[Question #9431] Follow up on previous question

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32 months ago
hello all, I asked a questiin a few months ago. I want to know that the info is still correct. 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, one night stand). This exposure took place right before the covid pandemic started so around oct-nov 2019. I live in Belgium.

So here is my situation;

I got tested for HIV with a HIV antibody-only test on May 23, 2022. The result was negative. I don't know if this was an ELISA test or a CMIA test or something else. On May 8th 2022 I tested positive for SARS-CoV-2/ covid-19 with a SARS-CoV-2 antigen selftest. I don't know which variant of SARS-CoV-2 I had, or which variant of SARS-CoV-2 was the most common variant back then, in my country. 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 and crp, neutrophils (lab report states neutrophils segments (formule)) and neutrophils segments (formule (absolute)) and trombocyts (formule (absolute)). MCV level and MCH level were also higher than normal. My level of ferritin (formule (absolute)) was also higher than normal. My level of monocytes (formule) was lower than normal (monocytes formule (absolute)were normal) and also the number of eGFR (CKD-EPI) was lower than normal. I took a SARS-CoV-2 antigen selftest, right before I went to the doctor for my HIV test, the SARS-CoV-2 antigen test was negative. 

My question is: can I be completely certain that I don't have HIV?
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Edward W. Hook M.D.
32 months ago
Welcome back to the Forum.  On this occasion I'll be replying to your question as Dr. Handsfield and I share the Forum and today your question came to me.  FYI, Dr. Handsfield and I have worked together for more nearly 40 years and while our verbal styles vary, the substance of our opinions never differs.  In preparing to address today's question I reviewed your earlier interaction with Dr. Handsfield and agree with all that he said.  I also note that your current question is rather repetitive and was completely addressed by Dr. Handsfield's replies.  Nothing has changed and there are no new data to suggest any reason for concern- your exposure was very, very low risk and your test results are entirely reliable, irrespective of the fact that you had COVID, no matter which variant.  The laboratory changes you note are quite non-specific and in no way suggest HIV.

 I encourage you to believe your earlier test results- they are conclusive.  I see no medical or scientific reason for further testing.  Should you decide to test to address your continuing concern, I am entirely confident that you will have a negative test, confirming that you did not acquire HIV from your encounter of concern.  

I hope this reassurance is helpful.  As you know, if there are further questions, you have up to two follow-ups that you can use for clarification.  EWH
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32 months ago
Hi Dr. Hook,

Thanks for the reply. The thing is, i am afraid (pretty phobic) of needles and the stress of having blood drawn is too much for me. I know that my anxiety gets really high for some reason from time to time, and especially my anxiety around HIV. I didn't want to bother you. I'm always afraid that I left out a detail here and there that is important. 

If I can just ask the following questions:
1)I read that you are talking about my HIV test results and that they are entirely reliable. I hope I was clear enough that I only had one HIV antibody-only test?
2) Is my one HIV antibody-only test result completely conclusive?
3) I don't have HIV and I don't need to have another test for HIV. Am I correct?

Thank you so much doctor Hook, I really appreciate it. 
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Edward W. Hook M.D.
32 months ago
Thanks for your follow-up.  In reply:

1)I read that you are talking about my HIV test results and that they are entirely reliable. I hope I was clear enough that I only had one HIV antibody-only test?
Correct.  Antibody only tests are entirely reliable any time more than 8 weeks after your encounter.  

2) Is my one HIV antibody-only test result completely conclusive?
Yes, see my response above.  Your results are entirely conclusive

3) I don't have HIV and I don't need to have another test for HIV. Am I correct?
Corret as well.  You do not have HIV and do not need further testing

Please don't worry.  EWH
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32 months ago
Hello dr Hook,

I'm going to make use of my third and last question. I freaked out during the weekend, I was rereading my diary from last May 2022. I made a mistake in my post 3 days ago. When I tested positive on the SARS-CoV-2 antigen selftest test (on May 8 2022),i took another SARS-CoV-2 antigen selftest, 5 to 7 days after my positive SARS-CoV-2 antigen selftest. This second SARS-CoV-2 antigen self test was negative. Then, right before I went to my appointment at my doctor for my HIV antibody-only test (on May 23 2022), i took another SARS-CoV-2 antigen selftest, and this SARS-CoV-2 antigen selftest was positive (in my first post 3 days ago i said this SARS-CoV-2 antigen selftest was negative, I was wrong about that). 

This will be my last questions, I promise:
1) Does this new information change your assessment?
2) Do I need to get tested for HIV again?
3) Can I be completely certain that I don't have HIV?

Thanks a lot, I won't bother you again after this. I read in your earlier reply that SARS-CoV-2 doesn't have any effect on the reliability and validity of hiv antibody-only tests, but I want to know for sure.
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Edward W. Hook M.D.
32 months ago
Irrespective of whether or not you had COVID-19 at the time you had your HIV antibody test, as long as that test was more than 8 weeks after your most recent potential HIV exposure, your results are reliable and completely conclusive.  Thus:

1) Does this new information change your assessment?
Not a bit, your results are reliable

2) Do I need to get tested for HIV again?
No

3) Can I be completely certain that I don't have HIV?
Yes

I hope the information and assurance I have provided has been helpful and you will be able to move forward without continuing concern.  Take care.  EWH
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