[Question #4547] Reliablity on tests

29 months ago
Hi Drs. I've been through a situation six months ago. I was with a CSW (from a non-developed country, in South AMerica). It happens that I was heavly intoxicated and don't remember if I did any kind of sex with her, I probably didn't do anything. But, just in case..... So, as I didn't remember what really happened , let´s suppose that I had unprotected vaginal sex to her. So, worried about this situations, I've proceeded to this same test, in the last months (they were all made at a traditional and respectable private lab in my town):

Electrochemiluminescence (ECLIA) 
Research for viral antigen HIV 1:  P24
Research for antibodies for viral antigens:
HIV1:  ENV GP 41, RT (ANTI TRANSCRIPTASE REVERSE)
HIV2:  ENV GP 36

The same test was performed on the days 40, 60, 96 and 179, all of them  became 'NON REACTIVE'.

What worries me the most is that checking other results at the internet, I saw that some tests perform the search against the antibodies for the GP120, or sometimes the GP 160 as well. So my questions are the following:

1) Is this a fourth generation kind of test ?
2) Is is a realiable test ?
3) Should I try another test , at another lab , that search for the antibodies for the GP120/160 ? 
4) Can I move on with the results that I have ? I really want to forget this all
5) Is it possible that I can seroconvert after all this tests ? 
6) If I were an Elite Controller, the tests would still be reliable ?
7) Should I try for another kind of test ?

Thanks in advance for the support and the job you've been making.

Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Welcome to the Forum.  I think you are overthinking this and urge you to put your concerns aside.  You do not even know that you has sex and in my considerable experience, it would be most unusual for you to not remember if you have not had sex.  Further, most CSWs do not have HIV and even with unprotected sex, less than 1/10th of 1% of unprotected exposures with infected partners  result in HIV infection.  Finally, your HIV test results were conclusive long ago.  Please believe your test results.

As answers to your specific questions:
1) Is this a fourth generation kind of test ?
Yes, the fact that p24 antigen was part of the test make it a 4th generation test.  The combination of antigen used for antibody detection is more than adequate and appropriate for HIV diagnosis.  Your results are reliable.

2) Is is a realiable test ?
Yes

3) Should I try another test , at another lab , that search for the antibodies for the GP120/160 ? 
No need for additional testing of any sort.

4) Can I move on with the results that I have ? I really want to forget this all
Yes, it is time for you to move forward without concern.

5) Is it possible that I can seroconvert after all this tests ? 
No, there is no chance that you will seroconvert in the future from the possible exposure that you have described.  It would have happened long ago.

6) If I were an Elite Controller, the tests would still be reliable ?
Yes.

7) Should I try for another kind of test ?
As I said above, there is no need for further testing.  you can be confident that you did not acquire HIV from the possible exposure that you have described.

I hope my comments are helpful and will allow you to move forward without concern.  EWH

---
29 months ago
Thanks so much for the reassuring answer, Doctor. One more thing, I have some nodules in my thyroid. Last year I punctioned them, and none had bad carachteristics. The hormones produced by thyroid are all ok as well, as I have checked them last month. Is there a might possbility that these nodules can cause false negative results ? Thanks again.
29 months ago
I forgot to Tell, I don't take any medicines for my thyroid. The only medicines that I am taking are fluvoxamin (antidepressant) , and sometimes clonazepam, for my anxiety. These medicine can make The tests unreliable? Thanks again! 
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Thyroid nodules would not in any way affect your test results. Nor would the medications you take.  Please believe your test results.  EWH---
29 months ago
Thanks again, Dr. !!! 
29 months ago
Sorry to bother you again Dr. I got one final question. This last Sunday , my body temperature were slightly elevated (until 37,3 Celsius degrees) for about four hours. Then it returned to normal. THe following day (monday)I got a little bit of sore throat, with a little of sneeze as well. Yesterday I was feeling kind congestionated and still feeling the sorethroat. Today I am ok.  Could this be somekind of late ARS, despite all my negative tests ? Do I need one more test, to rule out that this wasn't somekind of late ARS ?Thanks in advance.
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
No, the ARS would definitely not occur this far out.  Further, more as an FYI, few clinicians would not consider a temperature of 37.3C as a significant fever.  I urge you to believe your test results and move on without concern.  You are in the clear.

As you know this is my 3rd response to your questions.  Thus, as per Forum guidelines, this thread will be closed shortly without further answers.  EWH
---