[Question #2460] When are STD tests conclusive?

44 months ago
Hello,

I just recently started a new relationship and my new girlfriend encouraged me to get tested from past exposures.  I was tested from 6 weeks, 4 months, and 6 months from my most recent exposure for HIV, Hep B, Hep C, Syphilis, Chlamydia, and Gonorrhea and tested negative for all. Does this cover majority of STDS? I have never experienced any symptoms that I have noticed. The tests were done through Quest Diagnostics. I do know the RPR test was done for Syphilis and the 4th gen antibody test for HIV. I just wanted to ensure my results were conclusive. Also, is the RPR the correct test and is it accurate at those time frames?

Thank you for your time. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome to the forum. Thanks for your question.

Congratulations to you and your partner for your responsible approach to sexual safety. Your test results are conclusive -- indeed, you were overtested. All those tests were conclusive at 6 weeks; the 4 and 6 month tests were unnecessary. Hepatitis C testing wasn't needed at all, unless you are bi and have had potentially traumatic anal sex with other men:  that's the only group in whom sexual transmission of hep C has been clearly documented. The RPR indeed is the ideal test to screen for syphilis and is valid any time 6 or more weeks after the last possible exposure.

I'm assuming your gonorrhea and chlamydia tests were nucleic acid amplification tests (NAAT, i.e. DNA testing) on urine. Some labs offer blood tests for gonorrhea and/or chlamydia, but these tests are definitely not reliable.

I hope this information is helpful. Let me know if anything isn't clear. Best wishes for a rewarding new relationship!

HHH, MD

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44 months ago
Hello, 

You are correct doctor the chlamydia and gonorrhea tests were urine tests. Everything else was blood tests. I appreciate your expertise. I am glad I found this forum because it was difficult to figure out what information was reliable on the internet. My final question is 4th generation hiv antibody tests test for all subtypes correct? 

Thank you again and have a great rest of your week.
44 months ago
Hello Doctor,

I apologize I have actually one last final question.Do these tests give me conclusive results for exposures that have happened over 5 years ago?

Thank you again and this is my final question I promise. Have a great weekend.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Oops -- sorry for the delay in getting to your first follow-up question.

Yes, the 4th generation HIV tests cover all HIV subtypes. If there are any exceptions, they are exceedingly rare and essentially absent in the US and other industrialized countries -- although such subtypes account for some infections in the areas of Africa where HIV first evolved, and even there they are rare.

Once positive, except for chlamydia and gonorrhea, all these tests remain positive for life and thus are assurance against infection 5 years earlier (or any other time excpe the few weeks before testing).

You have one more follow-up question available. I'll leave the thread open a few more days in case something comes to mind.

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44 months ago
Thank you for your response. Since I have one more response I will use it. I just feared I tested too late. Based on your responses, i take it there is nothing for me to worry about and I should forget about it? 

Thank you again and I truly appreciate your responses.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Chlamydia and gonorrhea tests become negative over time, as the immune system cures the infections, usually over a period of 3-12 months. And it is possible (although very unlikley) that a syphilis blood test can become negative over several years, without treatment. All other blood tests, once positive, remain positive for life. So definitely "there is nothing for me to worry about and [you] should forget about it".

Thanks for the thanks about our services. Best wishes and stay safe.

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