[Question #5819] HIV window period

20 months ago
Hello, I'm a heterosexual straight man and I had unprotected vaginal sex with a very promiscuous woman.

I have tested 
Hiv-1/Hiv-2 AG/AB combo negative
Hiv-1 RNA/NAAT negative at 3 weeks 

Hiv-1/hiv-2 AG/Ab combo negative 
Hiv-1 RNA/NAAT negative at 7 weeks

My main concern is hiv2 because I have read that the window period for hiv2 could be different because not much is known about it.

1.When is the results conclusive for hiv-2 antibodies?Because I have read the the combo test does not test for hiv-2 antigens.

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

Despite all the media attention to HIV, it remians much less common in women in the US and most industrialized countries than you might assume, even among those "very promiscuous". There's probably under 1 chance in a thousand your partner has HIV; and if she did, the average transmission risk from a single episode of unprotected vaginal sex is around 1 in 2,500. (That said, I would advise you to get into the condom habit for future non-monogamous sexual events!)

In any case, your test results are conclusive. For HIV1 they were almost 100% conclusive at 3 weeks; and they are absolutely conclusive for both viruses at 7 weeks. You are correct that the antigen component of the antigen-antibody (combo) test, and the RNA test, do not dectect HIV2, but the antibody protion does so by 6 weeks. In any case, HIV2 is rare outside equatorial west Africa, where it evolved. There have only been a few hundred cases in the US, almost all in Africans or others who acquired the virus in Africa, and a few of their mostly regular sex partners (e.g. their spouses).

So all is well -- you're home free in regard to HIV. But would also recommend a urine gonorrhea/chlamydia test and a syphilis blood test, if not yet done. Since you apparently have had no STD symptoms, you can expect negative results. But the risks were a lot higher for these STDs than for HIV.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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20 months ago
I have tested negative for syphilis,chlamydia and gonorrhea at 7 weeks.I have had no symptoms.

1.Is it possible for HIV -2 antibodies not to be detected after 7 weeks with an Hiv-1/Hiv-2 combo test?

-I got the testing done at a local human services clinic for my county.
-I'm healthy, i take no kind of medication and I have no medical problems.
-The woman In the sex act i had been concerned about is not foreign.
-I do live in the USA


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Glad to hear the other negative test results.

1. No, not possible -- or so rarely it can be ignored. And it sounds like your partner is at very low risk for having HIV. You can move on with complete confidence you have neither HIV1 nor HIV2.---
20 months ago
What does so rarely so it could be ignored mean?

Are you talking about the 20 or so seronegative cases within the span of decades, that tested negative after the 3 month window period?Most who had tested with earlier second generation HIV antibody test and that were also severely deathly ill most of the time?
20 months ago
Sorry I recall there is 3 follow up questions and I just wanted a bit more elaboration before you closed the thread.Your information has been helpful and has relieved my anxiety.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
To my knowledge, those few documented cases of delayed seroconversion all predated the antigen-antibody (4th genertation, combo) tests. If on rare occasions antibody fails to develop, the antigen component and the RNA/NAAT would remain positive, probably even more strongly -- which is how those ~20 cases eventually were diagnosed. And for goodness' sake, are you really going to be concerned by a qualification like "so rarely it can be ignored"? Could that mean a potential false negative HIV2 test? I suppose so. But as discussed above, the chance you have HIV2 is vanishingly small; and the further chance that it was missed by the tests you have had is in the range of your odds of being struck by a meteorite. Let it go and stop testing.

As you correctly predicted, that ends this thread. I hope the discussion has been helpful.
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