[Question #363] Are my test results conclusive?

34 months ago
Hi Drs unfortunately I am writing to you one last time for confirmation that my test results are 100% conclusive. I was informed that they were once already and have had unprotected sex with my wife since, but have been still unsure about my results. My sexual Exposure was one time unprotected receptive anal with a guy of unknown HIV status. My tests were
12 days post Exposure RNA TMA-Negative
40 days post exposure RNA TMA and 4th generation duo- Neg
52 days 4th generation duo- Neg
62 days RNA TMA and 4th generation duo- Neg.
72 days 4th generation duo- Neg
84 days 3rd generation antibody- Neg
90 days 4th generation duo- Neg
Theses tests were all performed by Labcorp and were FDA approved. My questions are
1). Can I consider these 100% and move on?
2). What are my chances of them turning positive after three months( have you seen or heard of this)?
3). I've been told by one place that the 4th generation rapid test they offer is conclusive after 16 days and another place that offered a 3rd generation rapid test to come back in a year. The CDC says 97% in 3 months and the rest by 6 months. Why the difference?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
There have been two or three questioners with username John and I haven't tried to review whatever previous questions you had. But if Dr. Hook or I have previously reassured you that your many tests were valid and that you don't have HIV, the answers won't change. We havent changed our minds! Anyway, since you have been told it before, my replies are very succinct.

1) Your results are 100% reliable. You have been seriously overtested; every test following those at 40 days were superfluous, unnecessary, and wasted money.

2) Zero.

3) Nobody on this forum ever said the 4th generation test is conclusive at 16 days. It is conclusive at 4 weeks and beyond. The 3rd generation tests (antibody only) are conclusive at 6-8 weeks, and nobody knowledgeable recommends waiting a full year. As for CDC's advice, it is a) legally conservative and b) somewhat outdated, based on older tests.

Best wishes--  HHH, MD
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34 months ago
Sorry Dr. I should have been more specific about the 16 day 4th generation window. There's a STD HIV testing organization in the state that I live that offer a rapid 4th generation duo test that is conclusive at 16 days post Exposure. I just thought that was interesting especially when u drive a mile to another STD clinic and they say 6 months to a year for the 3rd gen rapid test. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
There are only a couple of 4th generation tests available in the US, and none that are conclusive at 16 days. You either misunderstood the information from the testing organization or missed a disclaimer; or they are posting misinformed marketing hype. Such tests may indeed be conclusive as early as 16 days and they certainly are very close, but that's not what most experts believe or say.

There are no regulations or rules about what various experts health education materials can say. And there are no definitive data on exact test performance, only the scientific principles behind each test, limted real-world testing, and statistical models based on limited data. So there is plenty of room for experts to lean one way or another, or for particular agencies (e.g. CDC) to take a very conservative stance, as does anyone who advises any kind of testing beyond 3 months (not counting testing after post-exposure prophylaxis). The fact is that virtually nobody who cares for HIV infected people or who frequently evaluate persons at risk has ever reported seeing a patient with negative results of 3rd gen antibody tests at 6-8 weeks, or 4th gen at 4 weeks, who later turned out to have had HIV.

It's definitely time for you to move on and stop wasting money on additional testing.


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34 months ago
Drs I just recently had a 4th generation duo at 4 month post exposure just to be sure I tested outside the 3 month window. Of course it came back negative. From all the testing I've had done with the negatives and time frames can I have unprotected sex with my wife?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
With the 4th generation (duo) test, there is no 3 month window. The window is 4 weeks. As I said above, "every test following those at 40 days were superfluous, unnecessary, and wasted money". That also applies to your more recent 4 month test. As I said over 2 weeks ago, "It's definitely time for you to move on and stop wasting money on additional testing."

You definitely can resume unprotected sex with your wife. You should have done so a couple of months ago.

So all is well. Do your best to stop worrying. And for goodness' sake, stop testing!!!

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