Dear Doctors hello,I met I guy (I am a woman) and I liked him a lot despite the fact that he is full of tattoos (everywhere in his body) and very promiscuous (i accidentally saw in his pc naked women and trying to do 1night stands). He told me also that in the past he used to do drugs (don't know if he ment intravenous or other kinds). I don't think he is bisexual but let's say he is: so we just kissed one time WITH TONGUE I don't remember tasting any blood but some times when I brush my teeth they bleed. 10 or 11 days after suddenly i felt extremely bad with headache, muscle and joint aches, fever and some cough with a bit low oxygen. No coronovirus, no influenza. On day 5th I went to the hospital and had pneumonia which resolved with medicines quite quickly! I couldn't believe it because I DIDN'T cough a lot, I was even able to smoke my electronic cigarette after the first 2 days of feeling sick (which were indeed terrible).1)Can this be ars???? 3 months later i tested with 4th generation ag/ab and was negative.2) I read that sometimes p24 doesn't work well. How do I know the test is conclusive? Cdc says that we should take 2 tests: one within the window period and one after 45 days to be sure. 3) do I need another test as per cdc?4) I am taking medication because of my thyroid being removed(LEVOTHYROXINE SODIUM ) and but because of my stress I mixed the doses of my pills (I take some days 150mg some other 137mg) for a span of 3 weeks before the test. Can that produce a false negative?5) Do antidepressants like sertraline produce false negatives?5) is it possible that a test from a lab is false negative after 3 months?6) I read that pneumonia can occur during ARS but in my case would it be that easily managed if it was indeed due to ars? My white cell count measured at the hospital during the pneumonia was 6,21  (ranges 4,5- 10,5) and cpr 3,98 (<0,5).7) If the cd4 cells were that low to cause a pneumonia wouldn't my white cells be low too?

Now I have read your questions. My initial impression is unchnaged. First, it is statistically unlikely a partner like yours has HIV. Of course he could be infected, but most such men are not, especially if you are in the US or other industrialized country. Second, your symptoms are not typical for ARS, despite what you might have seen online. ARS does not cause cough, low oxygen, or pneumonia. Third, it is imposible to have HIV for 3 months and test negative with the HIV AgAb (4th generation) test. (It is an urban myth that "sometimes p24 doesn't work well" in the test; and by 3 months the antibody portion of the test would be positive anyway.

Those commetns pretty well answer your numbered questions, but to be explicit and assure no misunderstanding:

1. Can this be ARS? No, it cannot.

2. See above about p24 antigen. The AgAB tests ALWAYS are conclusive 6 weeks or more after exposure. 

3. You do not need any further testing. (I don't know what you mean by "as per CDC". CDC doesn't advise any testing after the negative result you have had.

4,5. No medications, drugs or illnesses exist that delay the results or otherwise interfere with any of hte HIV tests, with the exception of the drugs used to treat HIV. Your levothyroxine makes no difference. Neither do antidepressants.

5 (again). All labs use the identical AgAb tests; results from all labs are equally reliable.

6. You read wrong about pneumonia and ARS. And anyway, your negative test results overrule all else. You could have had very typical ARS; even then, your negative tests are to be believed. Your WBC count means nothing and has no implications for your CD4 count. And once again, even if your CD4 was low, the HIV AgAb test overrules it.

So all is well. You definitely do not have HIV. Please don't worry further about it! Let me know if anything isn't clear.

HHH, MD

2)Also there was a value, I think 0,06, so I suppose that it was performed correctly?

3) I read another's person question (and added me some extra anxiety - he said something about rubbing the aclool before the injection - this could interfere with the test?!!! I thought it was common practice to disinfect the area with alcool before taking blood right?

4) So I am 100% negative you think?

No hiv whatsoever?

One last irrelevant question, Doctor as I trust you so much: last year I had something like a genital ulcer - only one - I never saw a blister, just the small ulcer kind of white inside and red outside. I think It could be caused by friction or heat ( I sometimes after swimming pool at the gym I.....blow dried ....my intimate parts...- I know...cringe). I took a igm hsv2 test and it turned "slightly reactive". Could this be a false (hopefully this time) positive?

Thank you!!!

2) The numerical value of 0.06 is definitely negative and also supports a correctly done test.

3) That must have been a questioner's statement. You didn't see anything any of the forum moderators saying that alcohol can affect HIV test results. It cannot.

4) Yes 100%. It is not possible you have HIV.

The HSV2 blood tests are a problem in general, and the IgM test absolutely and always unreliable. If an IgG HSV2 test was done and negative, and if the test was done at least 3 months after the last possible date the infection could have been acquired, then you can be confident you don't have HSV2. However, if you ever have another similar genital ulcer, see a doctor ASAP (within 2-3 days) so the ulcer itself can be tested for HSV by PCR. Most likely this won't happen, though.