[Question #1651] Hiv testing!!

44 months ago
Been stressing for months now just need help understanding recent results. 
Oct 18 i had an low risk exposure.
So at 10days pass exposure I recieved an full blood work up and HIV RNA test negative. Also had full CBC panel AST came back at 71 out of 0-40 normal range and ALT came back 57 out of 0-44 range. Following I received an sonogram of abdomen and liver which was normal. 20 days post exposure finger test 4th gen negative. This is when I began to get symptoms alot that have continued until now most alarming are these recurring herpatic looking painless tongue lesions. I won't go into detail because I've been told symptoms aren't a good way to determine status. At 5 weeks post exposure HIV RNA test negative. 3 Oraquick test between week 5 and 9. 9 weeks post exposure I recieved an 4th gen HIV blood test non reactive. And at 11 weeks took an oraquick swab which was negative. Had another full CBC and neutrophils was 35% 1.0 out of 1.4-7.0 range and WBC was 2.9 out of 3.4 to 10.8 range. In November my results were Neutrophils was 41% 1.6 and WBC was 4.0. My questions are simple should I still be concerned about HIV at this point? Is my low counts something to be alarmed about? Should I ask for more testing?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome to the forum. Thanks for your question. I happened to log in a few minutes after you posted it -- most users shouldn't expect nearly real-time replies!

One of the common themes that comes up almost daily on this forum is that the HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition; and that when testing is done sufficiently long after the last possible exposure, the results always overrule all other factors, including the nature of the exposure and symptoms. Even with the highest risk exposures or highly typical symptoms, negative test results are conclusive. The 4th generation blood tests are conclusive any time 4 weeks or more after exposure, and the oral fluids test by 3 months; and RNA testing detects over 90% of infections by 10 days. So your results are absolutely conclusive:  you are definitely in the clear and you don't need any more HIV tests.

Your symptoms and CBC results are not particularly suspicious for HIV, but in any case the HIV test results show HIV isn't the cause. (Not sure what you mean by "herpetic looking tongue lesions". Herpes rarely causes ulcers in the mouth, especially painless ones. Keep working with your doctor about your liver function and other issues, but you can go forward with 100% confidence you don't have HIV, assuming no exposures since last October.

I hope these comments have been helpful, but let me know if anything isn't clear.

Best wishes and stay safe--  HHH, MD

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44 months ago
Wow!
Yes that was indeed a real-time response. I greatly appreaciate the time you and other providers take to answer questions your exp in the field im sure is much more valuable than 25 a question. So thank you for your time spent with the non informed I  have reviewed previous questions and its seems everyone asks nearly all the same questions when the information is already. Example being myself lol. 
I will take your advice to heart as ive spent alot of money recently trying to clear my thoughts of this. 
Blessings to you and yours 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Thanks for the kind words. I'm glad to have helped.

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