[Question #3729] Oraquick

33 months ago
How accurate are 4 negative home gum swab oraquick tests be.  Took one march 27, April 2, April 15, and April 22, 2018.
Had  low risk exposure on November 2017.  I hear they are not reliable?
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Welcome to the Forum.  I'll be glad to comment.  You don't say much about your exposure as to just how low risk your exposure it is so I can't be too specific but I would have confidence in your results.  Admittedly, the OraQuick, oral tests are not our favorite tests because they test only for HIV antibodies so results are not conclusive as soon as the results of the more current combination HIV antigen/antibody ("duo") tests but by 12 weeks results of the oral tests are quite reliable (results of the combination tests are conclusive at 6 weeks vs. 12 weeks for the Oral tests).  In addition, in very, very rare cases, they may miss an infection but when compared to other commercially available HIV antibody tests there is no significant difference in performance.  Further, if you get the same result repeatedly, this tends to eliminate any chance that the test was done wrong.  Thus, following a low risk exposure, I would encourage you to believe your test results and not worry further.

I hope this makes sense.  If there are questions or parts of this are unclear, please feel free to use your up to 2 follow-up questions.  EWH
---
33 months ago
Thank you Dr Hook,    Reason for testing is the following:
In early December 2016, I developed burning sensation,  some form of neuropathy or neuropathic pain, in my feet.
It got worse over the next few months.  Right foot the worse,  no cause found.  I tested in Jan, feb, march, April, 2017, after symptoms started for HIV 4th gen tests,  they came back negative.  These symptoms went away in June last year, but returned in December last year,  so I did those four oraquick tests just recently just to be sure.  also last year I did an HIV  1 RNA qualitative test, in march 2017,  also Negative.  I just wanted to discard HIV as the culprit?  Hope I'm not wrong?.
Also,  last April, 2017,  on a 10 panel STD check,  herpes 1 positive, herpes 2 positive, without an outbreak ever?, so was surprised,  so I started to think maybe this silent herpes is causing these symptoms?  just sent my sample today to have the WB 
test.  My doctor says why in testing since he won't prescribe antiviral without symptoms,  I'm just doing it for piece of mind,
The exposure in November was oral sex.  












Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
thank you for the additional information.  It provides useful context.  I suggest you remember that your OraQuick tests are not the only data you have but can be considered in the context of a VERY low risk encounter -  am not aware of ANY scientific evidence that anyone has EVER acquired HIV through receipt of oral sex.  There are a small number of cases in which HIV has been acquired through performing oral sex on infected partners but these are very, very rare.  Your data showing that HIV is not a consideration are not only your OraQuick results but your RNA test and your multiple combination HIV antigen/antibody tests (presuming these were all done after your encounter of concern).  Putting this all together, I would say that you have proven that you do not have HIV.  there is no reason for further testing.

Neuropathic pain has many origins of which infections are minor contributors.  Whether or not you have herpes, again, your symptoms are not suggestive.  I would suggest you look for other reasons for your neuropathic pains.  EWH
---
33 months ago
Thank you Dr .  The only exposure I had after all those tests last year was the oral exposure in November, the tests were done 
 Between  jan and April, 2017.  That's why I took the oraquicks to make sure about the oral exposure,  these four oraquicks were negative.    it has been years, over 9 years, since I had a risk exposure,   So the exposure I was concerened was the one in november.
I was concerned because the symptoms,  only one I have, otherwise I'm healthy, other than high blood preassure and anxiety,
Went away and came back, so HIV came back to mind.
I was told that since I tested negative last year, that would eliminate hiv as the cause.  even though symptoms returned. 
Hope it is correct?
So the oraquicks I took was to eliminate the possible low risk oral exposure in November last year.
1. Hops these are not false negatives,  did not see anything on the T line,  hope I'm not supposed to scrutinize the test.
2.  Should I feel confident that HIV is not the cause?
3.  Was concerned about this silent herpes,  , so feel confident that herpes is not the culprit?  
4.  was told HIV RNA 1 qualitative test  is not reliable, is that true.  , if it's reliable, I hope that also excludes HIV as the cause,
I read it checks for the virus itself?  I was hoping that would also excludes the symptoms last year from a HIV.
Thank you Dr  Hook.






Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Thanks for the additional information.  You have eliminated HIV as a possible consequence of your November exposure and as a possible cause of your symptoms.  In answer to your specific follow-up questions:

1.  There is no need to scrutinize the T line.  Believe your negative results.   
2.  Yes, be entirely confident that you do not have HIV and that it is not the cause of your symptoms
3.  Correct.  Test interpretation of blood tests for herpes has many pitfalls so getting the WB is a good idea but irrespective, you can be confident that herpes does not cause symptoms of the sort you describe.
4.  The HIV qualitative RNA PCR does test for the virus itself and a negative proves that you do not have HIV, confirming the other testing you have done.  The problem with the RNA PCR is that is sometimes gives falsely positive results, not that it misses infection.

Bottom line, you are in the clear. 

This is my 3rd reply to these questions.  Thus, as per Forum guidelines, this thread will be closed later today.  Take care.  EWH
---