[Question #8385] HIV Test

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45 months ago
I had a low risk incident to HIV (I was giving oral sex). I took 6, 4th generation rapid tests over the last few weeks ( some were rapid 4th gen tests and others were from vein I did this to try and catch the p24antigen before it disappeared, as well as the antibodies that form afterward). I took a 4th gen test from the vein 40 days after exposure and it came back negative. Can I trust these results?

Additionally, I take Valtrex daily. Would this affect results (ie false negative)? I fully understand that my anxiety will not speed up antibody formation but my head has been a mess lately.
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Edward W. Hook M.D.
45 months ago
Welcome to our forum. Thanks for your questions. I’ll be glad to comment.  It appears that your concern about the disappearance of the HIV P24 antigen is misplaced. When persons acquire HIV., the P 24 antigen may appear before antibodies are detectable. When antibodies reach sufficient levels that the P 24 antigen may no longer be detectable HIV antibodies are readily detectable by currently available fourth generation tests. Thus the concept that there may be missed infections due to disappearing P 24 antigen is incorrect.

The exposure that you described was close to no risk. If your partner was infected with HIV, your risk of acquiring HIV from performing oral sex on him it’s less than one infection in 10,000 exposures (I.e. That would be one infection acquired if you performed oral sex Ion an untreated, HIV infected person every day for more than 27 years). Further, fourth generation HIV tests provide conclusive results at 42 days following exposure. Your test at 40 days is virtually conclusive and the chance the infection would’ve been messed is negligible.  

Taking Val tracks has no affect on the accuracy of current fourth generation HIV test.

I urge you not to worry further about the exposure that is making you anxious. Your risk was negligible before you tested and your 40 day test results effectively prove that you were not infected. Personally, I see no reason for further testing. If you need to reassure yourself, test at 42 days. I am confident that that test  will be also negative. EWH
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