HIV - Prevention Expert Forum
Concerns about conclusively of HIV result.
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Concerns about conclusively of HIV result.

I had a high risk exposure (unprotected vaginal sex) in September 2011. Around a week or two after the exposure I came down with a really bad flu. I tested negative for HIV in January 2012 (3 months post exposure). They drew blood  so I assume it was some sort of ELISA test. I was positive for chlamydia.

In March 2012 I had a pulmonary embolism, despite only being in my early 30's. This was accompanied by rashes , problems breathing, flu-like illness,as well as abnormal thyroid results (from a viral infection).They still have not come up with any cause for these things.

In June (9 months post exposure) I again tested negative for HIV. (Not sure which generation)
Around a year post exposure, I started to get more symptoms. I had a red, blotchy rash on my arms and legs. I also had confirmed swollen lymph nodes in my groin and neck, which still haven't gone away 6 months later. My most recent pap smear came back as LSIL, so I probably have HPV.

I seem to be getting health problems with unexplained viral causes.(HIV?) I am so paranoid about HIV that it is taking over my life.. It is affecting my relationships, work and I don't know what to do. I can't seem to trust my results.It's all I think about.

1.) With all of my unexplained symptoms, could I be the 00.1% to get false negative results or late seroconversion?

2.) Could the rashes and swollen lymph nodes that appeared a year post exposure have been my seroconversion? Could the viral thyroiditis and LSIL pap smear and swollen lymph nodes be caused by HIV?

3.) Can you explain how doctors know a window period is accurate? How do they know enough to have one window period for conclusive results if people seroconvert at different times?

4.) Am I really HIV negative based on my 3 month and 9 month results, despite the symptoms that appeared AFTER my 9 month test? My partner and I want to have a baby and I don't want to risk infecting him. How can I ever be sure,100%, that I'm not infected.
239123_tn?1267651214
Welcome to the forum. Thanks for your question.

Responding first to the title of your question, before reading anything else:  The HIV tests are among the most accurate diagnostic tests every developed, for any medical condition.  Assuming you had a negative test result more than a few weeks after your last possible exposure, then you can be certain the test is valid and you don't have it.

Now having read the question, it remains clear that HIV isn't the problem here.  Although you have had a number of health problems, none of them is at all typical for HIV.  Your cervical HPV infection is unrelated to any of the other issues, and neither is your positive chlamydia test.  I disagree that there must be "unexplained viral causes" of these problems.  It is conceivable you have an underlying immunologic (e.g., autoimmune) disorder, and it would be reasonable to ask your doctor about this possibility. But for sure there is nothing that suggests HIV.  And even if there were, the test results rule.  The HIV tests are much more reliable in judging the possiblity of an HIV infection than any symptoms or combinations of underlying health problems.

To your specific questions:

1) With the standard HIV tests in regular use today, there is no such thing false negative results more than 3 months after the last potential exposure.

2) Neither thyroiditis nor LSIL is caused by HIV.

3) There are tests for HIV infection other than ELISA.  Nobody ever has HIV positive by other tests but negative by ELISA.

4) Yes, you are :really HIV negative" bsed on these test results.  From an HIV standpoint, there is definitely no reason for you and your partner to delay conception or worry about an HIV infected baby.

You need to believe the HIV test results, and the reasoned, science based reassurance you have had -- undoubtedly from your own doctors, and now on this forum.  As I suggested above, talk with your doctor about the possibility of some other underlying immune system disorder -- but you truly need not worry about having HIV.

Regards--  HHH, MD
5 Comments
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Avatar_m_tn
Thank you for your very speedy reply.
One last question, just for clarification.

If third generation tests are only 97-99.9% accurate how can there be "no such thing false negative results more than 3 months after the last potential exposure?" Wouldn't the test need to have 100% accuracy to have absolutely no false negatives?

I don't doubt your answer, I am just confused as to how that can be the case.
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239123_tn?1267651214
It's probably true that there is no such thing as 100% sensitivity for any lab test.  But don't confuse the standards and requirements for regulatory approval (i.e., by the FDA in the US) with other research that documents something closer to 100% sensitivity once sufficient time has passed since onset of infection.

And it is a mistake for people to believe that because a test is, say, "only" 99% sensitive, they have a 1% chance of having HIV despite a negative test result.  If the risk of HIV starts out at, say, 1 in a million (which is a good ballpark for most "high risk" vaginal sex exposures), then a test with 99% sensitivity makes the chance against HIV 1 in 100 million -- which can and should be considered zero.

Please go forward without worry about HIV.  Go ahead and conceive that child and have a wonderful life!
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Avatar_m_tn
Thank you.

Would the fact that I have had two tests make this chance non-existent? If one test has a 1 in 100'000-ish chance?
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239123_tn?1267651214
One test or 50, it wouldn't make any difference.  You do not have HIV.  Accept it, suck it up, and move on.  This thread is over.
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