[Question #381] Question about HIV test

95 months ago
This is about question #69

It's now 5 months from the stupid thing I did and 4 months since I was tested by a Roche Combo Ag/Ab 4th generation test, and like I told before, it came non reactive, thanks God.

I have some questions:

1) Is it possible to have a false negative at 28 days ?

2) What are the chances of not having any ARS symptoms if someone is positive ?

I'm asking this because my GF had an herpes incident on her leg one month ago and neither she or I had nothing before.
I never had an herpes incident that I can remember before. I'm worried about this, but even more with any possibility of my HIV test had a false negative. I know my questions are a bit confusing, but I need peace of mind and your advice. I'm very anxious about this.

Edward W. Hook M.D.
95 months ago

Welcome to the Forum.  HIV tests are the most reliable way to find out if a person is infected and results of 4th generation, combination HIV antigen/antibody tests provide reliable results at any time 4 weeks (28 days) or more after an exposure.  False negative results virtually never occur except in persons who have taken anti-HIV medications (called post-exposure prophylaxis or PEP) after exposure. Believe your test results and move forward without concern,.

As for the possibility of getting HIV without having the ARS symptoms, exactly how often this occurs is debated but most experts agree that somewhat around half of persons who acquire HIV will not develop the ARS when they become infected.  Just as in herpes, there are many people who become infected without recognizing symptoms at the time their infection is first present.

I hope this is helpful.  From what you say above, you should be comfortable that your HIV tests are accurate and you did not get HIV through activities occurring 28 days before testing.  There is no need for more testing related to that exposure.  EWH 

95 months ago
Dr.Hook, thanks for your explanation.

This means that not having ARS is also a good thing but also means nothing in terms or having HIV. On the other hand, I see it's very complicated or even impossible to diagnose HIV based on ARS symptoms, and the real deal is to get test at 28 days or more. Only this will tell if someone is or isn't with HIV.

The only thing that makes me mad is the mix bag of recommendations for the window period for the 4th gen test. If you say 28 days will give a conclusive result and impossible to have a false negative for people with good health and not taking PEP, it's ok for me, and closed case about this aspect. But I think all this confusion about this from different sources on the internet have the potential to make people crazy and anxious.

Just a few more questions:

1) What's the window period for HEP-C and Syphilis testing ?

2) Is it possible to catch Syphilis and not having the primary and secondary lesions , fever or swollen nodes ?

Thanks for your patience and time. 

Edward W. Hook M.D.
95 months ago

Correct- the "real deal" is defined by test results.  Testing at 28 days will provide you with definitive results.

As for hepatitis C and syphilis, testing at 3 months following exposure will provide definitive test results. Hepatitis C is not sexually transmitted through heterosexual sex and syphilis is quite rare among heterosexuals. 

For all effective purposes, syphilis always leads to lesions at the site of infection. 

I really think you are worrying more than you need to.  EWH

95 months ago
Thank you Dr. Hook for the explanations. I'm ok now, you cleared my mind about this subject.

I wish you a happy new year, and also for all the ASHA staff.