[Question #6071] HIV question

17 months ago
Hi Dr,

I had an exposure 115 days (16.5 weeks) ago ( protected sex at a massage parlor, un covered blow job and pussy licking). NO PEP

I had a HIV 4th gen and HIV RNA test ( both at Loabcorp and Quest) on week 6, 12 and 15. All were Non reactive(for 4th gen) and NON detectable(for RNA). Can I 100% consider conclusive HIV negative with my week 15 test( 105 days after exposure). I read some threads about 2nd hiv window period and late seroconverstion in some people. Would those people also be conclusive by week-15. Also on some websites it still says they recommend another test on 6month mark, is completely outdated info.

is there any possibility or scenario for antibodies and antigens to stay at a very low un detectable level for the 4th gen and RNA tests on week-15

I wanted to make sure that am 100% safe with my 3 neagtive results and can safely move on with my normal life and sexual activities.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Welcome to the Forum and thanks for your question.  I'll provide a more detailed response below but the bottom line and answer to your question is that your results are entirely conclusive and you have proven that you did not acquire HIV from the encounter that you describe.  There is no need for additional testing, no need for continuing concern, and no need for you to abstain from unprotected sex because of concerns about HIV related to the episode you have described.  now for additional details:

1.  The was a VERY low risk event.  most CSWs do not have HIV. Even if your masseuse did have HIV, your genital sexual contact was very low risk because you used a condom and there are no proven cases of HIV acquired through receipt of oral sex.  Cunnilingus also only very, very rarely results in HIV acquisition.

2.  Your testing is conclusive.  4th generation HIV tests are considered conclusive at 6 weeks.  Thus your results at 6, 12, and 15 weeks are all conclusive at two different, highly respected labs.  You then have confirmed these results with HIV RNA PCR which is also conclusive.

3.  The so-called "2nd window" is an extraordinarily rare, largely theoretical concern related to 4th generation test performance. The way to rule out this possibility, if there is such a concern, is with a PCR test which you have already had done several times.  Thus you have absolutely ruled out the possibility that infection might have been missed.

Bottom line, your results are absolutely conclusive.  Believe them!  It is past time for your to resume your "normal life and sexual activities."  EWH
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17 months ago
Thank you very much for your reply and assurance Dr Hook.  one more question, is there any chance or possibility at all or was there ever a scenario that HIV was not detected or missed by 4th gen and RNA tests after 15 weeks? I am worried because of various kind of symptoms am having, probably most of them were beacuse of anxiety and am relating everything to HIV.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
 The answer to your follow-up question is very simple. Emphatically, no!. These tests are extraordinarily sensitive and the idea that both tests may have missed an infection is simply not realistic. You need to look for other reasons for your symptoms. 

I hope this response is helpful to you.  EWH.
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17 months ago
Thank you Dr. I will try to forget about the incident and trust my results and will try to move on with my life. One last question, I know you aready answered but wnat to ask one last time. I don't need to wait for 6 months correct, I can 1000% safely trust my results and they are conclusive correct.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
No need to wait any longer.  your results are conclusive.

End of thread.  As I suspect you know, we permit up to a total of three responses to each question. This was your final question. This thread will now be closed.  I urge you to move forward without continuing concern.  EWH
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