[Question #5647] HIV 1/2 Test Results Conclusive

19 months ago
Hello.  I had unprotected sex with a sex worker from Ukraine 11 weeks ago while traveling in Doha, Qatar.  At 9 weeks I took a 4th Generation HIV 1/2 Test.  The results were negative.  

1.)  Is this conclusive for HIV I and HIV 2 or do I need to get re-tested?  I have recently had headaches, achy muscles, nausea, and diarrhea, so I am concerned.  

2.)  If it is not HIV, is it possible that I became sick from this sexual encounter and that the illness is just now showing up 11 weeks later?
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
Welcome to our Forum and thanks for your question.  I'll be glad to comment.  I hope that in addition to testing for HIV you were tested for other STIs.  STI rates are relatively high in the Ukraine, particularly among CSWs.  As for your specific questions:

1.  Your HIV test results are absolutely conclusive, proving that you did not acquire HIV-1 or -2 from your exposure 11 weeks ago and that your symptoms are not due to HIV acquired at that time.

2.  This would be rather late for an STI infection acquired during your exposure 11 weeks ago to become apparent with the flu-like symptoms that you describe.  The symptoms you describe are typical of a wide variety of non-sexually acquired, viral STIs and are probably best evaluated with a visit to a doctor if they do not resolve after 3-4 days.  

I hope that this assessment is helpful.  EWH
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19 months ago
Thank you.  Your response says that the symptoms are typical of “a wide variety of non sexually acquired, viral STIs”.  Is this a typo?   My understanding is that an STI is a “sexually transmitted infection”.  

I’ve had similar symptoms off and on for about two weeks, so essentially since 9 weeks after the encounter.  Is this also too late to be an illness caused by the sexual encounter?
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
I apologize, I was typing too fast and "STI" was an error.  The statement should have read "a wide variety of non-sexually transmitted viral infections."  Your symptoms are non-specific and this really is too far out from your exposure to make STI likely.   EWH---
19 months ago
Thank you, again.  I presumed that is what you meant, but wanted to be sure.  My final follow up question will be in response to your comment about getting tested for other STI.  I did a multi panel test 20 days after the encounter (Syphillis, Gonnorhea, Hep B, Hep C, Chlamydia, Trich, HSV, HIV) .   All results came back negative.  Is there any reason to re-do any of those tests based on the symptoms I am now experiencing or the fact that they were done 20 days after the encounter?
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
Your testing for HIV, hepatitis, and syphilis was likely too early to be conclusive.  Among the long list of possible infections which might (but likely are not) cause your symptoms are hepatitis and syphilis in particular.  Early HIV can occur without symptoms.  To be entirely confident, I would suggest testing for hepatitis, syphilis and HIV although my guess is this tests will be negative (I continue to suspect that this is an unrelated, non-STI viral illness).  I see no need for further testing for gonorrhea, chlamydia, trichomonas, herpes, etc.

I hoe this helps.  EWH
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19 months ago
Thank you.  I had follow on Gen 4 HIV test at 9 weeks.   Came back negative.  No need to retest for that, right?
Edward W. Hook M.D.
Edward W. Hook M.D.
19 months ago
Correct. the results of a 4th generation HIV 1/2 test at 9 weeks is conclusive.  No need for further testing

This will complete this thread.  Take care. EWH
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