[Question #4494] Is this one 4th gen test enough at this time?

29 months ago
Hello Dr,s

Questions below

I had an encounter which i do not fully remember which prompted me to worry and get tested. I have been thru similar scares before and drove myself mad with overtesting. In light of that i focused on not overtesting this time around. The last two times i went thru a scare i tested out to 21 and 30 weeks and then drove myself mad with anxiety. It was some of the worst times in my life, thinking back to that time i am trying to be smarter and more knowledgeable this time and will take your advice to the bank.

1. 57 days after the event i went online and used stdcheck.com and tested with them. The test they perform is a 4th generation hiv test and a day later the results came back as negative. Is this beyone sufficient for me to be conclusive?

2. Would you recommend testing to anyone beyond this time frame if their test is negative such as mine?

3. What circumstances would there be if any that you'd suggest your patient to continue testing, would there be a need?

That's all i can really think of at the moment.
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Welcome to our Forum and thanks for your question.  I'm pleased to hear of your desire not to over test.  Sadly, a number of our clients test repeatedly long after there is no need to do so, increasing their anxiety and expense for no reason.  I've answered your questions below. If there are further questions of if part of my answer is unclear we permit up to two follow-up questions after the initial reply.  

1. 57 days after the event i went online and used stdcheck.com and tested with them. The test they perform is a 4th generation hiv test and a day later the results came back as negative. Is this beyond sufficient for me to be conclusive?

Your testing is conclusive.  Currently approved 4th generation tests are among the most reliable tests in all of medicine.  The are 99% conclusive at 4 weeks (28 days) after a possible exposure and completely conclusive at 6 weeks (42 days).  Thus your 57 day test is completely reliable and proves that you did not acquire HIV from the exposure of concern.  

2. Would you recommend testing to anyone beyond this time frame if their test is negative such as mine?
Absolutely not. There is no reason for further testing.

3. What circumstances would there be if any that you'd suggest your patient to continue testing, would there be a need?
The only situation in which testing at a later day would be if you had taken anti-HIV medication as post-exposure prophylaxis (PEP) after you exposure.  No other medications will delay accurate test results.  

I hope that these responses are helpful to you. EWH

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29 months ago
Thank you for the response dr, some comments and follow up. 

1. So regarding my status I should not give this another thought? Is that correct?

2. Could any symptoms I have now be a cause of this? I presume not since I do not have it. 
It has been 15 weeks since that ordeal. 

3.  If someone didn’t develop antibodies then the antigen would definitely be around when I tested, is that correct?

What concerns me is my girlfriend 5.5 weeks after intercourses started to feel sick with sore throat and headache along with sinus issues. That just drives my anxiety I believe. I do recognize it from my last two scares and going thru similar worries then. 

Just to put the halt on my thinking, there is no way I could have this disease after testing 2 weeks after the 42 days and I should not worry about this at all, even the slightest bit?

Thanks for your help here, I do appreciate it a great deal. 
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Straight to your follow-up questions:
1.  Correct.  No need for further worry.
2.Any symptoms you have currently are due to something other than HIV.
3.  Correct

We find that many clients, like you have increased concerns when a regular partner coincidentally becomes ill for another reason.  Guilt no doubt contributes to this.  I urge you to believe your test results.  I hope that your GF feel better soon.  EWH
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29 months ago
Thanks for added reassurance in regards to my situation. Since this is my last follow up i do have some questions.

1. Regarding what i read about 4th gen tests in particular on the CDC website, it says if you've had a test prior to 45 days then you should test again after 45 days to tell for sure... Does this mean i should have taken one within the 45 days along with one after?

2. I have read Dr. Handsfield say that 10-14 days is usually when the sickness that some experience occurs, Other sites say this could happen between 2-4 weeks while some still say 2-6 weeks. What' s the reality in terms of this sickness that is experienced.

3. Myself being out to 15 weeks with a test after 8 weeks (4th gen) being negative, there is no way that me feeling symptoms to be related to that exposure?

4. I have also seen that this test is actually pretty accurate at 2-3 weeks but 6 weeks is needed for 100% conclusive results, is that correct?

I guess i just worry alot and then coupled with girlfriend feeling ill after 5 weeks just keeps me un easy. Perhaps i need to speak with someone so i can get past this worry and me associating her feeling sick with something that i DO NOT HAVE.

Sorry for the redundancy on some questions.

Thanks again Dr, i will surely not be back on this forum.
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Final responses:

1. Regarding what i read about 4th gen tests in particular on the CDC website, it says if you've had a test prior to 45 days then you should test again after 45 days to tell for sure... Does this mean i should have taken one within the 45 days along with one after?
There is no need for additional testing if you test with a combination HIV antigen/antibody (4th generation) test more than 42 days after your exposure of concern.  Your results will be conclusive

2. I have read Dr. Handsfield say that 10-14 days is usually when the sickness that some experience occurs, Other sites say this could happen between 2-4 weeks while some still say 2-6 weeks. What' s the reality in terms of this sickness that is experienced.
Most people who develop the ARS do so by 10-14 days after exposure but for a very small proportion of persons the ARS can occur as far out as 4 weeks after exposure

3. Myself being out to 15 weeks with a test after 8 weeks (4th gen) being negative, there is no way that me feeling symptoms to be related to that exposure?
Correct. At his time, with a negative test at 8 weeks, any symptoms you are experiencing are due to something other than HIV.

4. I have also seen that this test is actually pretty accurate at 2-3 weeks but 6 weeks is needed for 100% conclusive results, is that correct?
Correct

I guess i just worry alot and then coupled with girlfriend feeling ill after 5 weeks just keeps me un easy. Perhaps i need to speak with someone so i can get past this worry and me associating her feeling sick with something that i DO NOT HAVE.
I agree.  You are worrying needlessly and having trouble accepting professional judgement that you do not have HIV.  For this reason, I agree that it is likely that you would benefit from professional counseling to help you move forward from your unwarranted concerns.

I hope these replies are helpful.  This will complete this thread which will be closed shortly.  Further questions about this exposure may be deleted without comment.  EWH

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