[Question #4136] Follow up - Question 4006 - 16 weeks

30 months ago
Dear Doctor 

greetings from canada

4 weeks ago i had asked a question regarding my exposure which occurred in india (blood on penis from hand job and protected handjob) 

Dr Hunter had mentioned that certain medication (advair , antihistamines ) i was taking may have trivial or no immunosuppression. It would have no impact on the testing of HIV 1 as the antigen would increase if the antibody production was delayed. I was particularly concerned as you said seroconversion of HIV 2 is longer and has no detectable antigen in 4th generation test. 

Today on 16 weeks after exposure  i took another test - 4th Generation. 

1.  Is that enough to rule out HIV 2 - in the event that trivial immunosuppression took place and my body didn't create enough antibodies (or delayed production)  against hiv 2 or any other strain of HIV which has no antigen . 


Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome back to our Forum although I am saddened that you felt the need to return regarding the exposure you describe.  I read his reassuring responses to your questions and agree with all that he said.  Dr. Handsfield told you in your earlier interaction that you could be confident that you did not acquire HIV-2 from the exposure you described.  That is all the more true now, nearly 4 weeks later.  I urge you to believe your test results.  You did not acquire HIV from the exposure you previously described.  It is now time to move forward without concern.  EWH
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30 months ago
Well actually - my wife and I were trying to start a family before this incident happened. We want to try to get back to that .
I wanted to be completely sure before we try again . That’s the reason for my question
In cases where immunosuppression takes place due to medicines - antibody production is delayed to what time ? 
Is 16 weeks enough in these cases .  I guess only hiv 2 is concerning as 1 would have the p24 antigen 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
As I have already told you, your exposure was a no risk event and your testing now proves that you were NOT infected.  This statement is true for both HIV-2 and HIV-1.  The effect of immunosuppressive medications is theoretical and the medications you mention are not immunosuppressive.  You need to believe your tet results and stop worrying.  EWH
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30 months ago
Hello doctors 
I developed a high fever today again - it was at 100.5 
I took an HIV rapid yesterday today and I was shocked as the result came indeterminate. My wife and I were completely shocked. It rocked our world. 
Today I went to a lab and got two 4th generation tests and at 18 weeks post exposure they were both negative . 
1. Can I overlook the indeterminate test ? 
2. Is the 18 week HIV test negative at a lab enough to continue moving on 
3. Do I need more.tests. I took eye drops thrice in the last three which contain dexamethasone - . Will this impact my test ? 
30 months ago
I mean could the dexamethasone containing eye drop taken thrice in three months cause delayed seroconversion? 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
1.  Most I determinant tests turn out to be negative and do not reflect infection.  Given the nature of your exposure, I am confident that this will be the case for you.   Nonetheless you now need further, laboratory-based testing for HIV.  When it is negative, I urge you to STOP further unnecessary testing as more testing just increases a person's chances of additional, rare events such as what I expect has happened in your case..
2.  See above.  When your follow-up test is negative you need to stop testing and move forward.
3.  Dexamethazone eye drops would not delay development of a positive HIV test.

I suspect your experience is a good example of why we urge patients such as you to not test unnecessarily.  Even with very good tests, rarely there are false positive or I determinant results.  

This completes this thread.  I will be off line for the next 8 days.  Take care.  EWH
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30 months ago
Doctor I think you misunderstood. Pls give a final reply before you go offline . Pls 
1. I took the rapid test yesterday - it was indeterminate
2. 24 hours after that - I took two lab based 4th gen tests and they were negative 
I assume that is enough follow up testing and don't need more 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Thanks for the clarification.  Be.ieve your lab tests and stop testing.  No more followup needed.  EWH---