[Question #13220] MY SITUATION

1 months ago

Had exposure in thailand 71 days ago - unprotected vaginal sex with one girl and condom broke with a different girl. 28 day after last exposure did the 4th gen lab test - negative. 43 days after last exposure did the 4th gen and rna for hiv 1 and rna for hiv 2 negative. Thought its conclusive. But when i got tested at the lab, i saw the person use a vacutainer needle, i was used to syringes. Syringes come out of sealed packages but vacutainer needles come as seperate needles with indiviual sealed plastic caps. When i saw that, immediately assumed the needle was reused as i was used to syringes even though i saw the person remove the green cap before using on me. Then I was extremely anxious.. waited then after 28 days I did the 4th gen test again and rna pcr for hiv 1 and rna pcr for hiv 2 all negative. This is 71 days after last exposure in thailand and 28 days after my hypothetical reused blood draw needle exposure. Im concerned about the reused blood draw exposure. Assuming the needle was indeed reused, and my 4th gen and rna pcr for hiv 1 and hiv 2 negative at 28 days, what are the chances i have hiv now ? Am i 100% in the clear ? Do you think i have a mental problem ?

1 months ago

Just for my knowledge , when are rna pcr tests conclusive for hiv ? 11 days, 15 days or 28 days ? have you or your colleagues ever seen a person with a negative pcr at 28 days become positive ?

Edward W. Hook M.D.

1 months ago

Welcome to our forum and thanks for your implied confidence in our service. I will be glad to come.

I would have no concerns about the fact that a vacutainer sleeve and needle was used to draw your blood. In fact, vacutainer needles are designed so that they cannot be reused. Your subsequent testing proves that you did not acquire HIV-1 or HIV-2 from the encounters that you described. I see no need at all for additional testing.

The best data on PCR testing for detection of HIV relate to HIV one. HIVRNAPCR tests are conclusive when taking any time more than 11 days an exposure. My urgent to put in a concern you might have aside and move forward. I see no need for further test testing of any sort.

I hope this information is helpful. EWH.

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1 months ago

Thanks Dr.Hook for the answer. It reassures me.

1) Is the rna pcr combined with 4th gen conclusive at 28 days ? I see 4th gen is conclusive at 6 weeks, have you seen anyone get positive after negative 4th gen at 4 weeks ?

Edward W. Hook M.D.

1 months ago

The HIVRNAPCR test is conclusive anytime after more than 11 days and does not need additional testing.

Fourth generation combination, HIV antigen/antibody tests are more than 98% conclusive at 28 days and entirely conclusive anytime more than six weeks following and exposure

EWH

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Edward W. Hook M.D.

1 months ago

I have never seen or heard of someone with a test which was negative at four weeks which went on to become positive between four and six weeks. This is a very, very rare occurrence. EWH.---

1 months ago

Thanks for the response Dr.Hook. My few final questions

1) I am an very anxious person. If in the future i have an exposure, what tests do you recommend me to get for conclusive results ? Rna at 11 days ? Rna + 4th gen at 28 days ? or wait 6 weeks for just a 4th generation ? Assuming money is not an issue, what tests would give me peace of mind at the earliest and is 100% conclusive ?

Edward W. Hook M.D.

1 months ago

Final response. If cost is not a concern the fastest way to get a conclusive answer to whether or not you were infected is to get an HIV RNA PCR test after more than 11 days. There is no need for additional testing.

End of thread. EWH

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