[Question #4236] When is HIV-2 Eliminated with tests?

31 months ago
Hello and I apologize for returning but symptoms continue without a dr figuring it out. I also continue to lose weight even though I eat when I can.   I "think" I have eliminated HIV-1 with all tests(Do you think?).  The latest few tests I have had were: 16 week HIV-1 viral load/qualitative, 26/27 week duos Siemens/Architect respectively, 31 week HIV-1 Adivoq, 35 week Insti rapid, 37 week surecheck(old clearview)--ALL NEGATIVE.  I still am having since my encounter last year all sorts of health issues and now my wife is coming down with similar symptoms.  I guess I will keep it short:
1) Out to that testing time is HIV-1 eliminated without doubt or still consider in light of symptoms?
2)I have read that if persistent hiv-1 negative tests, but infections that suggest hiv-2, one still needs to consider testing for it.  How long do you have to test for HIV-2 to be absolutely sure and by what method?
3)I understand CDC and UW have PCR that will detect HIV-2, does it make any more sense to do that now 9 months with the 6 month du0 and 8 month rapids?
4)Can seroconversion take longer than 6-8 months and if I had either type, "should/would" my tests have revealed?
5)To make sure I am doing what is right-- do I need to tell my wife to get evaluated in regards to HIV as it relates in exposure to me?
6) HOW LONG do i have to test for HIV of EITHER TYPE(HIV 1 crf,subtypes, group o/n, HIV-2 to make sure I am truly negative?  Especially for HIV-2 since no antigen in the tests?
Thank you much, I just want to eliminate this off the list of possibilities and figure out what is going on to feel well again.
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
I'm sorry, we have  software problem which does not allow me to review your earlier posts so my response will be based on what is written here.  If you wish to tell me the numbers of your previous posts, I can go back and review them.  My sense is that you are over testing and should be looking for other reason for your weight loss rather than continue to test for HIV-1 or HIV-2.  Your HIV test results are conclusive for HIV-1 and your 26 week Siemens test and your 35 week Insti tests both conclusively rule out HIV-2 as well.  Further testing, including specific tests for HIV-2 are a waste of time and of money, as well as potentially delaying discovery of what might really be going on.  Even if you had sex partners from West Africa or from India where HIV-2 are most common, only a minority of persons have HIV-2. 

Thus in answer to your specific questions;
1.  Yes, HIV-1 has been conclusively ruled out.  You should look for other reasons for your symptoms.
2.  See my comment above.  HIV-2 is relatively rare, even in the areas where it is most common, rarely causes symptoms and have been conclusively ruled out as I explained above.  
3.  See my comment about testing for HIV-2 above.  If you seek specific HIV-2 testing, I am confident that your results will be conclusively negative at this time, more than 6 months after the exposure you refer to.
4.  No, seroconversion would have already occurred by now.
5.  See comments above.  Nothing you mention suggests any reason for concern that your wife may have gotten HIV-1 or-2 from you.
6.  You have already tested sufficiently.

I hope my comments are helpful.  I urge you to stop worrying about HIV-1 or HIV-2.  Continue to work with your own doctor to determine what the non-HIV cause of your weight loss is.  There are many possible causes.  EWH
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31 months ago
Thank you, the question was #3045.  To clarify this was a lady from China and therefore VERY close to India.  Also in south Florida here and higher HIV rate.
I just really worry about the incident where she inserted her finger in me.  Seems low risk, but if cut or otherwise it could pose a higher risk.  I have had multiple HIV-1 aptima and like said viral load as well as a proviral out to 16 week  and all negative so that SHOULD rule HIV-1 out.  right?
1)What is considered "acute hiv" in terms of time?  3 months 6 months, more?
2)What is in fact the window period for hiv-2 in terms of antibody and are the duo as good as eia just for hiv-2(igg)?
3)Do you ever need a pcr for the correct diagnosis if one always test ab neg?
4)Is it possible that with all the tests i have had, including 6 month duo, 8 month rapid, that you can still get false negative because ab levels for type 2 arent high enough?
5)Regarding HIV-1 or HIV-2, would all these tests miss a subtype/crf/ or other odd group and the test itself is limited and therefore would always show negative despite one being infected truly?
6)I have tested regulary over past 5 years and always negative.  Is it possible that a person could have infection that long, immune system compromised now(weight loss, some mouth ulcers, easy bruising, constant nausea) and not showing antibodies to either HIV 1 or HIV 2 and now in more of AIDS like state?
__TO RECAP
-10,13,18,26,27 week duo negative
-7,16 pcr negative
-25,35,37 week  hiv 1/2 rapid negative
7)Can ALL those tests miss some sort of HIV whether it be type 1 or 2?

