After the exposure by 28 days I did an 4th generation hiv test with negative result.

After that i start using fluconazole (antifungal) drug which is immunosuppressive drug.

after by day 60 from exposure which it was 9 days after using the drugs (fluconazole)  last dose. i did the test again hiv test 4th gen and the result negative.

I don't know where and how you came to believe fluconazole is immunosuppressive. It is not, nor is any other anti-infective drug. In any case, immunosuppressive drugs in fact have little or no effect on HIV test reliability. In theory, high doses of some such drugs (in the doses used for chemotherapy, or as initial treatment in some autoimmune and rheumoatologic conditions), might suppress or delay antibody production in people newly infected with HIV. In fact, the reported cases in which this happen are extremely rare and always have been; and even rarer with the newer antibody tests, i.e. third generation of the past 10-15 years. And certainly there are no known test failures or delay with the antigen-antibody (AgAb, 4th generation) blood tests. That's part of the beauty in the AgAb tests:  if somehow antibody fails to develop or delayed, the antigen portion of the test remains positive. In theory, it could be that the AgAb tests have increased reliability in the presence of immunosuppressive drugs and medical conditions, not reduced reliability.

So your negative test results are 100% reliable, regardless of your treatment with fluconazole or any other medications that might come to mind. You do not need any further testing; you can be certain you do not have HIV.

I hope these comments allay your concerns. Please let me know if anything isn't clear.

HHH, MD

I found that in some health website mentioning that fluconazole can act by immunoregulatory mechanism stimulating the host immune resistance against opportunistic infections also in immunocompromised conditions. 

The test results you already have are 100% conclusive. Any additional tests at any time will simply confirm what you already know. Please do your best to accept this reasoned, science based evaluation and advice. You do not have HIV, period.

I reached the form a month ago and i just want your advice and opinion on my current situation please to move on with my life and stop the anxiety I’m having.

The exposure type that i had was, penis rubbing with a girl , penis rubbing through her anus while she’s totally naked but i was wearing only my boxer. 

I did many tests, 4th gen combo test by days 60 , 80 , 91 , 110 from exposure. And hiv type 1 pcr test  by day 110 from exposure. Negative result for all the tests.

I want your opinion on how reliable and conclusive my condition and tests ?

Is it advisable to repeat the test after 3 months  there is any protocol says that? And may the negative result I’m having  change after 3 months  ? 

The pcr test i had was only for hiv type-1 is it enough because it was the only type provided on the clinic,or I should have also pcr test for type-2 ?

Last question for the 4th gen combo test, if the antibodies didn’t appears in the body-system that means the ag still there and the combo test will detect the infection ? The Ag p24 only reduce when the antibodies start to appear the immune-system?

Thank you

Regrds

"The exposure type that i had was, penis rubbing with a girl , penis rubbing through her anus while she’s totally naked but i was wearing only my boxer." This was a zero risk exposure. There was no possibility of HIV or any other STI, and no need for testing for anything.

"...how reliable and conclusive my condition and tests?" 100%, therefore no reason to test again at 3 months or any other time.

"...should have also pcr test for type-2?" No. Although the PCR was only for HIV1, your blood test results show you did not catch HIV2. Anyway, HIV2 is very rare in most of the world; and as I said above, the exposure described was zero risk. 

"Last question...."  You correctly understand the AgAb (4th generation, combo) test. Within 4-6 weeks after catching HIV, either HIV antigen or antibody is detectable in the blood for life, so the test remains positive for life. There are no exceptions.

That completes this thread. I hope the discussion has been helpful. Please do not have any more tests for HIV!