[Question #7647] HIV TESTING

54 months ago

Hi doctors!

I (f) had an exposure back in late August in which i don’t remember much but I do remember oral sex (with a male) happened both ways. About a few weeks later i experienced muscle and joint pain, a sore throat, and headaches.

I want to make sure my tests are conclusive

4th generation tests:

6 weeks

11 weeks,

3 months,

4 months,

4.5 months,

5 months.

After reading through hundreds of posts, i know you would say it’s conclusive but I recently found out i have an overactive thyroid. I was finally accepting the fact that I don’t have HIV, but now i’m worried that this could delay a positive result. I’m having a very hard time moving on and reading through websites and articles that say “6 months is needed” or that “autoimmune conditions can delay a positive result” is driving me crazy.

I just want to know:

Are there any autoimmune conditions (in my case an overactive thyroid or hyperthyroidism) that may delay positive results? from what i’ve read, hyperthyroidism causes it’s own antibodies which may block antibodies from other illnesses including HIV.
After seeing that i have tested up to 5 months, do you think i’m 100% HIV 1 & 2 negative regardless of how high or low the risk was?
could my thyroid issue have been caused by an HIV infection even after receiving negatives?

Thank you so much for the help.

H. Hunter Handsfield, MD

54 months ago

Welcome to the forum. Thank you for your confidence in our services.

Thank you as well for reviewing other threads with questions similar to your own. However, you missed some points which we frequently make that should answer all your concerns. First, that there are no medical conditions or drugs of any kind that have any effect on reliability or timing of the AgAb (4th generation) HIV blood tests, with only one exception: if someone takes anti-HIV drugs just before or after an exposure, and if those drugs are not successful in preventing HIV, it takes longer for testing to become positive. But there are no other medical circumstances that have any effect. The second point you may have missed in other discussions is that the AgAb HIV tests always overrule all other considerations: no matter how typical the symptoms, and no matter how high risk the exposure, negative test results can be relied on as true. And third, the time to conclusively positive results with these tests is 6 weeks. Therefore, your first negative test was conclusive; all the rest were superfluous and unnecessary.

I'll also point out that you had a very low risk exposure. HIV has never been scientifically documented to be transmitted mouth to penis; and the risk for performing fellatio (penis to oral) has been estimated at 1 in 10,000. That's equivalent to giving BJs to infected men once daily for 27 years before transmission of the virus might be likely.

As these comments imply, you have found inaccurate information somewhere. There is absolutely no evidence that autoimmune conditions delay positive HIV test results. In theory, that might have been possible with older HIV antibody tests no longer in use. That's the beauty of the newer AgAb (4th generation) tests: they fill in a former theoretical gap in test reliability.

Those comments directly answer questions 1 and 2. For question 3, the answer is no: HIV infection doesn't cause thyroid disease, and certainly your negative HIV tests prove it did not do so in your case.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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54 months ago

Hello DR. H

thank you for the explanation.

The thing is, i’m not fully sure if it was only oral so im not quite sure how high my risk was. But regardless, since you made it clear that my tests are conclusive no matter how high the risk is, i will try to move on. I guess i’m just worried that i could be one of the rare cases.

I asked about the 6 months window period because my doctor told me to follow up at 6 months to fully make it conclusive. I just don’t want to wait that long because it fuels so much stress and anxiety.

one more question i have is,

is it possible for neither antigen or antibodies to be present? I dont quite consider myself as a healthy person so i was wondering if this is a possibility.

H. Hunter Handsfield, MD

54 months ago

Thanks for the thanks. Even if there was unprotected anal sex AND if your partner had HIV, the odds would still be strongly in your favor. But as you say yourself, the amount of risk at the time is irrelevant given your negative test results.

Many doctors remain ultra-conservative in their HIV test recommendations. But that doesn't make them right. No HIV expert believes it ever takes 6 months for conclusive test results, and 6 weeks is considered truly conclusive by virtually all experts. I strongly recommend you have no further tests at all. You can take your current results to the bank without further worry.

And no, it is not possible to have HIV and not have detectable antigen or antibodies to the virus. That's why the AgAb tests always are conclusive.

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54 months ago

Thank you Dr H!!

I’m assuming i can move on without worry and stop testing now.

This has been the most stressful situation ive ever gone through and i’ve been finding inaccurate information everywhere so thank you for clarifying. Best regards

H. Hunter Handsfield, MD

54 months ago

"I'm assuming...": Correct restatement of my advice above.

Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.

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