[Question #255] HIV testing

108 months ago

Hi there, first off I would like to commend the job you guys do! I'm a 32 year old male from the UK. My possible HIV exposure occurred some two and a half years ago. I have been thinking about it a lot recently and have the following questions if you would be kind enough to answer them.

First off My exposure was from sex with a female sw in Prague (very drunk embarrassing mistake). I did wear a condom but it split. I have tested negative with 4th generation test at 11.5 weeks (at which point I tested -ve to all sti's), two insti tests at 6 months and three further 4th generation tests at 8.5months, 10.5 months and finally 18 months. Then down to my anxiety I then had pcr test at 2 years which was also negative.

My questions are:-

I had a two week course of antifungal tablets (ketoconazole) at week 9 - 10 post exposure and I was wondering whether this would have effected my result of the test that was taken at 11.5 weeks (I.e, lack of antibody production) and if so surely the other later tests would then still have been ok?

When I had the insti tests at 6months two tests were carried out as I was convinced there was a 'mark' on the membrane during the first test (nurse said it was -ve) although the second one was clearly negative. Presumably my subsequent tests after this are further reassurance there can't have been anything wrong with the first insti test. (I.e if a person becomes positive for antibodies this should stay positive on all subsequent tests)? Or can antibodies dissapear and not show up on later tests? Really worried about this first test where I was convinced there was a small 'mark'.

I know these questions are probably driven by anxiety but have been niggling me for a while now and would appreciate your view on the above and whether all of my excessive testing is very much conclusive.

Edward W. Hook M.D.

108 months ago

Welcome to the Forum. I will be please to comment and hope that in doing so I can provide you with the assurance needed to move forward without concern. There are no data whatsoever to suggest that ketoconazole has a negative effect on antibody development. Please remember that most commercial sex workers to not have HIV and even if your partner did at the time your condom broke, HIV is transmitted through sexual contact, on average, only once for every 1000 exposures. In your case, you have now been tested 7 times using different methods and there is no evidence that you are infected. You can be completely sure at this time that you were not infected by the encounter that you describe. There is no reason for concern and no reason for further testing. I hope that this emphatic statement will be helpful to you. EWH
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108 months ago

Thanks for your response doctor.

I will take your advice and try to move on.

Can you please confirm that in the very rare case that antibodies don't develop an individual would be very very sick within a short period of time?

Thanks again

108 months ago

Can you also please answer my question regarding antibodies for complete piece of mind. (I.e would they stay for life in an infected individual?)

Thanks doctor

Edward W. Hook M.D.

108 months ago

I am not sure what you were asking. If you did not produce antibodies you would have become infected with the sort of bacteria that we co-exist with all the time and died. Further, even if you did not produce antibodies, your PCR test would have been positive. There is just NO way that you could have HIV. From the exposure you describe given your test results. EWH---

108 months ago

Thanks a lot doctor.

Really appreciate you taking the time to answer my questions.

108 months ago

Sorry one last question! Can hiv antibodies appear and then dissapear after a year or so?

Edward W. Hook M.D.

108 months ago

No, when a person is infected with HIV, the continue to have detectable antibodies to HIV throughout the duration of their life.

This will need to conclude this exchange, per Forum guidelines. Take are EWH

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108 months ago

So let's just say the test I was concerned about (I.e the first insti test where I was convinced there was a mark on it was +ve) would this be impossible as there was 4 antibody tests after that were -ve and PCR was -ve? Please answer this one last question to ease my anxiety.

Edward W. Hook M.D.

108 months ago

Whatever you saw with your first insti test was not HIV. Your subsequent results prove this. EWH---