[Question #3840] Tests turning positive after 6 month negative results for ANY HIV?

34 months ago
Hello.  Still nervous about encounter and went and tested the other week:
-25 week rapid test
-26 week LAbcorp 4th gen-Advia centaur
-27 week Quest 4th gen Abbott Architect
ALL were Non-reactive
I to this day have sore throat, lean muscle mass loss, pain behind the knees and some jaw pain, and various other symptoms.  I feel I have tested as much as possible and wanted to clarify a few things on testing.
1)If i was infected years ago(although I tested once a year for the past five), could I STILL be showing a false negative on the test because someway or somehow I am not making antibodies?
2)If I was infected years ago OR most recently as said above, is it possible that ALL my tests prior as mentioned in previous post as well as these could show negative with a subtype or strain not detectable by the tests?
3)Can it take longer than the 6 months now that I have tested to be ABSOLUTELY sure about negative status or can I confidently rely on those most recent tests?
4)If it were HIV-2 , would antibodies be formed by 6 months or need to wait longer to be sure( I see some say ONE YEAR!)
5)My exposure may have only had a "small amount' of virus exchanged, would that make a difference at 6 months or delay longer for any type of HIV?
6)Should i feel any hesitation in terms of risk to my wife and sex?
7)What else can I do or need to do, and when, to make sure WITHOUT question, that I am not HIV positive?
8)Can i feel confident that any and all symptoms, no matter what they are, are in no way related to hiv?
Thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome back to the forum. But I'm sorry to see you found it necessary.

The main point of Dr. Hook's reply a few weeks ago also is the crux of my response:  The HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition. They are never falsely negative if enough time has passed since the last possible exposure, and that time is never more than 6 weeks (or maybe up to 3 months for some of the older antibody-only blood tests). As a result, the test results always overrule exposure history and symptoms. Someone could describe the highest imaginable risk, say receiving an IV injection of known infected blood, or receptive sex with a known infected partner with high viral load. Or could describe absolutely typical symptoms of HIV or of various opportunistic infections that mark someone as having AIDS. If the HIV tests are negative, that person does not have HIV. There are no exceptions:  you can read about various medical conditions or drugs that in theory might interfere with test interpretation, but all these are theoretical, with few if any proved exceptions.

So as implied by those comments, you can be 100% certain you do not have HIV. But to assure there is no misunderstanding, here are replies to your specific questions.

1-3) Nope. These scenarios are not possible.

4) With the currently recommended, routine HIV tests (3rd generation antibody test or Ag/Ab 4th gen tests) HIV2 antibody is always detectable within 6 weeks.

5) The amount of HIV to which one is exposed has little or no effect on time to posiitve test results.

6) You should be continuing all your normal sexual practices with your wife. There is no way you have HIV or can infect her with it.

7) There's nothing else to do, except perhaps consider professional counseling to figure out why you are having such difficulty despite the overwhelming scientific evidence and science-based advice you have had, not only on this forum but probably from your own doctor(s). Often such feelings reflect unresolved guilt over a regretted sexual decision.

8) Yes.

I hope these comments help you move along without further worry. Let me know if anything isn't clear.

34 months ago
Thank you. What worries me still to this day is the illness(truly physical and not mental) that I feel.  Instead of going through all, I will just ask in a question format to make it easier.
1)If HIV-2, surely antibodies would be detectable by 6 months?
2)Does it ever take a PCR/viral load to diagnose HIV past 6 months exposure? Either HIV-1, or HIV 2
3)Is it possible tests used in US may miss imported/variant type(N/O/P/CRF)at this point in time( 6 months)?
4)Can you get new node swelling/other symptoms at 6 months and have negative tests still?
5)In terms of late seroconversion, you say it doesnt happen, does that go for any type of HIV?
6)If only talk about the AB part of test(P24 may be temporary), is 6 months absolutely conclusive for ANY type of HIV and no more need to test ever without another exposure?
7)I generally feel "ok", but with all prior years tests(5+ years or more), advanced HIV without AB production is not possible for HIV 1 or 2?
8)I know one can never be 100% certain in medicine, but with all my prior PCR and now most recent tests, can I without question put a fork in it, and whatever I experience in illness/symptoms, no matter how classic, or as some specialists say, may I have to test again up to a year?
I want to resume normalcy, but worried that some way, it possibly is being undetected.  If it weren't for symptoms for so long I would not worry, but they have now been going on WAY too long(6 months off and on).  I understand you deal with alot or worried people, but with this disease, I need to know without any question that I have done everything in my power to rule out, for fear of doing harm to others.
Thank you

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
You're re-askng the same questions in different words. The answers have not changed. There must be a hundred medical conditions that cause symptoms like yours. Whatever the cause, your test results prove it isn't HIV. Believe the science, and the science based reassurance you have had, not only on this forum, but undoubtedly from your own doctors.

1) Yes.
2) No.
3) No. This is an urban myth.
4) No, not due to HIV.
5) Yes, any and all HIV types.
6,8) Yes, always conclusive and never any need to retest.
7) Correct.

You should consider professional counseling. It is not normal to be so unconvinced in the face of such overwhelming evidence. I suggest it from compassion, not criticism. In any case, please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions on these symptoms, your concern that HIV may be the cause, or HIV testing will receive no replies, without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
One more comment:  your statement "p24 antigen may be temporary" is based on a basic misunderstanding of the Ag/Ab tests. The reason p24 become undetectable in blood is because the antibody clears it out. That is, it is the antibody component that makes p24 "temporary":  if antigen is gone, antibody must be present. That's exactly the reason these tests were such and important advance:  once p24 antibody appears, from then on, for the life of the infected person, either p24 or antibody is detectable. There are no exceptions.