I know stress can play a factor in things, but truly I know something is very wrong with me physically.
Thank you

Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
sigh- I think you are over reacting.  rates of HIV-2 in China are quite low and HIV-2 is extraordinarily rare in South Florida.  You already know that you do not have either infection due to your testing.  Further, when you worry about infection being transmitted through introduction of a finger, you are letting your imagination (and perhaps guilt) get the best of you- insertion of the finger is a form or masturbation and masturbation does NOT lead to HIV.  Briefly, in answer to your detailed and repetitive questions:
1.  Acute HIV typically occurs within 30 days of exposure.
2.  Less than 12 weeks.  Yes, the Duo tests are as good for HIV-2 as antibody tests which detect only HIV-2.
3.  No
4.  No
5. No
6.  No
7.  No

EWH
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30 months ago
Good evening and i thought I would wait until my latest result to reply.  The test was already in order when submitted.  I ended up having a 4th generation test last week via Labcorp and the result was non-reactive.  This is with the Siemens duo test.  I do see where that it supposedly is only 98.36% sensitivitiy.  That seems to be less than the rapids  and also less than the Abbott.  This test was done at 41 weeks(287 days/9.5 months)after exposure.  As stated before, I still have LOTS of symptoms including the weight loss and loss of fat in upper cheeks.
1)Can I be certain that this is not hiv of any type whether it be hiv-1 or hiv-2?
2)With so many symptoms, can I still exclude or would it sensible to see an HIV doctor?--what more would he/she do?
3)As asked prior, to be clear. even the HIV-2, CRF's, other rare groups would be detected by this timeframe?
4)Any value of any other testing for hiv, for example CD4/CD8, other?
5)Are there cases/patients where it "just cannot be detected" and therefore missed, therefore me putting my wife at risk?

I feel that at 9.5 months it seems that solid, but I need to be absolutely sure!
Any other insights or advice would be appreciated, and this will end this thread.
Thank you
30 months ago
Sorry, hit enter too soon

Good evening and i thought I would wait until my latest result to reply.  The test was already in order when submitted.  I ended up having a 4th generation test last week via Labcorp and the result was non-reactive.  This is with the Siemens duo test.  I do see where that it supposedly is only 98.36% sensitivitiy.  That seems to be less than the rapids  and also less than the Abbott.  This test was done at 41 weeks(287 days/9.5 months)after exposure.  As stated before, I still have LOTS of symptoms including the weight loss and loss of fat in upper cheeks.
1)Can I be certain that this is not hiv of any type whether it be hiv-1 or hiv-2?
2)With so many symptoms, can I still exclude or would it sensible to see an HIV doctor?--what more would he/she do?
3)As asked prior, to be clear. even the HIV-2, CRF's, other rare groups would be detected by this timeframe?
4)Any value of any other testing for hiv, for example CD4/CD8, other?
5)Are there cases/patients where it "just cannot be detected" and therefore missed, therefore me putting my wife at risk?
6)HIV-2 certainly eliminated by this time?

I feel that at 9.5 months it seems that solid, but I need to be absolutely sure!
Any other insights or advice would be appreciated, and this will end this thread.
Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Your unwillingness to accept your multiple test results long after the results were conclusive perplexes me, as do your repetitive questions:

1.  Yes
2.  Once again, seeing an HIV specialist is a waste of time.  You should see a general internist so that you can look for what is really causing your symptoms.
3.  Correct, you do not have these infections.
4.  No
5.  No
6.  Yes

This is the third and therefore final reply as part of this thread.  There will be no further responses and future repetitive anxiety-driven questions may be deleted without a response and with refund of your posting fee.   EWH
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