[Question #5671] HIV question

19 months ago
Hi Doctors,


I see Dr.HHH comments on other threads saying that 4weeks- 4th gen test is 100% accurate but when i searched online many people are still pointing to CDC which says 3 months. I had a handjob and un protected oral with someone and I don't know her status.  I am getting anxious thinking if what she has cuts and sore or I have them and thinking about diff scenarios. I get anxious when my partner is sick thinking that i have HIV and I transmitted it. 

can I be considered negative with below test results or should i have to wait 12 weeks to be 100% conclusive. Thanks in  advance.

how conclusive are the below test results irrespective of the risk( can unprotected vaginal and Anal also be considered conclusive with below results or the window period changes based on sex activity)? Yesterday was Day 36, I took another 4th gen HV test and HIV RNA test waiting for requests(anxious and hoping they will be negative).

14th day - HIV-1 RNA Qualitative - Negative

29th day - HIV-1 RNA Qualitative - Negative
29th day - HIV Screen 4th Generation wRfx -- Non Reactive

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks for your confidence in our services.

Not all HIV tests are identical. The CDC advice for conclusive testing at 3 months is for older (e.g. 2nd generation) antibody tests, not little used but still offered by some labs. The science is clear that 6 weeks is conclusive for the now-standard antigen-antibody (AgAb, "4th generation", "combo", "duo") tests for HIV. We stopped saying 4 weeks for these tests over a year ago, based on a review of all available tests at that time, which was endorsed by CDC.

Also, online advice from CDC and most other agencies typically depends on a single HIV test. The combination of negative RNA at 14 days plus AgAb result at 4 weeks (29 days) is conclusive. All tests beyond those were superfluous. It is 100% certain you do not have HIV.

In addition, I'll point out that nobody in the world has ever been proved to have caught HIV by oral to penile exposure. And there have obviously been billions of such exposures, including many millions in the presence of oral cuts or sores. So your partner's oral health makes no difference.

Definitely all is well. It is 100% certain you do not have HIV, assuming no other recent exposures you haven't mentioned. Do not have any more HIV tests.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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19 months ago
Thanks Dr.Handsfield, for your quick response, time and the explanation, it make sense.

I understood, its conclusive at 6-weeks with 4th gen HIV test but in may case it 100% conclusive at 4 weeks(29th day) since its a combination of 2 tests ( RNA and 4th gen). Thanks again. I am still waiting for my 36th day test results and will stop testing anymore once I get the results(hopefully tomorrow).

Was it a Typo below did you mean to say 12 weeks.
(We stopped saying 4 weeks for these tests over a year ago, based on a review of all available tests at that time, which was endorsed by CDC.)
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Your summary statement is correct.

There was no typo. When the AgAb (4th gen) tests first became widely available a few years ago, they were generally considered to be conclusive by 4 weeks, which was the advice we gave on this forum. After a published review about a year and a half ago concluded that it rarely can take 6 weeks, we changed our advice from 4 to 6 weeks.
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19 months ago
Thanks Dr, understood.

I just got one result(haven't got the RNA yet)
36th day - HIV 1/2 ANTIGEN/ANTIBODY, FOURTH GENERATION W/RFL  - Non Reactive

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
I'm glad your final test was negative -- but no surprise, of course.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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