I hope you are having a great week.

I did 2 kind of hiv tests.  I did 4th generation Combo test by the day 86 from exposure, and i did pcr quantitative test by 92 day from exposure. Both with negative results.

My main question and focus here is about hiv pcr test.

1- how reliable and conclusive is the pcr quantitative test ? And is a negative pcr result  by 92 days conclusive ? 

2- since the pcr test detect the virus itself, is there any medicine or anything else can affect the result? Other than prep and pep

You can relax:  for sure you do not have HIV. The HIV antigen-antibody test -- now normally called the AgAb test, the same as the "4th generation" or "combo" tests -- are 100% conclusive 6 weeks (officially 45 days) after the last possible exposure. That result alone at 86 days was proof you weren't infected 86 days earlier; it could have been done at 6 weeks instead of waiting until almost 12 weeks. The negative PCR test further confirms you are not infected.

1. The PCR test by itself actually can miss some positives, in those rare persons called "elite controllers", whose immune systems are especially effective in suppressing the infection. So technically, that result is a little less reliable than your negative AgAb test. But together the two results prove for sure you do not have HIV, assuming no new exposures within the last 6 weeks.

2. Contrary to information you can find on line, there are no medical conditions, medications, or other factors that have any effect on the reliability of either the AgAb or PCR tests for HIV. The only exception is when people take anti-HIV drugs after exposure to prevent infection (post-exposure prophylaxis, or PEP). If PEP doesn't work, i.e. someone is infected anyway, positive test results are delayed to 6 weeks after completing PEP treatment, instead of 6 weeks after exposure.

3. No, it is impossible for your test results to change. You do not have HIV and should not be tested again, until and unless you have a new high risk exposure.

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

HHH, MD

Thank you for your reply

2) Correct, elite controllers test normally on the AgAb and antibody tests, and AgAb is conclusive in them at 6 weeks.

3) As I said above, " there are no medical conditions, medications, or other factors that have any effect on the reliability of either the AgAb or PCR tests for HIV." There are no exceptions except HIV drugs themselves. That means no test interference or delay from steroids or other immune suppressive drugs, and certainly not from the low dose sort of steroid you used. All contrary information you can find online is false -- urban myth. The earliest HIV antibody tests, no longer in use, might have had rare problems along these lines with high dose steroids, potent chemotherapy, etc. Even that was rare, and is absolutely never a problem with the tests currently in use.

Sir to conclude, so my condition after 2 tests, combo AgAb at day 86 and pcr at day 92 is very conclusive and i don’t need more test in the future like by 6 months ? I can live without being worry about it 

The exposure i had was body to body massage , then i had penis rubbing on her anal while she is naked Without actual penile penetration and insert into the rectum. it was just rubbing for less than 1 minute

Last thing sir if you allow me please

So technically for the person “elite controller “ when his immune system suppressing the infection and the pcr test will miss the infection because of that. it means his immune system is working and fighting the infection and here the  antibodies should appears.

 So pcr test will miss the infection but combo test AbAg will deduct the antibodies that his body system created from suppressing the infection   ?  

when the immune system suppressing the infection the antibodies should appears right ? 

Thanks for everything 

Elite controllers are rare, under one in every thousand HIV infected persons. You are not an elite controller because you do not have HIV. 

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.