[Question #4886] HIV TEST

25 months ago
Hello doctors,
I had one risk situation with a prostitute,during the act condom was broken.This was happened 4,5 month ago.After that from 3rd day untill now i experienced many symptoms,general bad condition,pain in hands and legs,all the body (still i have),loss of weight,mild fever,swollen lymph,canker sore and other.I made 2 test 4th gen. at 3 months and 4 months and 2 weeks,both negative.But  still i am not relaxed,because i have these symptoms,pain in my body,loss of weight.I have some question about my situation:

1. I know you will say after 6 weeks is conclusive,but what can i do to be sure about my situation,to make one test RNA, is this test more reliable now at 4,5 months like 4th. generation, maybe my body dont produce antibodies and also p24 dissapeared after this time,can RNA to detect what 4th generation test missed.

2. Now at 4,5 months i made also a immunology test,results are aa follows:

cd 4 - 497
cd8  -  295
limfocite b - 184
limfocite NK - 375
ratio cd4/cd8 1,68

Seems like cd4 is low,from here my concern,instead i think cd8 and ratio is ok.My question is,if i have the virus in my body ( and for any reason cant be detectable with the test) after 4,5 months cd8 have to be increased and ratio have to be less than 1 corect? Which is your opinion about these results.
Thank you in advance
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Welcome to the forum.  I'll try to help and t encourage you to put your concerns behind you.  We teach doctors that when symptoms and test results do not match, the test results represent truth.  Thus in your situation, your test results at both 3 and 4 months after the event absolutely PROVE that you were not infected with HIV when the condom broke.  some of the symptoms you report (congestions, hand pain, canker sores) are NOT associated with HIV while others (weight loss, swollen lymph nodes, etc.) may be due to your anxiety.  There is just NO DOUBT that you do not have HIV from the encounter you have described.   As for your specific questions:
1.  Further testing, such as with an RNA test, is a complete waste of time and money.  The p24 antigen does not "disappear" unless antibodies are present.  You should believe the test results you have.  Additional testing in not needed or recommended. 
2.  Testing to determine CD4 lymphocyte counts and CD4/CD8 ratios by persons who are not known to have HIV is NOT recommended.  The concentrations of these lymphocytes normally fluctuate from hour to hour and non-specifically in response to numerous problems, not just HIV.  Further your CD4 count is in the normal range.  My opinion is that this testing was not needed and the results you got were normal.

I urge you to accept your test results and stop worrying about the exposure you have described.  EWH
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25 months ago
Ok, thank you for the reply, first of all English is not my primary language but i think we can understand well each other.These months has been very painfull for me,also maybe this stigma wich exist in my country corelated with the fact that almost doctors here advice to test at 6 months and 1 year to be sure.At the time when i send this message to you my ARN test was in progress,today i received the result,negativ. This test was made in the same time with Architect 4th gen. test at 4,5 month from the risk.Keeping in mind all these test which i made untill now i have only one question for you and after that i hope to move on,also your reply i want if is possible to be not only scientific and most important as per your experience.

1. I saw ARN test is only for HIV 1 and also p24 same,which is the chance now at 4,5 months to be infected with HIV 2 and not to be detected by the tests.Between 3 months and 4,5 months i made 4 test including ARN test.

2. I really want to move on,but these symptoms after few days from risk (some still disturbing me also now) give me this paranoia,for this give me one advice to forget about this problem.

3.Can i resume my sexual life with my wife, it is safe now, i dont want after 1-2 year to find out that i am positive.

4. Have to forget about test at 6 months how almost all the doctors in my country recommand.

5.As per your experience you doc. ever you saw or heard about any case wich turn positive later when at 4,5 months was negative.All these responses if is possible to be as per your experience not only as per guidelines, i know in almost all countries 3 months is final term but the human being mind......................

After that i hope to move on and forget about this situation,thank you in advance and i wish you all the best, you Docs make a great job.
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Your followup questions in large part repeat your initial question.  My answers are not going to change.  You did not get HIV-1 or -2 from your exposure of concern.  Your tests test for antibodies to HIV-2  as well as antibodies and antigen  for HIV-1.  Antibody tests are conclusive at 8'weeks, combination antibody/antigen tests at six weeks.  You are NOT infected.  Thus in answer to your questions:
1.please do not continue to waste your time testing.  The results will not change.  Your negative tests are conclusive.  See above.
2.  The symptoms you are worried about are not due to HIV.  BELIEVE YOUR TESTS.
3.  Yes, it is now safe to have unprotected sex with your wife.
4.  There is no scientific reason for firer testing.  A six month test is not needed.
5.  Again, no.  Believe your test results.
EWH
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25 months ago
Hello Doc.
I will ask 2 question and after i will move on with my life,i hope.
As per previous posts my concern now is HIV 2.I saw that hiv 2 have viral load low in comparison with hiv1.

1.Due to of low viral load it is possible my body dont produce antibodies?
2.Can i try the hiv rna 2  or western blot test to be sure,can be these 2 more accurate like part of antibodies 2 from 4th gen. test?

After that i will move on.Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
If you live in North America or Western Europe there is no reason for you to be concerned about HIV-2.  in response to your questions:
1.  If the virus is there, it leads to antibody detection which is reliable detected by current tests.
2.  These tests are no more accurate and may actually be less accurate than the commercial tests you have already had.

Thus, as I have already told you, the antibody tests for this infection are conclusive at any time more than 8 weeks after exposure.  You have two such results.  I have already told you to believe your tests. Further testing is truly a waste of money- you might as well just urn the money you spend on testing.  

This will conclude this thread which will be closed shortly.  i hope my responses will let you move forward with confidence and without the continuing doubts you have expressing in this thread.  Take care.  EWH
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