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Conclusive?
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Conclusive?


Hello,  

I posted the same question to Dr. HHH and got a great response.  I just wanted to get your opinion also.

Here is my story:  Had protected vaginal intercourse with csw in the caribbeans.  The condom did not broke, but it did slip, I don't believe it slipped entirely off because when I pulled out the condom was still on, though it was not snug over the head of the penis.  4 weeks later after this event I was diagnosed with shingles and given Valtrex. Having shingles at age 27 made me very concerned regarding HIV.  These are the following tests I've done:  

DNA PCR for hiv-1 by LabCorp at weeks 4 and 8 - negative
HIV 1/O/2 antibody test by LabCorp at weeks , 8, 12, 13, 24, 36 - all negative
HIV 1/2 EIA ab (3rd gen) by Quest Diagnostics at weeks 5 and 38 - negative (this test noted that it also tests for Group O)


I've recently entered into a new relationship with my now girlfriend and want to be 100% sure that I am HIV negative before I have sex with her.  My questions are as follows:

1.  Are my tests absolutely conclusive?
2.  Since my exposure was in the Caribbeans, is there a possibility that the modern day antibody tests that I had, could have missed a certain subtype?  I did not have any 4th generation tests done since they are hard to find here in Washington State.
3.  I know shingles typically has nothing to do with HIV.  But is shingles a symptom of primary (acute) HIV infection or is shingles a symptom of more longstanding HIV infection?
4.  Are the HIV 1/2 antibody tests as reliable as a standalone HIV-2 antibody EIA test for HIV-2 testing?
5.  Because the condom was quite loose over the head of the penis when I pulled out, but yet still covered the head, would this still be considered protected sex?
6.  Would you recommend any additional testing at this point, as I believe the both you of you are big proponents of 4th generation testing?  I am at about 8-9 months post exposure.

Thanks for your time.
936016_tn?1332769204
Hello

You have asked:-

1.  Are my tests absolutely conclusive?

Yes, entirely and absolutely.

2.  Since my exposure was in the Caribbeans, is there a possibility that the modern day antibody tests that I had, could have missed a certain subtype?  I did not have any 4th generation tests done since they are hard to find here in Washington State.

No, the tests will not have missed any subtypes. The combination of tests you have done and at the time intervals you have done them, have established as a certainty that you do not have HIV.


3.  I know shingles typically has nothing to do with HIV.  But is shingles a symptom of primary (acute) HIV infection or is shingles a symptom of more longstanding HIV infection?

You are confusing things. Shingles is a re-activation of the usual childhood chicken pox infection. We all develop chicken pox, then clear it but the virus - which by the way is a type of herpes virus - behaves like all herpes viruses and retreats into our neurological system and stays there in a quiet form. When we are stressed, ill, run down, very busy etc the chicken pox virus may reactivate and emerge in a superficial nerve fibre causing the painful appearance of shingles. Shingles may appear at some stage in HIV - but equally it may appear with any of the conditions I have mentioned above. In my experience of nearly 30 years practice, it is very rare for shingles to indicate a new HIV infection.

4.  Are the HIV 1/2 antibody tests as reliable as a standalone HIV-2 antibody EIA test for HIV-2 testing?

yes, entirely.

5.  Because the condom was quite loose over the head of the penis when I pulled out, but yet still covered the head, would this still be considered protected sex?

yes.

6.  Would you recommend any additional testing at this point, as I believe the both you of you are big proponents of 4th generation testing?  I am at about 8-9 months post exposure.

no - you are HIV negative. We use HIV 4th generation testing because this 1) allows for earlier and easier diagnosis of infection and 2) this is the standard testing modality in the UK and much of Western Europe.


kind regards, Sean
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