[Question #8956] Mail in at home blood tests

37 months ago

Hi, I wanted to ask what your opinion would be on taking a finger pick collection mail in 4th generation hiv test at 7 months post exposure. How accurate are they and can you trust the results? I bought a “my lab box” test and I know the samples are tested in CLIA laboratories so I feel they should be pretty accurate. I have had a negative 4th generation test 8 weeks post exposure but want to test again because I am experiencing symptoms to this day. I know you will say I do not need further testing but I want to do this for my peace of mind.

37 months ago

The mail in test I bought mentions that the samples are done in accredited laboratories, and are fourth generation. Would this be accurate 7 months post exposure? Also I wanted to ask- I read on some testing guidelines I found that if you have been co-infected with another viral pathogen, like cmv or hep B, that even with 4th generation tests you must be tested out to 12-24 weeks. Would having a coinfection suppress the p24 AND antibody production?

H. Hunter Handsfield, MD

37 months ago

Welcome to the forum. Thanks for your confidence in our services.

You can rely 100% on the test results you have had -- both the lab-based antigen-antibody (AgAb, 4th generation) test done at 8 weeks and the latest at-home test. That test is 100% conclusive by itself. You can be 100% certain you do not have HIV, assuming no more recent possible exposures since the one 7 months ago.

I am unaware of reports of delayed HIV test results on account of CMV or hepatitis B -- only hepatitis C, and that involved only one or two reports and is exceedingly rare if it occurs at all. In any case, the chance you have a new infection with any of these viruses probably is zero or very close to it. You really needn't worry about these or any other coinfecitons that would alter the reliability of the test results either at 8 weeks or more recently.

It sounds like you have seen other comments on this forum that HIV test results always overrule symptoms. You results prove that whatever symptoms you have had, they are not caused by HIV. Of course if they continue or you remain concerned, see a doctor to figure out what's going on.

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

HHH, MD

---

37 months ago

Thank you. I had read on another users post where you said that coinfection with other viral pathogens would not affect the antigen portion of the 4th gen tests is that true?

Even if I had been coinfected, would 8 weeks be plenty of time to detect antigen/ antibody on a 4th gen test? I have been unable to find any study or report online on why cmv or EBV or hep b would extend the window period for 4th gen tests. I don’t understand why European guideline are suggesting this when it should only affect seroconversion to antibodies not viral p24…https://iusti.org/wp-content/uploads/2021/05/PublishedHIVTesting2021.pdf page 7 says hep B and hep C but includes the words “any viral pathogen” and I have seen some include cmv and hiv. I have tested negative for hiv but I tested high IGM and IGG for EBV. Can I still trust my 8 week test results? Also What does it mean by “microbiologically proven”? I am having lasting symptoms.

37 months ago

Since the mail in finger prick home tests are done in a laboratory using 4th gen technology, are they just as reliable as one done with blood from a vein?

37 months ago

Sorry about that last question, you already said it was reliable. Sorry!

H. Hunter Handsfield, MD

37 months ago

The guidelines document you link is a nice up-to-date summary of HIV testing issues and recommendations. However, note that as a comprehensive guide, it has to cover all bases like atypical outcomes, no matter how rare. Also note my opening comment that I have not come across nor even heard of a case of false test results on account of other viral infections. But of course if you remain concerned, see and infectious diseases expert to discuss whether any additional, or confirmatory testing would be helpful.---

37 months ago

Thank you I will seek one, but do you personally think I’m in the clear? As far as, having an 8 week negative 4th generation 8 weeks past possible exposure?

H. Hunter Handsfield, MD

37 months ago

You're definitely in the clear. It is impossible to have HIV and have a negative HIV AgAb (4th generation) test any time beyond 45 days from exposure.

You haven't said anything in your previous thread or this one about the nature of the exposure. I would be happy to comment on that if you would like to provide some information about it. Otherwise, we're at the usual limit of two follow-up questions.

---

37 months ago

Hi I had a one time exposure with a heterosexual man who did not ejaculate in me, although I know that doesn’t matter. Afterwards I had BV that he gave me which I know increases my chances. He also tested negative a few weeks later. I’ve had copious symptoms. Does BV always come with hiv? If I didn’t develop the BV symptoms until a couple days after sex would it still have increased my chances? Thank you.

37 months ago

If someone is re-exposed to the same strain of hiv multiple times during their acute infection would that slow their seroconversion or suppress viral p24? (Asking on account of my ex partner’s negative test results, I don’t know what he had been up to after I last saw him)

37 months ago

I should mention I have not seen him since November.

37 months ago

I have one last silly question. Does biotin actually affect the results of HIV tests? I know this is silly but I use a shampoo called biolage, and I don’t know if it would be enough to affect test results, but I thought I’d ask anyway. Thank you!

H. Hunter Handsfield, MD

37 months ago

That exposure sounds pretty close to zero risk. You misunderstand some aspects about BV and HIV risk. BV can be triggered by sex, but the association with new HIV infection is very weak, and getting BV after sex does not imply the risk of HIV was higher. It is statistically unlikely your partner had HIV. And your partner's negative HIV test soon afterward should have been 100% reassuring to you: it proved he could not have given you the virus, no matter how many times you had sex with him.

Giant doses of biotin may have some effect on HIV test reliability. The amounts normally taken even by the most aggressive body builders has no effect, and certainly as an ingredient in a cosmetic is meaningless.

Do your best to avoid looking for trivial reasons why you might be the exception to the scientific principles and rules. You are not. There is no way you have HIV, and almost certainly were not at risk. Perhaps you would also like to know the tin the 15 years of this and our preceding forum, with thousands of questions from people worried about HIV, nobody has yet reported they were infected. You won't be the first. If and when it happens, I am sure it will be from a typical, truly high risk event (like unprotected anal sex with a known infected partner), and not one with near zero risk; and it will not be in someone with atypically negative initial test results. All is well: you don/t have it!

I hope this reasoned, science based advice settles the issue for you. Best wishes and stay safe. Finally, if you have been happy with the forum, why not consider a charitable donation to the sponsor, the American Sexual Health Association. It is the premier agency in support of sexual health with emphasis on STI prevention. Look for the Donate link on ASHA's home page: www.ashasexualhealth.org.

Best wishes and stay safe.

---