[Question #4671] Requesting info

26 months ago
Hello Dr's, here are my questions and background on situation.

About 5 months back i had a complete blackout and worried that something occurred, this led me to testing and anxiety. I see the pattern as i have been through scares before a few times over the past 2 years. I have had so many tests it is beyond ridiculous to be honest. These questions are based off an incident on 7.27.18.

1. Since that time i had two 4th gen. lab tests from stdcheck.com which uses quest as their lab. The tests were on the 58th day which was negative and then one on the 130th day. So thats basically 8.5 weeks and 18.5 weeks later. Both were negative.

- Is this more than sufficient to rule any possibility out?

2. I have read about elite controllers, would tests at those times be valid for individuals like that?

3. The 130th day test had a slightly higher value than the 58 day test, is that any worry. From what i understand values go up and down but negative is negative?

4. I also had a hep C test at 130 days, would that be enough for that as well?

I am certain that i have anxiety around this and it is out of hand. To the point where if my girlfriend gets sick a few weeks after intercourse i start convincing myself that my tests have been wrong which prompts me to yet again take another test.

In the past when i have had scares i have taken countless tests over the following 4-5 months however this time i only took two.

5. Any reason for me to worry any further at all?

6. Are there any better tests than i have taken?

Thank you and that's all i can think of for the time being.
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Welcome to the Forum. I'll try to help.  Let's just go straight to your questions:

1.  The tests that you have had are each conclusive.  Quest is a highly reliable laboratory and combination HIV antigen/antibody tests are conclusive any time beyond 7 weeks (42 days). Believe the results- no need for additional testing.

2.  Yes,. Elite controllers are still antibody positive.  You did not get HIV from whatever happened five months ago and are not an elite controller.

3.  Negative is negative.  Fluctuation in values below the cut off are meaningless.  

4.  Your hepatitis C tests are also conclusive.

5.  No, no reason for any further concern related to your encounter five months ago.  

6.  No.  Again, as I said above, no need for further testing.  

I hope these responses will allow you to move forward without concern.  EWH
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26 months ago
Thanks Dr. 

I think I have bad anxiety over this considering I have had these fears due to other encounters over the past two years. 

1. Do you ever recommend more than one test past 45 days if a 4th gen is negative?

2. My girlfriend seems to always be sick which causes me more anxiety and worry and the cycle continues. How do u suggest I get past this? Obviously not to keep testing I presume?

3. Is there any possibility of two false negatives using lab tests 4th gen past 45 days?

4. If you were in my shoes how would you have approached the situation/testing following an exposure before you were 100%

5. At 18.5 weeks either antigen or antibody would be 100% present is that correct?

I believe my thinking is flawed around this and I really want to move forward without attributing my girlfriend being ill frequently with something I am being told I have no possibility of having. 

Thanks for your guidance. 
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
I too think you are overthinking this.  Much of this sort of misdirection comes from spending time on the internet where there is so very much information which is out of date, taken out of context, misinterpreted or just plain wrong.  I urge you to stay off the internet.  It is not a healthy place for an anxious person and leads to lots of unnecessary tension and worry.

In answer to your follow-up questions:
1. Do you ever recommend more than one test past 45 days if a 4th gen is negative?
Only for persons who have been taking PrEP or who took PEP for HIV.

2. My girlfriend seems to always be sick which causes me more anxiety and worry and the cycle continues. How do u suggest I get past this? Obviously not to keep testing I presume?
Accept that her illnesses are not related to you or the result of STI.

3. Is there any possibility of two false negatives using lab tests 4th gen past 45 days?
No!!!

4. If you were in my shoes how would you have approached the situation/testing following an exposure before you were 100%
Realize that HIV is neither common (less than 1/2 of 1% of the U.S. population has HIV and most of those infections occur among men with other men as sex partners.  Even if you did have contact with a person who has untreated HIV (HIV on effective treatment is not infectious) the risk of becoming infected is just one infection per 1200 exposures (in other words, 99.9% of exposures to infected partners do not lead to transmission!  with that knowledge and practice of safe sex, there is just not that much to worry about.

5. At 18.5 weeks either antigen or antibody would be 100% present is that correct?
Correct.

Hope this helps.  EWH

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25 months ago
Thank you Dr, I have some  follow up questions 

1. Are there any better in the time frames that I have taken him to 100% confirm my status? 

2. I should have absolutely 0%  fear in having intercourse with my girlfriend ?

3.  Any illness or symptoms that come up could not possibly be related to HIV considering I have two tests past 50 days ( lab-based fourth generation tests )?

4.  Just for my own sake if a future situation should arise all I need to do in terms of HIV is take 4tg generation lab-based test after 45 days and then not give it another thought whatsoever am I correct ?

 Thank you for all your assistance regarding this matter and I really hope I can move past this otherwise I feel that I really may need to speak with somebody to help with my anxieties and fears around this whole topic   

Thank you very much again
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
I'm sorry you continue to worry- there is no reason to be doing so.  Straight to your questions:

1. Are there any better in the time frames that I have taken him to 100% confirm my status? 
All combination HIV antigen/antibody tests are conclusive after 6 weeks.  Conclusive is conclusive and does not get more so,  Additional testing after 6 weeks is a waste of time and money.

2. I should have absolutely 0%  fear in having intercourse with my girlfriend ?
Yes!

3.  Any illness or symptoms that come up could not possibly be related to HIV considering I have two tests past 50 days ( lab-based fourth generation tests )?
Correct.  Time to completely stop worrying about HIV.

4.  Just for my own sake if a future situation should arise all I need to do in terms of HIV is take 4tg generation lab-based test after 45 days and then not give it another thought whatsoever am I correct ?
Correct

I hope my comments have been helpful.  As you probably know, we permit up to three responses to each person's questions.  This is my 3rd response.  This thread will be closed shortly without further responses.  Take care and please don't worry.  EWH

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