[Question #216] Is there such things as delay seroconversion

36 months ago
I had a high risk exposure 10 months ago. The following are the tests I conducted:
at 28 days- 4th gen, RNA, and 8 panel std with stdexpress- negative except HSV1
at 5 months- 4 gen, RNA, and 8 panel std with stdexpress- same results as before
at 7 months- PCP ordered an RNA- negative
at 10 months went to clinic and had a rapid test- negative
I had Hep A when I was a child and I am afraid that could delay seroconversion. I was wondering if there is anything that could delay seroconversion at this point? Can I try to get pregnant without any worry? Thank you in advance for all your help.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome to the forum.

It is clear you are very concerned about the potential exposure you had. Such events can be stressful and frightening and I understand your concerns.

However, you have overreacted and have been seriously overtested. In reply to the question as posed in the title you chose, the answer is no:  there is no such thing as delayed seroconversion to HIV.

The HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition. There are no medical conditions that change delay them or otherwise change their reliability. And even if there were such a thing as delayed seroconversion, you are protected against that possibility, because you were not tested only for HIV antibody, but also for the virus itself (your 4th generation tests and the RNA/PCR tests). If seroconversion (antibody) somehow were delayed, it would make the other tests MORE likely to be positive. Your 4th generation test at 28 days was conclusive; all other tests after that were superfluous.

As for other STDs, the other tests in your panel are almost equally reliable as the HIV tests.

As implied above, your childhood hep A could not have had any effect. Neither could any of the other hundred infections of various kinds (colds, flu, diarrheal illness, etc) over the course of your life.

So for sure you don't have HIV or any of the other STDs for which you were tested. You can safely conceive and bear a child without risk to your risk or the baby's. Don't have any more tests.

I hope this has helped. Best wishes--  HHH, MD


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36 months ago
Dr. H H H,
Thank you for your quick response. I also want to thank you for the job you do. It is quite refreshing to have someone with your expertise to help answer the many doubts one who could have in moments of distress. Warranted or not, it is a situation of great stress and only a person with your experience can calm those feelings. I definitely learned my lesson and will try very hard to never put myself at such risk. 
Have a great rest of the week. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Thank you for those nice thoughts.  ASHA gets the credit for initiating and continuing this forum. But I'm glad to have helped. Best wishes and stay safe!---
36 months ago
Dr. HHH,

One last question. I know you mentioned the accuracy of the tests these days but speaking in percentage what is the reliability of the tests that I took?  Thank you again. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
As I said above, "Your 4th generation test at 28 days was conclusive; all other tests after that were superfluous." That means 100%.

Your worries have earmarks of anxiety, and perhaps shame or guilt, over a sexual exposure you regret, Or perhaps an exposure over which you had no control. But do not confuse those feelings with risk of HIV or other STDs. They aren't the same. Deal with the former feelings as you need to, but disregard the latter. It's really not an issue. If concerns remain, have another discussion with your PCP about it.

We've reached the forum limit of two follow-up questions and replies, so that will end this thread. Best wishes to you!


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