[Question #9290] Hiv window period

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34 months ago
I had unprotected sex with a woman about 6 weeks ago. At 27 days I got a sore throat and fever that went away within 2 days with amoxicillin. At that same time I took a 4th gen hiv test (27 days) which was negative. A week later I developed a yeast infection in both my armpits maybe due to the antibiotics. I tested again with a 4th gen at 34 days and it was negative. About at day 40 I took an insti test and came back negative. Am I like ok?
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H. Hunter Handsfield, MD
34 months ago
Welcome to the forum. Thank you for your question.

You're fine:  you definitely do not have HIV. In theory, it can take up to 45 days for a positive HIV AgAb (4th generation) blood test to become positive, but at least 98% of newly infected people have positive results by 27 days and 99% by 34-40 days. Equally important, if your symptoms were caused by a new HIV infection, your tests would all have been positive:  it is not possible to have HIV symptoms with negative test results. (Symptoms are not caused by the virus, but by the body's immune response. Therefore antibody always is present by the time symptoms begin.) I'll also point out that a single episode of unprotected vaginal sex with a female partner is a very low risk exposure, even if the woman has HIV -- and statistically it is unlikely your partner is infected. In addition, 27 days is much too late for onset for HIV:  symptoms of new infection, if they occur at all, begin 1-2 weeks after catching the virus.

So you needn't be worried at all about HIV. If you feel you need an absolutely 100% conclusive HIV blood test, have another AgAb test 45 days or more after the exposure; if you do so, you can count on another negative result.

You could try an over-the-counter anti fungal cream for your armpit inflammation; the same products that work for athlete's foot or jock itch will be effective, if your self-diagnosis is correct. But see a doctor for further advice if that doesn't take care of it.

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

HHH, MD
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34 months ago
Thank you for your detailed and informative answers doctor. I forgot to add that I had another 4th gen hiv test on Sunday. Exactly 6 weeks after the encounter (42 days) was waiting for results and they just came in minutes ago. Just like you said they were negative once again. So this is definitely conclusive now right.?
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H. Hunter Handsfield, MD
34 months ago
Sorry for slightly delayed reply. If you want to split hairs, the actual quoted time for conclusive AgAb results is 45 days, but we round that off to 6 weeks. To our knowledge, nobody has been reported to negative at 42 days and positive three days later, but this is why I said 45 days in my initial reply yesterday. So yes, I would consider your 42 day result conclusive, but you'll have to decide whether you'd feel more confident with another negative result at 45 or more days after the event.---
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34 months ago
Thank you Doctor! Appreciate your help.
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34 months ago
One last followup question doctor. All 4th gen test are basically the same right? What I mean by that is that they all test for antigen and antibody? Because I took a the test with cpl labs and the title just says 

HIV 1/2 4TH GEN, RFLX CONF.

 So I had a doubt about that. Then  I did some more research and I think they use roche cobas?
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H. Hunter Handsfield, MD
34 months ago
Yes, all AgAb (4th generation) HIV blood tests are "basically the same" and equally reliable. Roche Cobas is typical and completely reliable.

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