[Question #7393] Testing

5 months ago
Hello and thanks for taking my question.  Can you tell me if an hiv rna test at 16 days and a duo test at 28 days is conclusive?  I had condom protected sex on October 3rd and unprotected oral sex on October 10th.  The rna test was oct 19th and duo oct 31st.
I am asking because I received a false positive syphillis test, trying to figure out what causes this?
Rpr 1:1 non reactive for antibodies, I have since tested negative 2 weeks later
Thanks
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago

Welcome to our Forum and thanks for your question.  Thanks as well for your confidence in our service.  I'll do my best to help.  Your results are absolutely conclusive with no need whatsoever for further testing related the encounter of concern.  In general 4th generation, "duo" tests alone are more than 99% conclusive at 28 days - in fact, neither or us on this forum have ever seen or heard of someone whose test became positive after 28 days.  When combined with an RNA test however, the results are absolutely conclusive. 

False positive blood tests for syphilis are quite frustrating.  All blood tests have occasional false positive and for syphilis tests, the rate is a bit higher than for many other tests (including the tests for HIV).  While certain conditions such as chronic inflammatory diseases like Rheumatoid arthritis, or chronic infections are somewhat associated with falsely positive tests for syphilis, in most persons it's simply bad luck.  In more than 85% of persons with falsely positive RPRs the tests are reactive at titers of less than 1:2, as is the case for you.  In some persons false positive tests go away on their own, in others that can be a lifelong source of frustration.

I hope that this information is helpful. EWH

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5 months ago
Your answers were very helpful, thank you.  Should I be concerned about hepatitis from these scenarios?  I have had multiple oral sex encounters mostly with the same girl noted in my original post.
Also I believe I have gum disease been battling this forever.  I think this maybe a cause I was scared based on internet research saying hiv is a cause and possibly hepatitis.  Have never had a false positive on syphillis before, even though it’s recoverable it sent me into a spiral of depression and anxiety
5 months ago
I should add received oral sex not performed.  
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago

Hepatitis following oral sex is not a concern except if you practice both rectal and oral sex in a sequence which might lead to introduction of hepatitis A virus from the rectum into the mouth and throat.  While some internet sites list the possibility of acquiring hepatitis B or C from performing is totally theoretical,  Textbooks do not acknowledge the possibility and I have never read a research paper in which oral transmission of hepatitis  or C has been proven.  I would not be worried about hepatitis.   There is no transmission of hepatitis (or HIV) ever proven from receipt of oral sex. 

I hope this further explanation is helpful.  I urge you to accept your false positive as bad luck and not a manifestation of some other STI.  EWH

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5 months ago
Thank you, need to stop googling and accept the science.  Appreciate all that you do
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago
I'm pleased I could be helpful. Yo are correct.  In this area Google is not your friend.  EWH
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