[Question #5809] Hiv testing confusion

20 months ago
Dear doctor i want to ask you some question. Iam male 20 years old and circumcised man.
In 1 june i had risky exposure with csw. In 17 juIy I tested HIV in a lab in my country the customer service said it was 4th generation hiv test with cmia method with architect abbott machine and fortunately I got non-reactive result without titers from the test result. But afterwards I was totally confused after reading the message on the lab's official social media account
 "In this regard Anti-HIV test in this lab uses the 4th generation CMIA method, and can detect antibodies and P24 antigens but P24 antigens are not reported in the test result, because Anti-HIV examination is only used to detect HIV antibodies."
 So my question are :
 1. Can the 4th generation test with architect abbott machine with the cmia method be set to only detect antibodies without a combination of antigens and antibodies?
 2. Does the non-reactive result that I received mean the only non-reactive result for antibodies but the result of the p24 antigen is still unknown or it means antibody non reactive and antigen p24 non reactive?
 3. Can it be separated between the result of antigens and antibodies with the cmia method?
 4. Is my test result  conclusive?
 5. Should I test again 12 weeks from the risk behavior?
6. Is the lab statement in its official media account totally wrong?
7. What is the meaning of antigen p24 is not reported in the test result?
8. I searched in fda and abbott website  , the architect abbott agab combo  cannot distinguish between antigen and antibody but i asked in laborat in the lab she said this tes only report antibody result? Is it possible? Or is she wrong?
9. Is it possible that my antigen p24 result is not checked?
Iam totally confused to whom i must believe. Please help mee sirr
Sorry for my bad english 
Please answer my question iam totally confused
20 months ago
12. Can architect abbott with cmia method can detect and report antibody only??

20 months ago
Please answer 10 my question sirr iam totally afraid and confused
Thanks for your help
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
Welcome to the Forum.  I'll do my best to help.  Let me first ask you to be more patient.  Questions are not answered immediately.  All questions to Dr. Handsfield and I are answered within 24 hours of receipt.

The report you received from the laboratory confuses me as well.  The Abbott Architect is an excellent platform for HIV testing and the results of the CMIA tests are highly reliable.  Typically when the test is run both the HIV antibodies and HIV p24 antigen are tested for and, when this is done, results are entirely conclusive.  Thus if both tests were performed on your specimen no further testing is required.  HOWEVER, laboratories can turn off part of the test or change the test reporting so that only the antibody portion of the test is reported.  I would suggest that you contact the laboratory and ask them if your specimen was tested for both HIV antibodies AND the HIV p24 antigen or only tested for antibodies.  

In answer to your questions:
1. I believe this can be done with this machine.  You need to ask the laboratory.
2.  See my comment above.
3.  Repetitive.  See my comment above
4.  Sigh, See above.  If you were tested only for antibodies your result is about 95% conclusive, if you were tested for both antibodies and antigen your result was conclusive.
5.  See comments above.  If you have a conclusive test, you do not need further testing.
6.  As I said above, you need to clarify things with the laboratory
7.  See answer 6
8.  Why would the person in the lab not tell the truth.  If they state that they report only the antibody result, that is what they do.
9. Repetitive
12. Answered above.

You have asked the same question repeatedly using slightly different words.  My suggestion if to verify that your specimen was tested only for HIV antibodies.  If this was the case, you can retest at this time and with an antibody result at more than 8 weeks after your exposure, your results will be conclusive.  EWH
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20 months ago
my risk was protected vaginal sex 15 seconds with a condom but the condom only covered half my penis and I was afraid the condom leaked and  reverse condom because I got the condom from the prostitute he put on the condom using his mouth to my penis and I received unprotected oral 20 seconds she had oral ulcer in her mouth.  can i get hiv from that risk?
20 months ago
And i had  mild dry cough  4 weeks after exposure and mild sore throat 7 weeks after exposure.no fever and etc.  Were those ars?
20 months ago
Thanks for your reply sir
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
three questions in 10 minutes.  You need to be more patient!

1.  This was a low risk encounter for a number of reasons- Most commercial sex workers do not HIV.  No one has ever been proven to get HIV from receipt of oral sex (even if persons have ulcers on the mouths), you will not be the first.  Condoms provide protection as long as they cover the head of the penis- that only half of the shaft of your penis was covered does not mean that he condom did not protect you.  Condoms that a put on by a person using their mouth to apply the condom still work.

2.  Your cough and sore throat were not the ARS. If they were the ARS, your HIV test would have been positive soon after that. Further, fever is a typical part of the ARS.

EWH
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20 months ago
Because iam circumsised and condom only protected half of my penis iam afraid her vaginal fluid touch my circumcised scar because i have long circumciced scar and the condom didnt cover all of my circumcised scar. Was it risk of hiv transmision?
20 months ago
Thansk for your reply sir. Sorry sir Iam totally afraid now
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
You have now asked 14 questions.  This will be the final response.  FYI our Forum provides up to three responses to client questions.  This is my 3rd response.  therefore as per Forum Guidelines this thread will now be closed.  You should not have further questions:

1.  Healed scars do not change your risk for HIV. If your circumcision occurred more than 6 months ago, if anything, your circumcision reduces your risk for HIV and does not increase it (circumcised men are 50% less likely to acquired HIV than men who are not circumcised). As I said above the fact that that condom did not entirely cover your penis does not mean that the condom did not work.  As long as the condom covered the head of your penis you were protected.  Getting vaginal fluid on a scar does not represent a risk for HIV.

This completes this thread. EWH
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