, but now I’m worried what is taking so long. I’m in California, so I’m wondering if my Dr just hasn’t looked at it over the weekend to upload to my portal at Sutter? And how reliable was that RNA test?

H. Hunter Handsfield, MD

9 months ago

Welcome to the forum. Thanks for your question.

Your worries about HIV should be over; it is certain you don't have it. The PCR test for HIV RNA is conclusive by 11 days after exposure, so your 20 day negative result proves you do not have HIV. In addition, it is not possible to have symptoms due to HIV and to test negative. The symptoms are due to the immune response to the virus, not to HIV itself, so HIV is not a possible explanation for any of your symptoms, blood count anomalies, etc. And there are no medications of any kind that have any effect on timing or reliability of the HIV blood tests (except for anti-HIV drugs themselves if taken for post exposure prophylaxis (PEP); the prednisone and augmentin make no difference. Your pending HIV test also will be negative.

In addition, you describe a highly safe sexual exposure, given your partner's assurance he doesn't have HIV (people rarely lie about HIV status when asked directly) and use of a condom that didn't break wide open. (The notion of small or microscopic leaks that allow STI/HIV transmission is pretty much an urban myth.)

So all is well in regard to HIV. Keep working with your doctor if your symptoms continue or you otherwise remain concerned. In the meantime, I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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9 months ago

Thanks so much. I don’t currently have any symptoms other than some pains in my groin (lymph nodes?), but generally ok. It’s worth noting that I stopped working out 6 weeks ago due to an injury and have been sort of lazy due to it.

I guess I just wish my dr would communicate my results. The first Duo test and the RNA test came back to me in 24 hours, so I was concerned when Saturday afternoon (yesterday) rolled around and I received results for everything except the HIV Duo test.

Thanks again for your response. My anxiety has been off the charts and getting accurate information from anyone/anywhere has been a challenge.

H. Hunter Handsfield, MD

9 months ago

There is no need to know the newest test result (and there really was no need for it). Your RNA PCR test at 20 days already is 100% proof you don't have HIV.

Labs don't always turn around tests in the same time. A lab might run a particular test at say 2 pm every day; if your specimen arrives at noon, it's done that day; if at 3 pm maybe the next day. And if that's a Friday, maybe on Monday. Or for efficiency they wait until a minimum number of specimens have been received before doing them all together. And as you say, your doc might not have been sent the result yet, or isn't working over the weekend.

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