[Question #492] Autoimmune disease and hiv test

91 months ago
Hello doctors. 
I am male 48, I had sex with lady who I met in the bar, don't know her status, she give me open condom, don't know if condom was damaged.
In 7 weeks I took hiv test in family doctor office, blood from arm , answer in 4 days.
Test probably Elisa 3 generations. Negative. 
In 13 months I had a rush (2 inches) in my left side stomach, very itchy. Came back to doctor, he said allergy , give me cream , rush went away in 4 days. I request from him one more Test, same one . Negative. He is not hiv Doctor, did not ask me questions. 
Another year later (23 months total after sex) I went to the hospital and ask for hiv test. 
I took 2 tests with 7weeks apart, rapid test, blood from finger. Negative. 
I have autoimmune disease,  Hashimoto. 
5 years ago was on medications (tiroyd over reactive). Now is normal. 
Can autoimmune disease affect my test results? Window period? Can I trust my tests?
Two years I have stomach problem, Need to go to the bathroom 3-4 times special in the morning. Some time pain in my upper spine and some times headache in the back.  
Gastro Doctor after colonoscopy and endoscopy said: nervous stomach. I never told him about another tests. 
Thank you 
Best regards.alex 

H. Hunter Handsfield, MD
91 months ago
Welcome to the forum. Thanks for your question.

You needn't worry; your test results are valid. There are no medical conditions that are known to reduce the reliability of HIV testing, especially now that testing includes direct tests for the virus (p24 antigen or DNA/RNA, depending on the test) in addition to antibody. In theory, certain immune deficiencies could impair development of antibody to HIV, i.e. the body's immune response to the virus. But if that happened, it would INCREASE the detection of antigen or DNA/RNA. Even this has rarely if ever been shown to be an actual problem with any illness, autoimmune or otherwise, or with any medications with the possible exception of very potent chemotherapy and immunosuppressive drugs -- far more potent than anything you are likely to have received. All this is theoretical only.

I will also add that your exposure was very low risk. I'll bet that each year not 5 people in the entire US acquire HIV from exposures like this. You had condom protected sex with someone who statistically had less than a 1% chance of having HIV, probably a lot lower than that. But even if you'd had the highest risk exposure you can imagine (e.g. if you had shared drug injection equipment with a known infected person), the test results you had prove unequivocally you do not have HIV.

As for your symptoms, they do not even hint at HIV as the cause. And just as modern HIV tests overrule exposure history, they also overrule any and all symptoms. Even if you had conditions suggesting overt AIDS, your test results would prove that wasn't it.

So all is well in regard to HIV. Don't have any more tests, and stop worrying about it.

I hope this has been helpful. Best wishes--  HHH, MD

91 months ago
Hello dr. Handsfirld. 
Thank you for your answer. Sorry to bother you again. 
I don't know exactly what test my dr.used. 
I just looked on report and I didn't see rna, dna,p 24. 
I think it was antibody 1/2  test 3rd generation (2 of them). First after 7 weeks and second after 13 months.
And 2 tests  after 23 months, rapid tests  (blood from finger)in NY hospital . Dr. Told me test very sensitive. 
Can I trust those tests? 
Thank you . 
H. Hunter Handsfield, MD
91 months ago
Each of the 4 of the tests you mention, by itself, was conclusive and you can trust the results. You could have stopped after the first test at 7 weeks:  "antibody 1/2 test 3rd generation" is valid any time about 6 weeks or more after the last exposure. 

So no change to my original advice above. Stop testing for HIV unless and until you have another potential exposure.

91 months ago
Thank you dr. Handsfield. 
Case closed. 
Best regards. 
H. Hunter Handsfield, MD
91 months ago
Thanks for the thanks. I'm glad to have helped. Take care and stay safe.