Dear Docs,
Following an exposure that I have been told is no risk, I took a long series of Syphilis (antibodies) and HIV (4th gen), up to 3 months which all came back negative (previous threads).
Case was close, BUT while archiving all my test results yesterday, I fell on a generic blood analysis results from last April 2018 I took before an IRM / radiology exam: the protein electrophoresis results report highlighted that for gammaglobuline I was slightly below “normal” values:  10.7% (normal frame indicated in the report for comparison being 11.1 to 18.8). By that time I asked two different doctors and both told me “nothing to worry about, if something would be wrong, you’d be constantly sick. Your immune system works”. A few months later (sept 2018), I took a “commitment” HIV, etc. test prescribed by my girlfriend gynecologist, and more recently the series of tests described in my previous threads.
Because all tests I have taken were antibody tests, I am again really worried. Would you please be kind enough to answer the following questions?
Many thanks for your answers.

Welcome back to the forum, but I'm sorry you found it necessary after Dr. Hook's repeated, science based reassurance. I reviewed your discussion with him.---

Dear Doctor,

 

Many thanks for your swift reply. I never intended to challenge answers I’ve been given so far and hope you believe I am not questioning answers I’ve been given by either you or Dr Hook.

 

I am myself quite disappointing to notice that I have not been able to move on following all the pieces of advice I’ve been given.

 

Regarding the “hypogammaglobinemia” I was concerned about, just for you to know, this exam was ordered last year by my physician independently from any STI/STD consideration as part of a very generic blood/serum check. You perfectly cleared my concern by confirming it is kind of minor deviation which cannot interfere or lower confidence in tests HIV tests I later took in different contexts.

 

Just because I want to close and leave everything behind me, from all answers I got from both of you, and though I thoroughly selected sources, I come to the conclusion that I’ve been reading too much.

 

The worst aspect of this is regarding HIV-2 because when reading all threads, it appears it has not been deeply studied and since there is no antigen detection to consolidate antibody aspect of the test, in the end, it looks “less reliable” to non-experts like me.

 

1/ I did not receive PostEP, did/do not take medications, I am not treated nor suffering for any chronic illness nor cancer (no chimiotherapy), and I am negative for hepC. I understood there is NO medical condition or “what if” scenario that would let think an expert clinician like yourself that HIV1 or HIV-2 antibody appearance may be undetectable at 3 months. Right?

 

2/ The once (or maybe still in force) US CDC recommendation for 6-months follow-up after high risk exposure is outdated since 1^st / 2^nd generation tests are no longer in use and the only (two?) cases of seroconversion after 3-months were documented back in the 1980s when 3^rd / 4^th gen tests were not in use. No other documented case since with 3^rd / 4^th gen. Am I correct?

 

3/ Was not my case, but assuming one had an high risk exposure in a part of the world where HIV-2 is more common (central Africa), and he come to your clinic, would you consider a 3 month neg with 3rd or 4th gen 100% definitive with no need for follow-up beyond three months as well? Is the 3-month worldwide (conservative) gold standard?

 

4/ I remember a thread on another platform where you said to a forum user with a NEG test at somewhat 7-8 weeks, that even if he had voluntarily injected himself KNOWN HIV infected blood directly in his bloodstream, you would not recommend further testing and consider these results as strictly definitive. That’s the kind of strong image that helps me moving forward. Would this image apply regardless of the kind of HIV types one could have been exposed, including if this injected blood was known to be HIV-2 infected?

 

5/ In the same way I found out French specific guidance addressing  medical professionals (e.g. surgeons) that got accidentally in contact with blood as part of their medical practice (provided they haven’t been put on PEP), that HIV test are definitive 3-month after exposure. Do you agree?

 

6/ My 3-month mark 4^th generation HIV (and previous ones) NEG testing exclude any kind of HIV infections, and results I got so far are “SOLID ROCK” and definitive proof that I have not been infected with neither HIV-1 nor HIV-2 because even if no HIV-2 antigen is screened with 4^th gen test, all HIV-2 infection will be picked up without remaining doubt at 3 months through antibodies.

 

Many thanks for your additional comments, after which I hope I will feel no need to come back and better be focus on resuling my life with my beloved one without further concern of passing her something.

1) Your summary is correct.

---