[Question #13055] HIV

2 months ago

Risky exposure in September 2023, unprotected sex with a female from Ireland. I had tests at 2 weeks including HIV. The following January I realised that I had ARS symptoms a month after the exposure, night sweats, feeling poorly, rash on my torso, body aches. I had 3rd Gen test at a nurse led clinic, negative. I had other 3rd Gen tests throughout last year. In January 2024 I started to feel poorly, lump in my throat, headache which I put down to stress. I repeated the 3rd gen test, but then discovered that autoimmune conditions can affect testing - I’ve had IGA Nephropathy for years. I convinced myself that my tests were wrong and had a lab 4th gen test and a PCR Qualitative in last 2 weeks. All my tests have been negative but I struggle to accept the results. I’ve convinced myself that the current throat issue is candida. Could the autoimmune condition affect my test results? My PCR sample was not analysed at the lab for 48 hours. The lab is large/accredited, they said it passed all internal checks and was accurate. Can I rely on this?

Edward W. Hook M.D.

2 months ago

Welcome to our Forum and thanks for your questions. I'll be glad to comment. You do not have HIV- that is clear. There is no need for further testing related to the encounter you described. Here are some of the reasons why:

1. The encounter was low risk. While you do not say anything about your partner, most women do not have HIV. Even in the unlikely circumstance that your partner had untreated HIV, the risk of acquiring HIV from a single unprotected exposure is less than, on average 1 in 2000, i.e. chances are more than 99.5% that you DID NOT get HIV.

2. Your flu-like symptoms occurred a bit late to be the ARS and when carefully studies, over 99% of persons with the "classical" symptoms of the ARS do not have HIV but have some other, non-STI illness such as influenza, COVID, or one of the many other all too common community acquired viral illnesses that most persons get from time to time.

3. Most importantly, your tests are repeatedly negative. Neither 4th generation tests for HIV, nor HIV PCR tests require antibody production to give a positive result. Your tests are negative proving that you did not acquire HIV. That the specimen was not processed for 48 hours does not change the reliability of the results.

It's time to move on. Be confident that you did not acquire HIV from the exposure you have described. EWH

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2 months ago

Thank you for your prompt and reassuring reply. I don’t know if I mislead you in my explanation of the ARS symptoms - they came on exactly 4 weeks after the encounter but it was only in the following January ( when I was searching the net ) that I realised the potential significance. At the time I saw a Dr who thought it might be shingles. I’ve never been able to get over the coincidence, despite the negative tests. Re the autoimmune condition which I have had for over 20 years - I am just monitored and as far as I’m aware am not immunosuppressed. This is another thing which has caused me significant anxiety in recent weeks - is there evidence that IGA Nephropathy could affect tests? Thank you again.

Edward W. Hook M.D.

2 months ago

The vast majority of HIV ARS occurs 2-3 weeks after an encounter. When it does, tests are ALWAYS positive and do not become negative. Your results are conclusive.

As i said earlier, your IgA nephropathy would not keep your test from becoming positive. You need to believe your test results. My assessment is unchanged. You need to take a deep breath and put these anxieties behind you. EWH

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2 months ago

Thank you, I really appreciate your time and the clarity you have given.

2 months ago

Apologies Dr, one further follow up. I meant to say that my PCR sample was posted and took 48 hours to get to the lab where it was seemingly analysed immediately. Looking on the web, it seems samples would be stable at room temperature for up to 72 hours, but other labs insist on arrival/analysis in 24 hrs. As stated, the lab have confirmed the results, but due to ongoing anxiety it’s easy to pick up on these things. Does this change anything?

Edward W. Hook M.D.

2 months ago

I understand what you meant about the delay but this in no way changes my assessment. Please be confident of your test results.

As you know, we provide up to three responses to each clients questions. This is my third response. The thread will be closed now. Please don’t worry EWH.

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2 months ago

Thank you again, I will try to do as you say.