[Question #9580] Same Case

31 months ago

Hi Doctor,

Just had some final questions despite your reassurance that’s I’m basically home free. I will do what you and my physician advised and take the test 6 weeks after the second exposure which will be Jan 23 (next week) but as for the first exposure since you said there isn’t any data regarding late PEP and it’s effects on test validity, if I were to take a 4th gen test say tomorrow would that be conclusive for the first exposure at least? You said the test a day after PEP ended is 98% conclusive for my second exposure but for the first exposure it’s hard to say because of a lack of data but if I were to take a 4th gen test tomorrow it would mark 7 weeks from first exposure and one week after PEP ended. In that case would it be conclusive for the first exposure in your opinion? I’m only assuming this because it would be a week after PEP so whatever supposed PEP effects that can affect a test result are sure to be dissipated especially since a week after tomorrow it’s conclusive for my second exposure which was two weeks after my first.

I’m sorry if the question and concerns seem overtly paranoid but I’m sure you know that the waiting period for these tests are extremely stressful so if I can get some type of affirmation ASAP then I want to. And to reiterate, regardless of if I take a test tomorrow or not, the test next week marking 6 weeks since second exposure, 8 weeks since first exposure and 2 weeks since PEP would be conclusive for both exposures?

Thank you,

Edward W. Hook M.D.

31 months ago

Welcome back to the Forum. As you know, r. Handsfield and I share the Forum and I happened to pick up your follow-up question. In preparing to answer your questions, I have reviewed your situation and agree with all that Dr. Handsfield has said. I hope that my reaffirmation will help you t move forward. Both of the exposures you have desribed were no risk. Your test results at this time, despite the PEP taken in the interval between testing provide strong data that you were not infected by either encounter and you can be confident that your 2nd exposure was no risk for HIV since your partner has since been tested and has negative tests (if her tests are negative following your encounter, you cannot have been exposed- the presence of blood makes no difference).

Bottom line, your test next week, 6 weeks following encounter no. 2 and 8 weeks following exposure no, 1 will be entirely conclusive. Further, I am quite confident that it will be negative.

I hope this perspective is helpful. EWH

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31 months ago

Hi Doctor,

I couldn’t handle the anxiety of waiting another week so last night I went to the clinic and did another 4th gen test as well as a PCR RNA test. My results will be coming out soon and I will let you know the results. If the 4th gen test comes out negative today what is the likelihood the PCR test willl come out positive? Obviously the PCR requires a bit more time so I will be receiving the results in a few days time.

Also another question I had since the internet is full of random data is what is the actual risk of HIV infection per exposure from a woman to a male knowing the woman is HIV positive? I don’t know to a high certainty that my first exposure was negative but I feel the second exposure is quite conclusive. But just out of curiosity I wanted to know the risk of HIV transmission for the insertive partner with vaginal sexual encounter. The data on the web goes as low as 4 out of 10,000 exposures and as high as 1,500 out of 10,000.

Thank you

Edward W. Hook M.D.

31 months ago

I anticipate that both your 4th generation test and your HIV PCR test will be negative Hopefully with that information you will be able to quell your anxiety and move forward.

The internet is a bad place for you to seek information. Much of what is there is taken out of context, out of date, or just plain wrong and you have no way to tell what is right and what is wrong. The risk for acquisition of HIV from a single insertive sex act (male/male or male/female) is substantially less than, on average, one infection per 1200 encounters (in other words more than 99.9% of such exposures do not lead to infection).

I hope this information is helpful. EWH

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31 months ago

Hello Doctor,

Thank you for your reply and assurance. I took the two tests last night and the 4th gen test results have come out today with the results being as you and Doctor Handsfield expected. This is obviously a huge relief for me mentally and emotionally. As for the PCR test I’m still waiting for the results which will be available in a few days.

I wanted to ask now that the 4th gen test from yesterday is negative what are the chances the PCR test will come back positive? And does the negative 4th gen test from yesterday at least finally clear me from my first exposure since it’s been a week since PEP ended and 7 weeks since first exposure.

Dr. Handsfield also initially recommended that I get tested next week to mark 6 weeks from my second exposure but because I was too anxious I got tested yesterday. If the PCR results come out negative this week then that will be two more negative tests, both PCR and 4th gen, marking 7 weeks from first exposure and 5 weeks from second exposure. So I wanted to ask if both tests from yesterday come out negative will they be considered conclusive for both my exposures or should I still go get tested next week?

To recap:

11/27 - first exposure

12/12 - second exposure/begin PEP

01/08 - PEP ends

01/09 - 4th gen test (NEGATIVE) 6 weeks post first exposure 4 weeks post second

01/16 - 4th gen test negative (NEGATIVE)/PCR (PENDING) 7 weeks post first exposure 5 weeks post second exposure

>>2nd exposure girl tested negative 4th gen 12/12-12/29-01/12 and will do one more test 01/31 (50 days post exposure)

I am still anxious about the PCR test.

Thank you,

Edward W. Hook M.D.

31 months ago

Sigh. This is a repetitive question. I’ve already provided you with my expectation in assurance that your PCR test will be back at it. Repeating your question will not change my answer. I will not repeat my earlier responses.

PCR tests become positive before fourth generation tests. The negative HIVRNAPCR test result supersedes any need for further testing. When your test returns and its negative, you can accept that result as conclusive. No further testing will be needed.

As you know, this is my third response to the series of follow-up questions. This thread will be closed shortly. Further repetitive, anxiety- driven questions from you are discouraged and should you post again, your questions may be deleted without a response.

There’s no need for further exchange. You have the information you need. Take care. Please don’t worry. EWH

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