[Question #7304] Hiv testing

4 months ago
Dear dr ,

I had a question regarding an hiv exposure . I am a gay Male and in dec 2019 I gave unprottevted oral sex to a Male friend of Unkown hiv status .

He also rubbed his penis on my anus . I am quite sure there was no penetration , since I haven’t had anal sex ever I assume I would have known if there was penetration .

I got tested in August 2020 with a combo 4th gen test . It was non reactive .

I wasn’t too sure about the result as the report took quite long and when I asked the lab they said it was being rechecked , however the final result was negative .

For my peace of mind I got restested at another lab in sept 2020. The result was non reactive . It was a combo 4th gen test . However the report said that this is a CMIA test and it tests for hiv 1 , type M and O as well as HiV 2 and p24 antigen .

I have read that there are two more sub types of hiv and I don’t think it was covered in this test . But I googled and it says that a combo test is definitive at 6 weeks .

I noticed 2 small nodes in my neck recently and I am a bit worried . Because of these nodes I am unable to Believe my results .

Do I require any further testing . Request your valuable advice . I am a bit anxious and worried . Thanks doc 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
You keep returning with repeat questions about the same exposures, or virtually identical ones; and about timing of HIV tests. You also have had my warnings about over-searching the internet for information that confirms your fears and concerns. Th business about various subtypes of HIV not detected by the tests you used are exaggerated; this is simply a non-prolblem. The test results you report prove 100% you do not have HIV. Your symptoms don't suggest HIV -- one or two small lumps under the skin (whether they are lymph nodes or something else) -- never suggest HIV. (When HIV causes node enlargements, they are numerous, large, and body wide.) But even if your symptoms were typical, the test results override both symptoms and exposure history. In addition, as we have discussed repeatedly, you describe sexual exposures that carried little or no risk of HIV -- but just as with symptoms, even with the highest risk exposures, the test results overrule exposure history, proving you were not infected.

You don't have HIV and don't need any further testing.

You have previously been advised about the forum policy against repeated anxiety driven questions with obvious answers. This is your sixth and must be your last. Future questions along these lines. Future ones will be deleted without reply and without refund of the posting fee. Thanks for your understanding.

HHH, MD
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4 months ago
Thanks Dr Handsfield ,

Sorry to bother you with my questions again . Just had some final clarifications :

1. I live in Mumbai, India . Are the 4th gen CMIA test done here same as anywhere else in the world . I mean in terms of accuracy , etc.

2. I also have  a worry that what if there was any sort of error in the testing . This is coz the first time I did the test they said it’s being rechecked .

3. When nodes  swell in hiv , are they small or are they large enough to be noticed ?

4. Does the window period of 3 months cover hiv 2 as well ? 


Thanks for your understanding . 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
1,2) All available HIV tests, undoubtedly including those used in your country, are highly automated and equally reliable in any lab equipped to do them. Testing errors are virtually nonexistant.

3) Obviously you didn't carefully read my reply above. I see no need to repeat myself.

4) The window period is 6 weeks, not 3 months, and includes HIV2.
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4 months ago
Thanks dr ,

One final question . I have heard that the combo test is over 99 percent accurate . Which test would be considered 100 percent accurate to confirm ?

Have there been any rare cases of delayed seroconversion after a Period of 6 weeks ever ?

I have also done a cbc , esr test recently few weeks bak . All the readings are normal . What could be the cause of the nodes then ?

Thanks dr Handsfield 


4 months ago
Also my second report from the other lab disent have any index values mentioned . The lab lady said they don’t mention it . It just says non reactive .

Is that fine ? Or should index values always be mentioned . What if the index value was closer to 1 and I didn’t know as it wasn’t mentioned on the report and it just read Non reactive .

Thanks for all your help doctor Handsfield . 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
The combo test is 100% accurate. To my knowlege, nobody has ever been documented to test negative if enough time (6 weeks) has passed since exposure. The only exception is when someone has taken antii HIV drugs, which can delay positive results to a few weeks after the last dose.

Small nodes like you describe are not abnormal. See my opening reply above about this probably not being abnormal. This forum is limited to HIV and STD issues, and your test results prove you don't have HIV, so I have no other comment about possible causes. Probably nothing is wrong, but see a doctor if you remain cocnerned. Also, keep your hands off. Repteading feeling for nodes can inflame them and make them persist or perhaps enlarge.

That concludes this thread. As discussed above, In any case, this will have to be your last such question on the forum. Repeated anxiety driven questions with predictable answers are not permitted and future ones like this will be deleted without reply and without refund of the posting fee. ASHA is not keen on getting paid for information whose answers already have been given; repeated answers often prolong anxiety rather than helping relieve it; and such questions have limited educational value for other readers, one of the forum's main goals. Thank you for your understanding.

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