4th gen hiv testing accuracy

[fufrank]

Hello;

I am 26 years old circumsized male. CSW gave me unprotected oral and we had sex with latex condom. i realized condom was broke after sex. I realized this when i pulled out my penis. This happened on october 27 2013, 02:00 AM. (october has 31 days please consider this)

2 weeks after the incident i tested for gonorrhea and Chlamydia and i was negative.

11/23/2013, time 13:03 i gave my blood and tested with hiv ag/ab, result was negative. i gave this blood after 27 days and 10 hours after this incident. How accurate is this test since i red it is reliable after 4 weeks?

HSV-1 - HSV-2 and syphillis also negative on this blood work as well.

I had night sweats but i cant really tell this is due to my anxiety or hiv infection. They are irregular as well. not every night. when i wake up to change clothes after sweating i check my temp and its always 95 or 96. never over 98.

no rash, no fever never.

The only major difference i feel on my body is swallowing diffuculty. my throat is red. there is absolutely no pain but i am having hard time swallowing saliva. my anxiety level is high all the time regarding this i am also smoker. Can this also be related with hiv ?

[Edward W Hook, MD]

At 28 days after infection, all persons with new HIV will have either antibodies to the virus or circulating virus which would be detected with either an RNA or p24 antigen test.  Your results were conclusive.  EWH

[Edward W Hook, MD]

Welcome to the Forum.. You can be confident that you did not get HIV from the exposure you have described.  There are at least two ways to look at this- in terms of probabilities, and in terms of the performance of the test you took.  i will mention both.

The likelihood that you are going to get HIV from unprotected sex with a CSW is low on a statistical basis.  Most commercial sex workers do not have HIV, probably less than 1% unless your partner was an IV drug user, then the chance of infection goes up to no more than 10% in most Western cities. Then, on average the risk for infection in the unlikely situation that she had HIV is also low, about 1 infection per 1000 sex acts, at most.  Thus mathematically, your risk of infection was somewhere between 1 in 100,000 (if 1% of CSWs have HIV) and 1 in 10,000 (if 10% have HIV).  Pretty good odds.

Then there is the test.  At 4 weeks ((27 days, 10 hours is close enough) the combination HIV antibody/HIV antigen test you were tested with would detect more than 99.9% of infections.  

Further, since these tests are virtually always positive in persons who have symptoms of HIV, this proves that your night sweats and other symptoms are not due to HIV.  

Putting these two facts together, there is no realistic reason to be at all concerned that you acquired HIV from the exposure you describe.  There is absolutely no reason to worry and no reason for further testing.

I hope this helps. Please don't worry further about this event. EWH

[Edward W Hook, MD]

Final answer.  Yes.

This thread is over.  EWH

[fufranco]

hiv ag ab 4th gen screen test is same as what you are mentioning right ?

[fufranco]

you are stating that within 28 days, 4 weeks body will produce andibodies so the test would be positive. what if you are asympyomatic or if
you seroconvert after 4 weeks ?

[fufranco]

thank you again..

[Edward W Hook, MD]

No, a fever does not need to accompany the swollne lymph nodes of HIV. Swollen lymph nodes however are a non-specific finding however and if your swollen lymph nodes were due to HIV, your test would be positive.  

As I already told you, your test results are effectvely defintive.  EWH

[fufranco]

Dr. Hook;

i appreciate you kind response. it was a total relief. Just a curiosity, could you please tell me if enlarged lymph nodes regarding hiv MUST come along with low grade fever ? Diffuculty swallowing and red throat could be hiv symptom ? Night sweats you are having MUST come along with fever ? According to Dr. Handsfield, if there is no fever, no infection. Could you please confirm this?  Can you have seroconversion in 5 or  6 weeks after exposure?