[Question #4463] Is an HIV 1/2 4th Generation ag/Ab combo test conclusive at 46days?

30 months ago
0n 07/21/18 I had unprotected vaginal sex with a man who claims to be clean. I do not know the man well and the sex was not planned. The man did in fact finish inside, unfortunately I was drunk. Which was wrong. Since then I had three HIV tests which where all negative, the 1st one was 4th Gen HIV combo test at 4days to create a baseline, 2nd was at 35days Determined 4th Gen combo test finger prick, 3rd was at 46days HIV 1/2 4th Gen combo test  blood drawn from the vein. I am terrified because a tec at the lab where I got my test done mention that it could take 5 months to get a positive result, I later asked the nurse that Schedule the test and she agreed mention I should test every 3months unil the end of the year. Based on the tests I have taken should I consider myself negative or should I continue testing and for how long ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome to the Forum.  I'll be glad to comment.  The tech you spoke with was mis-informed.  Your results are entirely conclusive and you  do not need further testing.  Combination HIV antigen/antibody tests are 99+% conclusive at 4 weeks and entirely conclusive at 7 weeks (42 days) after exposure.  There is no need for further testing and no need for continuing concern.

I hope this information is helpful.  EWH
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30 months ago
Thank you Dr HOOK for your reply I really do appreciate it because I have been terrified. I am glad to have received a response from an expert in the field. I do like to add just in case, which is  my paranoia talking, my last test was at 46 days ! I see that you wrote 42 days 7 weeks. I just wanted to make sure ! My test results are still good and conclusive. I wanted to know if it is safe to have Intimacy with my boyfriend which he is completely clean, verified.  I plan to always use protection and stay safe going forward. But I like to ask one more time for confirmation. Thank you again for your reply and your time. 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Testing at 46 days is certainly conclusive.  Please do not worry. There is no reason related to the encounter that you describe to hesitate or about unprotected intimacy with your regular partner. EWH---
30 months ago
Thank you Dr Hook for your replies. 
I do like to add to my final question some information that I think would help others who might read my question. I live in the US, NY. I am assuming this has no bearing in regards to my test results but I thought it would help someone reading my question to know. 

I also like to add that my blood test came out positive for Genital herpes, I was told that I might have had it for a while without knowing it. To be honest testing positive for herpes was what lead me to HIV anxiety. I want to ensure I told you everything. 

I like to consider having a child with my regular partner and I am just making sure given all my information and given any crazy symptoms I thought I might have had. 

That if I wanted to continue with regular sexual activity with my regular partner aside from Gential Herpes, I have nothing to worry about HIV because my HIV tests are consider conclusive. 

Therefor I can not pass HIV to him since in your medical opinion I am considered negative based on the 4th Generation HIV 1/2 ag/ab combo Test taken at 46 days after the July 21st encounter. 

I just wanted to ensure that aside from all the added inform it would not change your medical opinion. I understand that this thread will be closed after your final reply and hope that I have not inconvenience you too much with my repeated questions on the subject. It just my way of trying to understand and accept my results.  

Thank you again

Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Thank you for the additional information.  I have several comments related to the information you have provided which I hope you will find helpful. 

The medical laboratories in New York are tightly regulated and superb.  You can have confidence that the laboratory did its job well. 

If you did not know that you had herpes before your blood test, it may be worthwhile to look into this a bit more.  Teri Warren answers questions about herpes on our site and can be quite helpful.  Here a few facts which you may or may not already know:
1.  If you did not know you might have herpes before the blood test, you are not alone.  Most people (about  8 out of 10) do not know that they have the infection so your situation is not unusual.
2.  For some persons, and particularly persons infected with herpes simplex type-1, the virus that causes cold sores, the IgG blood test for HSV-2 may be falsely positive.  The "index number" for the test result may be helpful in sorting this out.  If the test was an IgM test, false positive results are particularly common
3.  When a person finds out they have HSV from the IgG blood test, unless there are other associated factors like an episode of genital lesions, the test will not help you to know how long you have had the infection.  

With respect to your questions about HIV however, that you have a positive blood test for HSV in no way changes my opinion.  Your results are conclusive and can be believed.

I hope the information I have provided has been helpful.  As per Forum guidelines, this thread will be closed in a few hours without further replies.  EWH



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