Hi. Doctors

 Welcome to our forum. I will be glad to address your question.   As you point out HIV2 infections are quite rare in countries other than those of western Africa so the chances that you acquired HIV-2 are quite small.  Further, the antibody detection portion of fourth generation tests for HIV detect of HIV-1 and HIV-2.  Thus,  while it is possible, as you point out in your question, for the antigen detection portion of these tests to miss HIV-2,  each of the tests that you had performed at nine, 10, 11, and 12 months has proven that you were not infected with HIV  of any sort through the encounter did you mention.   Your test results are conclusive for both of HIV-1 and HIV-2.  It is time for you to move forward without concern. ---

Thank you Doctor for your answers.

1. "official" guidelines for HIV 2 seroconversion are not specifically present given the rarity of the infection and the fact that the natural history of this infection is essentially the same as for HIV-1.

2.  No, the CDC will not change the "window" period.  I  have pasted in a recent explanation of this that Dr. Handsfield wrote for you to read.

" CDC developed its advice before 4th generation tests became available. The first reason is that many government agencies generally take conservative positions on prevention advice, and 3 months does that. Second and perhaps most important:  As a government agency, CDC's advice usually must be consistent with the official information provided by the test manufacturers in the tests' package inserts. That information is based on original research, before the tests were marketed, and much of that research is conducted in a way that probably underestimates the tests' true performance. In any case, that information cannot legally be changed unless and until the test manufacturer conducts and new research to justify the change, and that research is vetted and approved by the US Food and Drug Administration. That's a very expensive process and therefore is rarely done. Other research, or the clinical experience of experts using the tests in the real world, and theoretical considerations about how the tests work may not be used to justify a revised package insert or any other information provided to the public. However, independent experts do not have those restrictions and can give advice based entirely on their clinical experience and their interpretation of the science of the tests and published science. That's what we do on this forum."

3.  Because the 4th generation tests, by virtue of the fact that they detect HIV antigen as well as antibody, become positive earlier than antibody only tests.

EWH

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Last question.

Measurement of the CD4 count is not a recommended tests for persons who do not have HIV as CD4 and CD8 concentrations may vary.  Your CD4 count is in the normal range and your CD8 count is not concerning low.  Given your test results, it certainly does not suggest HIV.  You do not have HIV and do not need further testing for the exposure you mentioned.  My advice is to put your concerns aside and try not to worry. 

I hope my comments have been helpful.  Our Forum Guidelines permit up to three answers per question. This is my third reply to you.  Therefore this thread will be closed later today.  Take care.  EWH

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