[Question #6179] Question on testing and scenarios

16 months ago
Hi Dr. I read many posts on this website before posting my question.i see that 4them ge. Ab/ag test conclusive at 6 weeks and RNA at 3 weeks. With no PEP irrespective of type of exposure 

Is there any possible real chance for anyone to be not get detected by 4th gen and RNA test at 29 weeks. I have been thinking about what if scenarios. Can my test result at be 20 weeks irrespective of exposure and what if scenarios.


16 months ago
I meant to say, can my negative test results with 4th gen and RNA be 100% conclusive at 20 weeks 
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago

Welcome to our Forum.  I'll try to help.  You are "bargaining" here.  HIV RNA PCR tests are almost always positive at 11-12 days following an exposure.  Over 99% of 4th generation tests are positive at 4 weeks (28 days) and are completely conclusive at 6 weeks.  A combination of a negative PCR test and a negative 4th generation test at 20 days is almost certainly not going to change with additional time but there are no data to inform the answer.

Further, you apparently do not want to describe your exposure but the fact is, that too matters. 

Let's not play game.  Get a grip on yourself! Personally, with both tests negative at 20 days would give me great reassurance and I would not feel a need for further testing BUT, if you want to know if there is scientific evidence that these results would be absolutely conclusive, then the answer is no.

I hope this comment is helpful.  EWH

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16 months ago
Hi Dr Hook. I think you misread my question, the exposure was 20 weeks ago not 20 days. 

I had a negative 4th gen and RNA at 8 weeks and 20 weeks post exposure.

It was mutual mastrubation and am pretty sure her vaginal fluid was on my penis since I touched it after figuring her. and protected sex and worried that condom is broken.

Can my negative test results with 4th gen and RNA be 100% conclusive at 20 weeks 
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago
Thanks for the clarification, I did misread your question.  Negative tests at 20 weeks are absolutely conclusive.  No need for concern or for additional testing of any sort.  Again, sorry for the error in reading your question.  EWH
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16 months ago
Thanks dr and one last question and I will stop.

Is there any possible real chance for anyone to be not get detected by 4th gen and RNA test at 20 weeks. I have been thinking about what if scenarios.
And was it scientifically proven that the tests are conclusive at any time after 3 months
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago
Your follow-up question, as I read it is repetitive and does not change my answer.  Current 4th generation tests for HIV are amongst the most reliable tests in all of medicine.  They are conclusive for all persons who have not received anti-HIV therapy at all times more than 6 months after an exposure.  The statement that they are conclusive is based on the evidence provided by many studies evaluating virtually tens of thousands of persons using different tests which agree, validating each other.  For instance in your case, your two tests have looked for evidence of HIV in three different ways- by looking for viral RNA (the PCR test), by looking for viral proteins (the p24 antigen) and by looking for antibodies to HIV.  Believe your test results.  No further testing is warranted for any encounter which occurred more than 20 weeks ago.  EWH
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16 months ago
Thanks Dr. I believe you meant 6 weeks in your answer and not 6 months. 
Edward W. Hook M.D.
Edward W. Hook M.D.
16 months ago

You are correct- 6 weeks.  Typing too fast

I have now replied three times to your questions and comments.  As per Forum Guidelines, this thread will be closed shortly. EWH

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