[Question #6250] HIV Testing 50 Days After Possible Exposure

17 months ago
Dear Doctors,

After the sexual encounter I told you about a couple of weeks ago, I went to get tested for HIV (in Germany), 50 days after what might have been an exposure. I was wondering if you have ever heard of a "5th Generation Test" which the lab apparently performed. The nurse took a blood sample from a vein in my arm and sent it to the lab. The next day I got the result which was negative. The test looked for antigenes and antibodies.

My questions are

1) Does the negative result mean my symptoms were certainly not due to HIV?
2) Is such a test at 50 days 100% conclusive?
3) I smoked some weed approximately two weeks before I took the test — could that have affected the result?

Thank you very much in advance and best wishes!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
I'm sorry you found it necessary to return. We discussed the virtually zero risk natore of your exposure.

"5th generation" is sometimes used for a newly developed antigen-antibody test. It is a fine test, but most experts believe it is not a sufficiant technological advance to call it a new generation of testing. It performas as well as the excellent 4th generation tests. 

1,2) The result is 100% conclusive and proves your symptoms are not caused by HIV.

3) There are no drugs, medications, or medical conditions that have any effect on any HIV test results, except for HIV drugs themselves (e.g. when taken for post-exposure prophylaxis). Smoking a joint has no effect.

It is time for you to move on without worry.

HHH, MD
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17 months ago
Dear Dr Handsfield,

Thank you for your reassuring reply! And don't be sorry — there is information in your reply that others will read and it will help them calm their anxiety. I would like to use this occasion to emphasize just how remarkable it is what the mind can do to the body.

Thanks again and best wishes
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
Thanks for the thanks. I'm glad to have helped.---
17 months ago
Dear Dr Handsfield,

given I can move on from my HIV fear following a seven weeks ECLIA "5th Generation" Ab/Ag test that came back negative, I was wondering if you could tell me whether any other STD comes to your mind in my case.

It has now been more than 8 weeks since the sexual activity described in my first question. I have now caught a cold, but that does not really worry me since pretty much everyone else around is in a similar condition. I have nasal congestion and a cough.

Anyway, what worries me more is that my fingernails have recently changed in appearance. There is some white stuff that covers the lunula. It comes off whenever I wash my hands but always reappears a couple of minutes later. It's not at all painful, but I'm  sure I would have noticed it even had I not just experienced weeks of anxiety and increased awareness of physical symptoms. I have never seen it before.

I guess my question is whether in your expert opinion this is something that hints at a condition that could have been caused by the sexual encounter discussed.

Apologies for bothering you again! I think I may be traumatized after what I've been through.

Thanks again and best wishes.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
No STD causes cold symptoms or the fingernail changes you describe. Neither sounds serious, but see a doctor if you remain concerned.

Reflecting on "I may be traumatized after what I've been through", I will point out that whenever someone suspects his or her own symptoms have an emotional or psychological origin, usually s/he is right.

That concludes this thread. I hope the discussion has been helpful.
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