[Question #2263] Hiv question and testing - Dr Handsfield / Dr Hook

98 months ago

Dear Drs,
Thank you for the wonderful service and I hope you can help me as i'm losing it.
9 weeks ago i had an unprotected vaginal sex, exactly 2 weeks later i got a flu for 3-4 days and a mild fever for 2 days.
6 weeks ago I was at party where some drug users were, was drunk and a fight got on. I got injured by one of them on the back of my hand (not a major wound/puncture but still it was bleeding) it was chaos and i didn't know with what i was injured (syringe or sharp thing)... the panic and anxiety started here !
2 weeks later i developed a rash on my legs (diagnosed as keratosis Pilaris) had a headache that stayed for more than 4 weeks, loose stool/constipation and lost around 5 kgs of my weight, loss of appetite and feeling weak . i don't know if it is anxiety as i'm under immense stress due to hiv thinking and searching...
I got 2 hiv rapid test (no clue what's the generation- sure it's not 4th gen.)
1 at 4 weeks after the unprotected sex
2nd one after 6 weeks from the fight (and 8 and half weeks from the unprotected sex)
The nurse told me that after 6 weeks no further test is needed and i'm safe... but honestly after reading the internet i'm freaking out... i live in an arabic country and you can imagine what will happen if i'm +
what are my chances ? and are my tests conclusive ? can i at least say that the symptoms are not due to hiv ? as my tests are more than 3 weeks from the start of them ?
Thank you a lot all the way from Lebanon :)

Edward W. Hook M.D.

98 months ago

Welcome to our Forum. I will be glad to comment. You are in the clear. I understand just how easy it is to assume that a flu-like illness or headache after a possible exposure can make a person nervous but all of these sorts of symptoms can be cause by many things other than HIV. In fact among all people with such symptoms, HIV causes far less than 1% of them (this has actually been studied).

In your case, more importantly, you can be completely sure that your symptoms are not due to HIV since the onset of symptoms of the ARS mark the development of HIV antibodies. Further, I would consider your results conclusive. Certainly, no matter what test was done, an negative 8 week test is strong evidence that you did not get HIV and for most of the world, use of combination HIV antigen/Antibody tests are standard tests making your results all conclusive. I would not worry and hope that my comments will be helpful to you in addressing your concerns. EWh

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98 months ago

Thank you Dr Hook for your Reply,
But I think you missed one point, my test wasn't a 4th generation ... it was a rapid test which i don't know what generation it is.
My last test (the rapid test) was done after exactly 6 weeks from the second exposure (41 days to be exact)
If my symptoms were due to ARS, will the rapid test be positive after 2 to 3 weeks after they start (the symptoms) regardless of the generation ?
How much faith should i put in a 6 weeks rapid test ? is the nurse right to tell me it's conclusive
I'm sorry i'm asking too much questions but it's killing me lately...
Thanks a lot for your help ! Really Really appreciate it :)

Edward W. Hook M.D.

98 months ago

Actually, I did not miss that. There are widely available rapid 4th generation tests in much of the world and even if this was a 3rd generation test (which it was at least, for sure), at 6 weeks in the neighborhood of 95% of recent HIV infections will be detectable. Further, as I said, if your symptoms were due to HIV, your rapid test would have certainly been positive within a week (and probably less) of the onset of your symptoms -this is true regardless of the test generation. Thus, given your situation, I would agree with the nurse who told you that you really had no reason to continue to worry. EWH
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98 months ago

Thank you a lot Dr Hook,
In fact it was an honor that you replied to my post. have a great day

98 months ago

Sorry it seems my pc somehow deleted my last question.

Would your reply be the same even if it was a 2nd generation rapid test (finger prick) ?

No further testing available right ?

Thanks again :)

Edward W. Hook M.D.

98 months ago

To my knowledge 2nd generation assays are no longer used anywhere. Even if your test were a 2nd generation test however, my answer would not change. You need to put these concerns behind you.

This 3rd reply will complete this thread which will be closed later today. Take care. EWH

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