[Question #4285] HIV infection

31 months ago

Hi doctors,

I had unprotected sex with girl I met in a bar. We were drunk and had Anal and vaginal sex. I don’t know if she is HIV positive.

I tested at 58 (8weeks) (both 4th gen combo and pcr qualitative) and combo test at 65 (9 weeks), all results are negative.

Some organizations websites give this information which confused me about the conclusive of the tests I have done: “The window period for a 4th generation antigen/antibody is 4-6 weeks, at this time 95% of infections will be detected. It takes 12 weeks (3 months) after the exposure to detect 99.9% of the infection.”

1-     What are the chances and possibility that I have HIV and not detectable?

2-     During the window period me and my girlfriend had sex 3 times without using condom, what the chance that I transmit HIV to her?

 

Please advise how is my situation


Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to our Forum.  I will be happy to comment.  You can be completely confident in your test results- you did not get HIV from the exposure you describe. 

Let me elaborate- you do not mention in what country this exposure occurred but most women in North America and Western Europe do not have HIV with rates typically being far less than 1%.  even if your partner did have HIV, the risk for each of the exposures you describe is far less than 1% and thus, even before testing, your risk for HIV was less than in 10,000 and probably far lower.  Your test results take that low probability of infection and effectively and definitively rule out any chance that you were infected.  Despite the overly conservative and often out-of-date statements made on some web sites, the fact is that 4th generation, combination HIV antigen/antibody tests provide definitive results at any time more than 6 weeks after exposure.  We previously counseled visitors to this Forum that results were definitive after 4 weeks but in the past year or so the CDC has described a very small number of persons who developed positive tests some time between 4 and 6 weeks after exposure.  As a result, we now state that results are not entirely conclusive until 6 weeks after exposure.  You did not get HIV form the exposure you describe and there is no risk that you transmitted HIV to your GF during the window period. 

I hope this information is helpful.  You are in the clear- your tests prove this. EWH
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31 months ago
We were in Dubai (meddle east) . 
1- Doctor Can I say I’m totally free from hiv with tests i have done?
2-  Is it 100% conclusive or i have to repet the test later at 12 weeks. 
3- Can I resume having unprotected sex with my GF without fear of transmiting HIV to her?
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Thanks for the additional information.  The HIV rate is Dubai is VERY low, thus I think my estimates are accurate.  For your follow-up questions:
1.  Yes
2.  Any result at more than six weeks is conclusive.  There is no need for 12 week testing.
3.  Yes, nothing about this encounter suggests a need to avoid unprotected sex with your girlfriend.  You are in the clear.  EWH

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31 months ago
Thank you Doctor. I'm sorry for my poor English language. I have last quotations.
1- you said "You are in the clear" what dose that mean?
2- According to your answers, it means that my negative combination HIV antigen/antibody test at 9 weeks definitely confirms I don't have HIV?
3- Is it possible that my results change later?
4- How accurate the PCR qualitative RNA test I did at week 8?

Thank you again Doctor  
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Sorry for the confusion.  Replies below:

1.  By "in the clear" I meant that you can have confidence in your test results and that you do not HIV.  There is no need for further testing.
2.  Correct
3.  No, your results will not change.
4.  A negative HIV RNA PCR at 8 weeks is also conclusive proof that you did not acquire HIV.  The RNA PCR tests however are more expensive and have occasional falsely positive results.  At 8 weeks the PCER test and the combination HIV antigen/antibody test are equal in accuracy and reliability.

This is my 3rd response to your questions.  I hope that the answers are clear and have been helpful.  You can be confident that you did not get HIV from the encounter you describe above.  As per Forum Guidelines, this thread will be closed without further answers in a few hours.  EWH
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