Hi doctor

I am writing this on behalf of my cousin who doesn't understand english

I decided to test as i was really scared. 

My test were as follows.

4th generation test from reputable LAB 

Day 17, 28 , 31, 47, 89, and 140. (- ALL NEGATIVE) -venous blood sample

Day 220 (8th month)insti rapid antibody (- NEGATIVE) 

end of 8th month (day 240) i went for blood donation. 

They test for POOLED PCR RNA- 24 specimen per pool and 4th generation test as well.

( BOTH NEGATIVE -VE).

I was all satisfied and happy since my pcr was negative too. However, last month in april all of a sudden i had really bad fever 39.3 with no reason. My chest was so congested that i had to call ambulance. Shortness of breath, fatigue, sore throat, mucus and severe cough that sometimes small spots of blood with green mucus. 

I took augmentin antibiotics and i went all fine in 7 days. Maybe. I had pneumonia or tuberculosis. 

My questions are bit technical. I hope you address them as i woukd trust your comments. 

Q1 - how satisfied are you about my status in terms of testing ?

i read on abbott website pooled rna pcr test for example size 24 pool (which i had) would compromise the sensitivity to 500 to 600 copies/ml.

Question 2- have i been infected and had not produced antibodies by month 8 or even very low titer antibodies...do you think my RNA would have been below 500 or 600 copies thus below the threshold of pooled rna pcr to detect?

Question 3- if someone who had all those negative tests means he didn't had any sort of antibodies in his blood and if it possible to have this low RNA? 

I will be happy to have your discriptive answer. BIG HUGS

The exposure you describe was low risk and your testing proves that you were not infected.  Most women do not have HIV and even when a partner is unprotected vaginal intercourse has untreated HIV, most single exposures do not lead to infection. The estimated risk of a single encounter with an untreated infected partner is less than 1 in 2000- in other words, even in the unlikely circumstance that your partner had HIV, there is a more than 99.95% chance you would not be infected.  The testing you report proves as well that you were not infected.  Your fever is due to something other than HIV and is almost certainly unrelated to the exposure you describe.   Delayed seroconversion does not exist.  It is a myth promoted on the internet.

In reply to your specific questions:

No.  See my comments above

Please don't worry.  You certainly do not have HIV.  EWH

Q1- considering above senario no antibodies detected in all 9 (nine) 4th generation lab tests till day 240 (month 8), and no art or pep initiated, rna below 500 copies couldn't be the senario? 

Q2- Even though manufacturers label their reagents with the types and subtypes of HIV, such as O or M, the body's natural antibody response is what is picked up by the 4th generation lab test in the blood, allowing it to identify every case of HIV infection regardless the hiv virus type? 

Q3- no matter what typical symptoms i may have but i shouldn't be worried about the hiv regarding that 12 month exposure in presence of my 9 4th generation and one pooled pcr rna tests till month 8? 

Last question- can i resume unprotected sex with my regular partner without fear of infecting her? 

Thank you very much! You're helping people deeply. We are glad to have such doctors like yourself 

2.  Also, correct

3.  Correct 

4.  There is no reason for you to hesitate to resume normal, unprotected sexual activities with your wife.

EWH

Why does blood banks do naat pooled  pcr testings with dillution just to save money and time pushing sensitivity  500 to 600 copies per ml rather just doing individual naat based testing thus keeping the sensitivity to 20 to 30 copies/ml.?? 

Just incase someone is slow progessor  and has viremia below the 500 threshold ?? And at the same time very low antibody titre for the test to pick up? 

Dont you think it could have huge impact during blood transfusion, especially in this era? 

Much thanks!!! 

You are worrying needlessly.  This completes this thread.  There should be no need for you to return to the Forum.  EWH