[Question #2188] test combo

46 months ago
Hello, Dr. Hunter and Dr. Hook, I have a question that I need to answer very strongly
 I maintained an unprotected vaginal relationship lasting about 5 minutes or less
At the start of the second week, I felt a headache that lasted about a week
At the beginning of the third week, the lymph nodes swelled by the neck
I do not remember a fever but I remember the pain in the abdomen lasted almost a week
 At the beginning of the fourth week there was a sore throat and felt pain in the thigh muscles and between the thighs
At the end of the fifth week a small skin rash appeared and disappeared the next day, possibly because of an antibiotic (klavox)
I am now at the end of the sixth week and some glands still swollen in the neck and sore throat heals and returns after two days .. Maybe it was because of smoking?
 I checked the combo after the relationship with 16 days, 21 days and 28 days, all of them nonreactive
I have some questions
 First if the symptoms were hiv .. Was it supposed to be a positive test? Do I believe it is true or wrong? The meaning of the test is negative, indicating that the symptoms are not due to hiv ?
 Second, how much is the combo test crucial after 28 days
 Information may help you .. I am a crazy smoker during the recent period .. Tired and worried and very afraid
When I get nervous and worried and fear rises the temperature. I can say that my temperature is related to the state of mind
I'm sorry I do not speak English well
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question. Your English seems fine -- your questions are quite clear.

First, vaginal sex is not very efficient in transmitted HIV. Most likely your partner is not infected; but even if she is, the average transmission risk for a single episode of vaginal sex, female to male, is somewhere around 1 chance in 2,500. That's equivalent to having sex with infected women once daily for up to 7 years before transmission might be expected. Second, although some of your individual symptoms can occur with HIV, the timing is wrong:  with acute HIV infection, all symptoms generally start 10-14 days after exposure. Further, all the symptoms you report are also consistent with many minor viral infections, all of which are more common and more likely than HIV.

But most important, the modern HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition. The results are 100% reliable if done sufficiently long after the last possible exposure, For the antigen-antibody (4th generation, combo) tests, that time is 4-6 weeks. Because the HIV blood tests are so accurate, the results outweigh all other factors, such as exposure history and symptoms. Your 16 day result was around 50-60% reliable, the 21 day test 90%, and the 28 day test nearly 100%. Therefore, the "meaning" of the negative test results is that your symptoms are not due to HIV.

I cannot judge the cause of your symptoms, except I am confident they are not due to HIV. Most likely a combination of things, especially a garden variety minor virus plus anxiety. Your "state of mind" has no effect at all on your temperature. Fear and anxiety do not raise body temperature, and it sounds like you do not have fever anyway. 

For an even more conclusive result, have a final Ag/Ab (combo) HIV blood test 6 weeks after the exposure. It will also be negative, and 100% conclusive. In addition, if you are not under a doctor's care, do that now, to learn the other potential cause(s) of your symptoms.

Finally, perhaps you will be reassured to know this:  I have been moderating this and a prior forum on HIV risk and testing for 13 years, answering around 10,000 questions. Not one of those persons turned out to have a positive HIV test after an exposure they were concerned about. I am confident you will not be the first. So stay relaxed as you wait for your final test result.

I hope this information is helpful to you. Let me know if anything isn't clear.


46 months ago
Hi Doctor
Thank you very much for the quick answer
The answer is very clear
But I'm concerned about just one point
After your answer, I started to think about the time of the symptoms (I know this is a madness and an anxiety over normal limit) but really I do not remember anything now
If the symptoms were at the right time 10-14 days from the date of exposure
Fever, sore throat and swollen lymph nodes (all at the same time)
The test result was negative .. This means that the symptoms are not from hiv?
I think I should ask the question in another format
 If someone was infected and showed symptoms at the right time and tested the blood combo in 16 21 28 days .. Was the test supposed to be positive?
I want to apologize for repeating the question but I trust your heart and your chest
I want to inform you that there is an Arab forum that believes in everything you say and updates its information based on your new comments and they told me to send you their greetings
I will give you a promise that I will not write any questions after your answer, but I will only include the result of the test
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Everyone with HIV symptoms has a positive blood test within a few days of onset of symptoms. Therefore, if your symptoms at 10-14 days were due to HIV, your blood tests would have been positive at both 21 and 28 days, and probably at 16 days as well. In other words, the negative results prove a) you did not catch HIV and b) HIV was not a possible cause of your symptoms.

I look forward to hearing your final test result and will not have anything more to say until then. As I said, you can count on a negative result. Believe it.

45 months ago

Hi Dr. Hunter 

Thank God. after 65 days I had the test of the combo and the result was negative I thank you very much, Doctor. Now I'm supposed to be not worried about hiv?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Congratulations. No surprise, at least not to me -- and from our previous discussion, you also should not be surprised. You definitely do not need to worry about HIV.

Best wishes and stay safe.