[Question #13621] Seeking Clarification on HIV-2 Detection After Reading Comment from #13471

2 days ago

Hi Doctor, I'm sorry to trouble you again. This is not a repetitive question. I know my previous tests have already ruled out HIV and other STDs, but I recently saw a new question by other user #13471 (from just a month ago) that mentioned HIV 2 detection reliability. That comment confused me, and I would like to clarify whether any recent changes in medical affect the reliability of my own test results.

You mentioned that "until a couple of years ago, the AgAb tests did not detect all HIV-2 infections, but most manufacturers have since improved them so they now detect HIV-2" and that earlier AgAb detected most but not all HIV-2.

This made me wonder which time period "a couple of years ago" refers to?

For context, my tests were done between August 2024 until November 2025 (Abbott Alinity and Siemens Atellica). Q1: Are these period of 4th-generation assays fully capable of detecting all HIV-2 infections?

I previously tested multiple times, all of which were more that 3 months after the exposure in Malaysia. (unprotected oral, protected vaginal sex with Vietnamese sex worker) and all AgAb tests were negative; an HIV-1 RNA was also negative. I understand my results already rule out HIV, but I want to ensure there is no remaining concern specifically about HIV-2 detection after reading that very recent comment. Q2: Do I need any additional HIV-2 RNA testing? Q3: or are my AgAb results alone already 100% fully conclusive for ruling out HIV-2 and confirming that 100% I was never infected HIV-2, so that I can stop testing and not worry about this anymore in future?

Thank you again for your time and guidance!

Edward W. Hook M.D.

2 days ago

Welcome back to our Forum. I’m sorry to hear that you are having so much trouble accepting your test results. Tests for HIV-2 performed in 2024 and 2025 detect virtually all HIV-2 infections. You should believe the results and accept that your low risk exposure has not led to infection with any STI including HIV-2. Further testing is not going to change this. Thus:

1. Yes, believe your test results.

2. No. HIV-2 RNA PCR would almost certainly only confirm that you were not infected

3. See above

I encourage you to move forward. If you are having trouble doing that, I would suggest that counseling rather than further testing will be most helpful. EWH

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18 hours ago

I think I understand, but I just want to double check, if that's okay-

1) Is it correct that my HIV AgAb tests detect HIV-1 and HIV-2 with the same reliability, and that they fully cover all

HIV-2 infections?

2) Is my worry about possible missed HIV-2 detection by these AgAb tests medically unfounded and driven by anxiety rather than science?

3) Regarding your comment on "No. HIV-2 RNA PCR would almost certainly only confirm that you were not infected": is your meaning that I do not need HIV-2 RNA testing at all, if I were to do it, it would just be a waste of money, add no new medical value, and would only re-confirm what is already established- that I was never infected? correct?

Thanks so much again!

Quick recap for your convenience: Exposure 1: Unprotected oral/ protected vaginal. HIV AgAb at 3, 9, 10, 12, 15, 16, 18 months, HIV-1 RNA at 15 months, all negative.

Exposure 2: Fingertip contact with vaginal fluids. Exposure 3: Receiving handjob and breast sex.

I know Exposure 2 and 3 are no risk at all now. But I had HIV AgAb after the very last exposure at 4,7,16 weeks, 7, 8, 8.5, 10 months. Negative. Some Tests were performed on the same dates but appear different due to calculation from different exposure times.