[Question #7218] Multiple Tests but still curious

8 months ago
Hello,

I have read around the site and tried to gather as much information as possible but needed to ask for more clarification. 

I’m an American straight man and I bite my fingernails a lot so they occasionally bleed due to that. I fingered this female and noticed a slight burn and forgot that I had just bitten my nails that caused pulled skin and slight bleeding on that specific finger. So that got me worried. 

I had the following tests:

ADVIA Centaur 4th generation HIV test from a lab using blood on a vein at:

6 week, 10 week and 6 month post exposure:
Non reactive (Lab this is part  of Quest Laboratories)

She had a 4th gen HIV test (Blood from vein lab test) at 3+ months from Lab Corp including 10 panel STD tests Post exposure:
Non  reactive for HIV. 

I can’t seem to shake reliability of the test I took. 

Questions:

Does the brand matter that it was a ADVIA Centaur HIV essay? The Other brands I heard may be slightly better. 

Sensitivity and specificity of the tests, what is that exactly and how does that matter from a rating of 98% or 99% difference? (Hope that made sense). 

I know there was a total of 4 tests done, 3 with me and 1 with her but can’t shake the fact that maybe the tests were done incorrectly. Would these tests truly be conclusive without a doubt?

How does a 4th gen hiv test truly work? Antigens start showing up no matter what by 6 weeks? As well as antibodies at 6 weeks. Is that why the 6 week timeline is used that one or the other will be in your blood 1000% if you have it, by 6 weeks?


Appreciate your time with these questions you all deal with on a daily basis. I think it’s the mix of information out there that confuses a person and 2nd guesses themselves. 

Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago

Welcome to our Forum. Thanks for your questions.  I'll be glad to answer.  Before I get to your specifics, let me assure you that the events you describe did not put you at risk for HIV.  If you had asked me if you needed testing, I would have told you that here was no need for testing.  Over the 40 year course of this epidemic millions of persons have had contact with genital secretions and blood using hand that had cuts, scrapes and abrasions present yet no such exposure in the course of masturbation have led to infection.  You are not going to be the 1rst. 

The Quest labs are highly regulated, College of American Pathologists certified, and highly respected.  You can have confidence in the test results they provide.  Your tests at 6 weeks, 10 weeks and 6 months were all taken at times when tests are conclusive and each PROVES that you were not infected.  Your 10 week and 6 month tests were not necessary.

Similarly, your partner's tests prove as well that she was not infected.  Thus you can also be sure that you were not exposed and therefore were not at risk for infection.

Currently available HIV tests are among the most reliable tests in all of medicine.  You should believe the results.  The published sensitivity estimates are minimum, conservative estimates.

HIV virus starts to reproduce just days after infection.  As a result in some persons antigen can be detected within a week or two of initial infection.  Similarly antibody infection also begins.  By 6 weeks all persons who have not taken anti-HIV medication will be positive on the antigen, antibody or both tests. 

Bottom line, the risk you report was no risk, you tests prove that you were not exposed and were not infected.  Further testing is a waste of time and money.  Time to move forward without concern.  EWH

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8 months ago
Good evening Doctor and thank you for your detailed response. It does make me feel much better reading this. 

The only follow ups I would have are the following. 

The Lab I was speaking about is Sonora Quest which Quest Diagnostics is a parent company of. Now knowing the exact lab, would your remarks still remain the same about all that was said about Quest in your first response?

Also, it’s good to know that nail biting (bleeding or not) is not a way to get HIV If fingering a female. Is it safe to say unless it’s penetrative sex (penis to anus and/or vagina), its the only way a person would be at risk for HIV? 


Thank you once again. 


Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago
Yes, my assurances regarding the Quest lab also apply to Sonora Quest.

You are correct that penetrative sexual encounters are the only means by which persons require HIV.  The vast majority of sexually acquired HIV infections occur as a result of genital-genital or anogenital contact. I’m a very small proportion of cases, persons have acquired HIV from participating in fellatio. There are no known cases of HIV which have resulted from receipt of oral sex. EWH
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8 months ago
Wonderful. Thank you Doctor for your time and insight to help me understand all of this. With so much information out there, that can confuse people.  

Thank you once again sir. All the best.