[Question #4728] HIV testing after a year?

29 months ago
Hello and Merry Christmas!  I will keep it brief.  Exposure end of 2017 with lady from China/Asia in massage parlor.  Since then LOTS of symptoms to this very day.  Latest round of tests:
-43 week Advia Centaur 4th negative, HIV-2 EIA neg, HIV geenius not detected
-45 week Abbott Architect neg, HIV-1 RNA not detected <20, HIV-2 DNA negative
-52 week Advia Centaur 4th neg
-54 week Bio-rad bio flex 5th neg
--also from 6 weeks to this point, 8 other LAB based 4th tests done all negative

1)Can ALL these tests miss ANY sort of HIV out to a Year? because of odd strain or what the heck ever?
2)I read about group N,O,P, CRF, and the fact that she was not north American, puts me at a slight more risk.  If infected with some NON-M HIV-1, would at least one of these tests be positive or could you get all negative and just plain keep missing it?
3)HIV-2, conclusive or not?, and is there a point where you have to keep testing for it?
4)At what point for SURE, can one disregard ALL and ANY symptoms, regarding HIV of ANY type, and be CONFIDENT that they do NOT have this disease?
5)Any more testing to do for 100% confidence ?
Thank you

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Welcome back. However, you asked all these questions and had conclusive replies in two threads several months ago. The main point of Dr. Hook's and my replies is that the standard HIV tests are always positive within a few weeks, and that after that time, the test results overrule all other considerations. No matter how high the risk of exposure at the time, and no matter what symptoms somone has, the test results rule. For sure you don't have HIV.

Because exactly these questions were asked before, my replies are very brief. Re-read your two previous threads for more details.

1)Can ALL these tests miss ANY sort of HIV out to a Year? because of odd strain or what the heck ever?  NOPE.

2)I read about group N,O,P, CRF, and the fact that she was not north American, puts me at a slight more risk.  If infected with some NON-M HIV-1, would at least one of these tests be positive or could you get all negative and just plain keep missing it? NO, NOT POSSIBLE

3)HIV-2, conclusive or not?, and is there a point where you have to keep testing for it? YES, CONCLUSIVE. No testing needed more than 6-12 weeks after exposure.

4)At what point for SURE, can one disregard ALL and ANY symptoms, regarding HIV of ANY type, and be CONFIDENT that they do NOT have this disease? 6-12 weeks, depending on the specific tests done, or cominbation of tests

5)Any more testing to do for 100% confidence ? NO TESTS EXIST THAT ARE ANY MORE CERTAIN THAN THE ONES YOU HAD

Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding. 


I hope these comments are helpful. As noted above, read your previous threads for more explanation about these questions. Best wishes and happy holidays.

---
29 months ago
Thank you for the reply. If you may please clarify?
1) by this time (a bit over a year) definitely some of the tests would have been positive if truly infected?
2)I should not worry in the least in regards to risk to my wife?  Or not even mention my concerns to her? (She doesn’t know). 
I just do r want to be that case you read about in the literature that was missed because of strange circumstances.  It just seems that I’ve done as much as I can to rule out these possibilities. 
That’s all, I wish you and your family all the best. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
1) It doesn't "clarify" anything to just keep repeating the same answer, and that includes the same question using different words. How many times do I have to repeat it to make you believe it????? Have you not understood my replies or just don't believe them?

2) Correct. You cannot transmit an infection you do not have.

There are no "strange circumstances" that could alter any of this.

As for discussing with your wife, many couples would do this, and you may find she is very supportive and helps you get beyond your frankly irrational fears. But I'm an STD/HIV expert, not a relationship counselor. It's up to you.
---
---
---
---
29 months ago
Thank you for that information. I guess what concerns me most is that the tests I have had(from 6 weeks to 54 weeks post exposure) are from what I gather, primarily to detect group M and O(although not as sensitive for group O). Also they don’t test for N,P.   I understand the odds are in my favor in this instance but articles like this are concerning, especially with all My symptoms have started a week after exposure:

1)if infected last exposure(NOV 2017) or even a few years back, (tested every 6 months since 2012) would at least one of these give a positive result if truly infected?
2)if elite, still show antibody?
3)can you go this amount of time, at least a year,, maybe more with past exposures, and still continue to have falsely reporting tests?
4)I seem to have lost facial fat, muscle mass, does that have any influence that tests could be wrong?
5)as regards to HIV, and all the tests I’ve had, any group, subtype, would be recognized?
6) if I’m  in a later stage of disease than tbought(infected earlier than most recent), would still show some sort of abnormality with these last sorts of tests, no matter what type of hiv?
I thank you and I know this is my last. 
Have a Merry Christmas 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
You're really obsessed with this if you're searching the medical literature to find articles like this. Such HIV variants remain very rare and standard tests almost never miss them. The report you cite analyzes 20 patients in whom some tests missed them, but not all tests; most of them had positive results on one or more of the kinds of tests you had.

Having "LOTS of symtoms" and the timing of their onset mean nothing. Symptoms always have been infinitely less reliable than testing to judge whether or not someone has HIV.

These follow-up questions once again are asking similar questions in different words. The answers are 1) Yes, 2) No, 3) No, 4) These symptoms are not suggestive of HIV in absence of detectable antibody or virus, 5) Yes, 6) Yes.

I'm going to repeat the statement above to assure you can't miss it. This forum cannot help you further, and the answers will never change. Please do not ask again.

Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about this exposure, testing, and your fears about HIV may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding. 

---