[Question #2064] HIV RNA TMA test

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83 months ago
I would like a professional opinion on the reliability of an HIV RNA TMA test by LabCorp at 8 days and again at 15 days post possible exposure. I have had conflicting answers anywhere from 99.9999% to not reliable. Your personal professional opinion please. 
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H. Hunter Handsfield, MD
83 months ago
Welcome to the forum. Thanks for your question.

This result is somewhere between "not reliable" and 99+% reliable. Roughly half of newly infected people would have positive results by 8 days and probably 90-95% at 15 days. You should also have an HIV antigen-antibody (Ag/Ab, "duo", "4th generation") blood test at 4-6 weeks. That result will be conclusive, especially in combination with the RNA test already done.

I might have expanded advice about it if you'd like to say more about the nature of the exposure you are concerned about. Until then, best wishes--

HHH, MD

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83 months ago
The exposure was a condom break while having vaginal sex with a sex worker. Probably several minutes after the condom was broke. This was 27 days ago. After about 7 days I began getting very sore legs, grumbling stomach, more recent neck shoulders pain. At 23 days I woke up with a temperature of 100* which lasted a full day, since that day it has been between 90-97*. I do have a slight discomfort in my throat, it looks like possibly cold sores. Anxiety is very high and I know that can't help. 
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83 months ago
Sorry, temp has been 99.0-99.7 since last fridy
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H. Hunter Handsfield, MD
83 months ago
OK, thanks for the additional info. These symptoms are not at all suggestive of a new HIV infection, and your temperatures are normal. (Many people assume any temperature over 98.6 is abnormal. In fact, 98.6 is the average over the day, and most people's temps are occasionally up to almost 100.) Also, statistically there is under a 1% chance your partner has HIV; and even if she does, the average transmission risk for a single episode of vaginal sex, if the woman has HIV, is once for every 2,000 exposures. When we also factor in a 90% reliable test, there is almost no chance you have HIV. But I would advise going ahead with an Ag/Ab test in the next few days. That negative result, plus the negative RNA test at 15 days, will be 100% conclusive. So stay mellow until you have that result; I'm confident it will be negative.

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83 months ago
Thank you. I know anxiety is getting the best of me. I am sure the aches and pains are do to the anxiety, but the temp and cold sores are what really triggered the worry. I have done the gen4 test and I'm waiting on results. I was looking for some reassurance in the mean time. Also, I am HSV2 positive. I have read that that will increase your odds of getting HIV. Any comments on that? 
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H. Hunter Handsfield, MD
83 months ago
Having HSV2 roughly doubles the risk of HIV infection if sexually exposed. But "doubling" really doesn't mean much. If your partner had HIV, your risk rose from 1 chance in 2,000 to 1 in 1,000. No big deal. And you have the negative test results reported, plus the coming test result which also will be negative.

Threads normally are closed after two follow-up comments and replies, and we're there. However, I'll keep this thread open so you can tell me the latest test result. But I won't have any more comments or advice until then.

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83 months ago
Hi Doctor. I did get the labs back today with a negative HIV gen 4. Thank you for keeping this open. I also had my blood work done and it came back with several abnormalities. I would really like your input, but I'm not sure if I can upload the results to you, or if you are willing to take a look. I am happy to pay for another consultation