[Question #12478] Quick Clarification

7 months ago

Good Afternoon,

I had a quick question concerning another referenced answer. In question 9885 Dr. Hook stated that any negative 4th gen test beyond an exposure rules out the possibility of exposure. I was under the impression there was still a possibility, though quite remote. For instance, if you have a potential exposure and your partner tests a week later and is negative on a 4th gen test, is that really all the assurance one needs?

Thanks so much!

H. Hunter Handsfield, MD

7 months ago

Welcome back, but I'm afraid you misread that question. 9885 was about gonorrhea testing, not HIV. As Dr. Hook said, 4-5 days is plenty of time for gonorrhea.

HHH, MD

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7 months ago

Hey Doc,

Not trying to be a pain, but I wanted to verify what I'd read. That question was speaking to HIV directly:

"A few additional comments for future reference:

Condoms break about 1% of the time. Breakage rates are higher with rectal intercourse.

When a partner has a negative 4th generation test any time beyond a sexual encounter, they cannot have transmitted HIV."

Thats the statement I was looking for clarification on.

H. Hunter Handsfield, MD

7 months ago

You're right about that statement, which I missed previously. But you're ignoring that just before then, Dr. Hook wrote "4th generation tests for HIV are 99% conclusive at 4 weeks and entirely conclusive at 6 weeks - when combined with a negative HIV RNSA test, tests are conclusive any time more than 4 weeks after an exposure." The later statement you quote obviously was a quick statement of reassurance, not intended to override his main message. This is also a good example why users should depend on the replies we give to their own questions and not look for others addressing the same topic; the wording of our replies often varies with the particular question and the user's circumstances.---

H. Hunter Handsfield, MD

7 months ago

And it's true that people without detectable HIV p24 antigen (the Ag component of the 4th generation test) and those with negative PCR/RNA tests cannot transmit the virus. A negative test in a partner following exposure proves no HIV exposure occurred.---