[Question #4722] RNA - Can I consider it conclusive?

26 months ago
high risk encounter - receptive anal - other party negative and on prep. But cautious here.
RNA Aptima test - 11 days - negative - 
4th gen (not rapid). negative antigen and antibody  at 14 days (very early I know)
RNA APtima test - 40 days - negative - it looks like Dr. Hook previously states that 14 days is considered all good on an RNA.
 Am I in the clear?
The past month has been agony.  I wish I had found this forum sooner. So much unreliable information on the internet.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome. Thanis for your confidence in our sevices.

These results are very nearly conclusive but not quite. It is true that virtually all newly infected patients with HIV have positive nucleic acid amplification tests (NAAT, i.e. DNA or RNA testing) by 14 days, but there are rare exceptions. Most experts would also recommend an antibody tests (or antigen-antibody) at 4+ weeks. Almost certainly you are in the clear, but standard recommendation is that you also have the additional test to be 100% sure.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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26 months ago
Thank you Dr. In retrospect I should have done the 4th gen at 40 days instead of the another RNA test.  The testing center in San Francisco told me 14 days would have been conclusive.  I wish there was a general agreed upon, the varying information makes one nervous.  Although your advice is certainly better "safe" than sorry.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
I agree that an AgAb test at 40 days would have been smarter. 14 days for NAAT is often considered conclusive. The problem is that the data are not 100% certain:  if a particular uncommon event has never been known to happen, how do you prove it cannot occur in rare cases? You can't. I guess you could say the same about a prediction that the sun will rise tomorrow. OTOH, there have been billions of days in which the sun rose every time, but probably only several thousand HIV NAATs by people concerned about a recent HIV infection. ---
26 months ago
Valid points. I do at least fill much better than I did. Thank you for the fast response. This forum is a treasure on the internet. Have a wonderful holiday and I thank you for your decades of work. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
You're just lucky I happened to be on line soon after your questions and comments came in. Most responses aren't so quick! But thanks for the kind comments. Spread the word!

Happy holidays!
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