[Question #4088] Follow-up from question #3624

32 months ago

Hello Dr. Handsfield,

 

After the bad experience with the blood drawn to my wife, we followed your advice on question #3624 for not testing due to the minuscule risk for HIV or any other STDs and now we are very happy to let you know that after we started unprotected sex to conceive my wife became pregnant!

 

Now at 6 weeks of pregnancy she had her routine 1st trimester testing at the hospital lab including HIV 4th gen, Hep B, C & Syphilis, and all the test came back NEGATIVE!

 

So, considering the timeframe, this 4th generation HIV Ab/Ag Architect test was done 6 months after the incident to my wife, and our doctor is telling us that this Negative test completely confirms that no infection happened at all (as you said before), and that no other test is required since there was no real risk to begin with.

 

I only have some questions regarding the 4th generation Architect Ab/Ag HIV test:

 

1. Is this HIV test conclusive at 6 months? even now that she is 6 weeks pregnant?

2. Can pregnancy affect HIV testing reliability showing a false negative after 6months?

3. My wife has always had white blood counts in the 4.2 range (even now at her 6 weeks pregnant screening) which doctors tell us are in the normal range (3.5-10.5), and her immunoglobulins IGM, IGG and IGA are in the normal range as well (she got this tested last year on a health check package), so, will this mean that she has normal production of antibodies making her test conclusive at 6 months?

4. Is it possible for a person to not develop antibodies to HIV by 6 months or for a 4th generation test to not detect either the antibody or the antigen at 6 months even on a pregnant woman?

 

We are extremely happy for this negative test result and ready to completely move on! I just want to be sure that no other test is required and that my wife and new baby are safe from this bad experience (minuscule risk) that happened 6 months ago.


Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Welcome back  to the Forum.   All questions regarding herpes go to Ms. Warren and Dr. Handsfield and I split all other questions.  As it happened, today I happened to pick up your question.  As an FYI, having worked closely for over 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary.  I will be addressing this question.  While I understand that pregnancy can raise one's anxieties regarding past exposures adn appriciate your desire to have the safest possible pregnancy, I agree with all that Dr. Handsfield said and there really was no need for follow-up.  Your results were definitive before.  To address your current, somewhat repetitive concerns:

1. Is this HIV test conclusive at 6 months? even now that she is 6 weeks pregnant?

Yes, they were conclusive 6 weeks after exposure.  Pregnancy does not change this.


2. Can pregnancy affect HIV testing reliability showing a false negative after 6months?

No, not at all.


3. My wife has always had white blood counts in the 4.2 range (even now at her 6 weeks pregnant screening) which doctors tell us are in the normal range (3.5-10.5), and her immunoglobulins IGM, IGG and IGA are in the normal range as well (she got this tested last year on a health check package), so, will this mean that she has normal production of antibodies making her test conclusive at 6 months?

See above, her test was and is conclusive.  Repeating the question does not change the answer.


4. Is it possible for a person to not develop antibodies to HIV by 6 months or for a 4th generation test to not detect either the antibody or the antigen at 6 months even on a pregnant woman?

No.


I hope these answers are helpful. You are in the clear.  EWH


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32 months ago

Thank you for your answer Dr!


Maybe there is some misunderstanding but the issue on our original question #3624 was not about our previous partner exposures but rather a potential incident that happened to my wife 6 months ago with a very bad procedure from a nurse that drew blood from her for another test nothing to do with STDs.


This negative HIV test now to my wife is the first one she´s ever had after the "incident" from that bad blood drawn procedure that happened 6 months ago, this test is part of her routine pregnancy checkups for the 1st trimester, so I don't understand when you say "your results were definitive before".


Just for knowledge and to clear some misconceptions, could you guide me on the following?:


1. Can you recheck our previous question #3624 to Dr. Handsfield just to be sure we are talking about the same issue? and re-confirm that your answers will be the same as stated above?


2. Do you agree with our doctor that this negative 4th generation test (only one she’s ever had) after 6 months is conclusive without the need of further testing during this pregnancy or after?


3. One week prior to her testing, I applied to the house a home depot product called Ortho Home Defense Insect Killer for Indoor, which has bifenthrin as active ingredient and states is safe, but my wife complained that the smell was really strong and she got a headache and stomach issues after (probably not related); could this product affect her immune system temporary and thus the reliability of the architect HIV 4th generation test by decreasing or eliminating temporary the antibodies? Is something like this (loosing temporary the antibodies) even possible? Or do they persist for life without any medication or product affecting them after being developed by the body?


4. Also, I read on another answer by you (on question #4078) that some people tend to be missed by HIV tests, can you explain what these situations are? Or does that refer to antibody testing only? Are we still in the clear?


Thank you Dr!



















32 months ago

Hello Dr., I read your answer again and I think I understand now what you meant with "Your results were definitive before", you meant definitive before the 6 months right? not because you though my wife had another HIV test before this one, correct?

Please let me know your insights on the other questions I sent on my reply. Thanks for all your support!



Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
I really think you are overthinking this.

I remember your concern about the possibility of a contaminated blood draw, an event which has NEVER led to infection in the past 20 years.  Regarding your follow-up questions:
1. Can you recheck our previous question #3624 to Dr. Handsfield just to be sure we are talking about the same issue? and re-confirm that your answers will be the same as stated above?
No, I will not.  Dr. Handsfield and I have not disagreed on our assessments or the information we provided in the past 35+ years. 


2. Do you agree with our doctor that this negative 4th generation test (only one she’s ever had) after 6 months is conclusive without the need of further testing during this pregnancy or after?

Yes


3. One week prior to her testing, I applied to the house a home depot product called Ortho Home Defense Insect Killer for Indoor, which has bifenthrin as active ingredient and states is safe, but my wife complained that the smell was really strong and she got a headache and stomach issues after (probably not related); could this product affect her immune system temporary and thus the reliability of the architect HIV 4th generation test by decreasing or eliminating temporary the antibodies? Is something like this (loosing temporary the antibodies) even possible? Or do they persist for life without any medication or product affecting them after being developed by the body?

There is no reason to think that the insecticide you used would cause a falsely negative test.  There is no such thing as temporarily loosing antibodies.  Once present in persons with HIV the antibodies are present lifelong. 


4. Also, I read on another answer by you (on question #4078) that some people tend to be missed by HIV tests, can you explain what these situations are? Or does that refer to antibody testing only? Are we still in the clear?

This is a problem with all tests if the testing is done too soon.  The period before tests become positive depends on what is being measured.   Tests that detect antibodies tend to take longer (8-12 weeks) to become positive than test that detect both antigen and antibody (6 weeks).


EWH


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32 months ago

Thank you for your guidance and answers Dr. Hook!

 

You have no idea how relief we feel knowing from an expert like you that this negative 4th generation test reassures and confirms once and for all that my wife was never at real risk and that we can continue with our normal lives without the need of other test as this was completely conclusive!

 

I told your confirmatory good news to my wife and we are immensely thankful and happy that we can erase that bad experience form our minds FOREVER!

 

We will take good care of our family and of our upcoming baby and will also learn from this experience to be more mature and educated in order to not be fearful of medical procedures like giving blood or go for blood tests as they do not possess any real risk of transmitting STDs when done within established facilities in the health care system.

 

I personally want to thank you for your patience and I want you to know that your work helps enormously in our society as there is a lot of wrong, outdated and pretty much fake information about STDs out there! Specially over the internet.

 

Please send our regards to Dr. Handsfield as well from one more happy family!


Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Thanks for your thanks.  Our goal here is to help persons who visit our site.  I'm glad my responses have helped you.  Your comments are much appreciated. EWH
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