Glad you provide this service. I have a few questions. I'll give some background info. I am a girl, and i had an unprotected sexual exposure to a guy (who i know nothing about). This exposure took place right before the covid pandemic started so around oct-nov 2019. 

I got tested for hiv with a hiv antibody test on May 23, 2022. The result was negative. I know i'm prone to have anxiety issues, and unfortunately now my anxiety has raised its ugly head again. On May 8th 2022 i tested positive for SARS-CoV-2/ covid-19 virus with a covid-19 antigen selftest. I had a few mild symptoms, some symptoms lingered a bit longer. By the time (may 23, 2022)i had my hiv antibody test, i had (almost)no more symptoms. The results from the blood draw on May 23 2022 also showed high levels of leukocytes, crp, neutrophils (formule) and absolute neutrophils and absolute trombocyts. (Maybe still because of the covid-19 infection? )

Sorry to hear about your COVID, but happy to hear it wasn't serious. You needn't worry at all about your HIV test result. One of the most common responses on this forum is that no known medical conditions, infections, or medications have any effect on reliability or timing of the standard HIV blood tests. That includes COVID. Your negative HIV antibody test ~6 months after the sexual exposure you are concerned about is 100% proof you did not acquire HIV. Early in HIV/AIDS diagnosis, with the earliest antibody tests -- back in the 1980s and early 90s -- there were concerns about delayed antibody development as a result of immune suppressive drugs, chemotherapy, etc. Even then, this was rare, if it occurred at all. With the more recent antibody test technologies, it simply doesn't happen.

As a possible issue, I wonder if you actually had an antigen-antibody (AgAb) blood test, also called "4th generation" or "combo" test. These are the most commonly used HIV tests these days. All I have said above applies to the AgAb as well as antibody-only tests. (The main difference is that the AgAb tests become positive sooner than the Ab-only tests.) If you had an AgAb test, it would have been 100% conclusive 6 weeks after the sexual exposure. The most commonly used antibody tests take 8 weeks. Either way, you didn't need to wait 6 months for a conclusive test result. And no, you needn't worry about your blood count results. HIV doesn't cause the changes you describe; and even if it did, the HIV blood test results overrule all symptoms, risk factors, and lab test results.

Finally, I'll add that your risk for HIV may have been lower than you thought. In the US and most industrialized countries, under one in a thousand sexually active straight men has HIV (assuming no other major risk factors, like injection drug use, past incarceration, etc). And when a male has HIV, the average transmission risk from a single episode of unprotected vaginal sex is around one in a thousand. Combining these two statistics, your HIV risk from that exposure probably was somewhere around one in a million.

So all is well -- for sure you don't have HIV. I hope these comments are helpful; let me know if anything isn't clear.

HHH, MD

Thank you for your reply. 

The result on the lab report stated it was a hiv AL test (AL meaning antibodies in my country's language). I don't know if the test was an Elisa, cmia, or another technique. Another thing i want to clarify is that my exposure was in sept 2019 and my hiv antibody test was on may 23 in 2022. the exposure was more than 2 years ago.  

 I took a SARS-CoV-2 antigen self test before i went to the doctor to get my hiv test done, the SARS-CoV-2 antigen self test was negative. Besides the high levels of leukocytes, neutrophils, thrombocytes and CRP, i also had a higher level of ferritin and a low level of relative monocytes but i did have a normal level of absolute monocytes, at the time of my hiv antibody-only test.

I was kinda stupid and tried to look online for articles about hiv and covid-19. I found these articles,maybe you find them interesting:

 https://jcp.bmj.com/content/74/9/614

https://www.sciencedirect.com/science/article/pii/S2049080121009778

These articles got me thinking that if a false positive for hiv is maybe possible if you have SARS-CoV-2 virus, maybe a false negative for hiv with an hiv antibody test is also possible if you have the SARS-CoV-2 virus? 

another question, i found out about two months ago i seem to be having plantar warts between my toes. i had these kind of warts like ten years ago when i was like 20 years old, and they cleared up naturally. would having new plantar warts be a sign of hiv infection? i also don't know where i would have gotten them from.

my most important question: can i just move on with my live knowing that i don't have hiv?

Thanks a lot for your help

I have never heard of plantar warts being more common in persons with HIV, although I cannot say it doesn't happen. But the HIV test results overrule any and all other factors, as long as they are done long enough after the last possible exposure. No matter what symptoms someone has, and no matter how high the risk of HIV infection at the time of exposure, the test results are to be believed. Indeed you can move on knowing for certain you do not have HIV. Perhaps you also would like to know that in the 15 years of this and our preceding forum at MedHelp, with thousands of questions from people concerned about having HIV, not one person has turned out to have been infected. You certainly will not be the first!

i just asked the lab that analyzed my blood about the hiv test. they used an hiv antibody-only test. so to conclude i have a few more questions:

1) do all the things that you said in your previous posts to me about hiv testing also apply to hiv antibody-only testing?

2) you say that the near universal consensus among HIV/STI professionals is that HIV testing remains completely reliable in people with covid/ SARS-CoV-2 virus or those immunized against it. does this also apply to the hiv antibody-only tests?

3) does my hiv antibody-only test remain completely reliable? is my hiv antibody-only test result completely reliable?

last question that i cant seem to find an answer to: does the level of ferritin in the blood go back to normal level immediately after infection or can the level of ferritin remain high for a while after infection? 

Thank you so very much

3) The antibody test requires a bit longer after the last possible exposure for negative results to be conclusive, about 8 weeks. If you were tested at least that long after exposure, the result is conclusive and completely reliable.

Ferritin levels can take quite a while to decline after an infection. I am unaware of how long this might take following Covid-19. 

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