Hi Doctors,

47 days ago, I had a likely protected one-night stand with a former sex worker. Around Day 19 I felt unwell, and from Day 25 onwards I had mild neck night sweats.

All tests below used blood drawn from a vein (half a tube) at a Dutch clinic. They probably processed the blood on-site using automated benchtop analyzers ("airfryer sized"  or like "coffe machine" sized machines):

* Day 21: HIV-1 RNA test (result in 90 mins) -> Negative

* Day 42: 4th Gen Ag/Ab test for HIV-1/2 + p24 (result in 35 mins) -> Negative

* Day 47: Repeated the exact same 4th Gen test (result in 35 mins) -> Negative

The nurse assured me these machines are as reliable as sending blood to an off-site lab. However, she then claimed my Day 47 result is only "90-95% reliable" and told me to return at 90 days to be "99.9% sure."

Questions:

1. Are my Day 21 RNA and Day 47 4th Gen tests conclusive for both HIV-1 and HIV-2?

2. Are these benchtop machines true lab equivalents, or are they the "point of care" tests the CDC says require a 90 day wait?

3. Why would a clinic nurse quote a 90 day window for a venous 4th generation test?

Thank you!

1.  HIV RNA PCR tests are conclusive any time more than 11 days after an exposure.  $th generation tests are conclusive any time more than 6 weeks after an exposure- you now have 3 conclusive tests for HIV, tests for HIV RNA, test for HIV antigen (the virus) and tests for HIV antibody at times when the results are conclusive- they should be believed.  

2.  Yes, the performance of benchtop machines is equivalent to those of larger lab-based tests.  The main difference is that the lab-based tests are automated and efficiently process larger number of specimens more quickly than the benchtop machines.  

3.  The advice the nurse provided was overly conservative and out of date- your tests are conclusive and there is no need for further testing.

I hope this information is helpful.  EWH