[Question #7978] Assessment

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50 months ago
Hello, 

I had 2 combo tests at 46 days. Are these considered conclusive? 

Also, just wanted to ask why some experts and doctors are still recommending to re test at 90 days? Is it really necessary? Have you ever experienced a combo test at 6.5 weeks change later on?

Thanks
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Edward W. Hook M.D.
50 months ago
Thanks for your question.  I’ll be glad to comment.  Your results are conclusive and no further testing is needed.  4th generation, combination HIV antigen/antibody tests provide conclusive results at all times beyond 6 weeks/ 42,days.  Sadly some overly conservative and/or out of date persons still state that longer periods are needed.  This is incorrect.

I have never heard of a test which was negative at 42 days over beyond become positive at a later date. Please don’t worry. EWH
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50 months ago
Hi Doctor,

Thanks for the reply. It is quite reassuring. Due to the anxiety I have searched quite a bit and have put myself in a bad place.

I just wanted to clarify a few things:

1. Is combo test conclusive for both HIV 1/2 at 6 weeks?
2. I read somewhere that 42 days is the 99th percentile for combo tests? Does it mean that these tests will cover 100% accuracy at 42 days is there still a tiny chance of missing at 42 days?
3. Is there any chance of delayed incubation in an average human being?
4. Do most people get symptoms in the first 3 or 4 weeks? Is asymptotic infection quite rare?
5. If a condom does not break, will it protect 100%? 

Thanks
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Edward W. Hook M.D.
50 months ago
Straight to your follow-ups:
1.  Yes it is. FYI less than a fraction of 1% of all HIV found in the United States is HIV-2. Realistically unless you’re sex partner was from west Africa or India there is no reason for concern about HIV-2.
2.  As I said earlier the fourth generation, combination tests are conclusive at six weeks. Conclusive means entirely conclusive not almost conclusive.  I have never seen or heard of a person who had combination test become positive after having a negative test at six weeks or beyond.
3.  Delayed incubation of HIV is an urban myth. It sounds to me like you’ve been spending too much time on the Internet. Not a good idea. All too much miss information there.
4.  Somewhere between 40 and 60% of persons with recently acquired HIV get the acute retroviral syndrome.
5.  For all practical purposes, yes. There are occasional instances in which person’s claim that they’re kind of did not break who require HIV but these are exceptions to the rule and most experts are skeptical that the condom with used correctly throughout the encounter.

I’m not sure why you were so worried. You provided no information about your encounter. That said, if you have been tested at six weeks or beyond for HIV and your test is negative you could be absolutely sure that you were not infected. EWH

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