[Question #9152] HIV Test Results and Window Period

35 months ago

Thank you for your time. I had unprotected sex with a women of unknown hiv status vaginal sex for about 30-40 minutes and tested at Kaiser for STDs including HIV. All tests were blood drawn from vein. The days that I tested negative were 22, 30 and 135 post exposure and did not have new risks or exposures since then. Additionally, I took 4 oraquick oral swab tests on week 17, four on week 18 and 2 recently on week 22 which all were negative. Reading your responses, you answered my questions regarding COVID having no affect on the test results. Since then, these are the symptoms I have experienced: nausea, headaches near eyebrows, muscle and joint pain, tingling in hands and arms, sore throat, costocondritis, fast heart rate, only Two night sweats. Never a fever, no rash, no oral thrush, no discharge. I had an ultra sound day 32 and they said my lymph nodes in my stomach were prominent and they diagnosed as mesocentric adentitis. I googled it and one of the reasons my lymph nodes were prominent is due to hiv so that really got my anxiety over the roof.

My questions:

Are my lab tests and oraquick tests results mentioned above conclusive and confirm I do not have HIV despite symptoms ? Do I need to worry about lab error?
Do I need to retest at 6 months? On kaisers website, they said it takes up to 6 months for antibodies to produce.
Are the prominent lymph nodes (e.g mesocentric adentitis) on day 32 due to hiv that the tests did not capture? Is it possible I am a late seroconverter at 23 weeks post exposure?

Edward W. Hook M.D.

35 months ago

Welcome to the Forum. Thanks for your questions. Thanks as well for sharing your testing history. You can be confident that you did not acquire HIV from the exposure you describe and that your mesenteric adenitis is not due to HIV. Regarding your specific questions:

1. The Oraquick test tests for HIV antibodies while the venous blood tests at Kaiser at 4th generation, combination HIV antigen/antibody tests. OraQuick results are conclusive at 8 weeks following an exposure and the 4th generation tests are absolutely conclusive at 6 weeks. Current tests for HIV are among the most reliable of all lab tests. You can have confidence in your results. Your identical results on multiple tests rule out the possibility of lab error. Further, if your symptoms were due to HIV, your tests would be positive. There is no need for further testing.

2. No further testing is needed

3. If your lymph node swelling had been due to HIV, the test would be positive. HIV symptoms, including lymph node swelling are due to the presence of the virus and antibodies fighting the virus. Your negative tests prove that your symptoms are not due to HIV.

The internet has not been your friend here. "Late seroconversion" is an internet generated myth.

I hope this information is helpful. Time to look elsewhere for the cause of your mesenteric adenitis. EWH

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35 months ago

Thanks for clarification as I was concerned finding online that HIV cause mesentric adentitis. Last question before leaving. According to fda and other health agencies, the oraquick at home test is only 92%. I know I took them all after the “90 day window period” so should I trust those results or should I base my hiv negative status on the 4th generation blood test performed on day 135? I took more oraquicks to lower the chances of false negatives and I followed their directions when performing the oral swab.

Edward W. Hook M.D.

35 months ago

Good questions. The Oraquick test is admittedly our least favorite test. The ease of collecting saliva specimens has a modest cost in terms of the detection of infection soon after infection has occurred. On the other hand you have multiple negativeOraquick tests and with repeat testing the sensitivity goes up. In addition, you’re 135 day fourth generation test is absolutely conclusive. Combined, there is simply no way that you could have HIV.

Hope this helps. Please don’t worry. EWH

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35 months ago

Thank you. I will follow your medical advice and no longer worry that I do not have HIV. You may close question as this has been resolved. Thank you for your guidance.

35 months ago

Hello Dr.

I am about to enter into a monogamous relationship and want to know if i can move forward with unprotected sex? My new girlfriend does not have HIV so just wanted to ensure it is fine. After answering this question, please close my question and mark as complete. Thank you

Edward W. Hook M.D.

35 months ago

Based on the testing you mention, I see no reason related to HIV or other STIs for you not to move forward with a new relationship. Sometimes when entering a new relationship going to get tested together provides a firm, reassuring foundation for the relationship to move forward. You already know that your tests will be negative but it still might be worth considering.

As this is my 3rd response, as per Forum guidelines, this thread is now complete and will be closed. Take care, stay safe. EWH

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