Conclusive test?

[b3b3kterbang]

Doc,

I live in Indonesia, i have an unprotected sex with a csw, i am very worried and goes to testing frenzy, i know that the window period for HIV test is 3 month, after 3 weeks of exposure my doc suggest i test my cd4 and the result is 1140 with cd4 percentage 36%, on 5th week i tested my cd4 again and the result is 1042 and the cd4 percentage is 34%, as i cant wait for a 3 month window i have an hiv test on the 40th days (PCR RNA test and HIV antibody test using CMIA, ELFA, and MIA method and also another CD4 test), the result is as follow:
PCR RNA test : virus is undetectable (the PCR RNA test only test for hiv-1);
HIV antibody test : non reactive;
CD4: 756 and 28%

1) is it mean that i dont have HIV and its conclusive?
2) should i get another test after 3 month window period?
3) is it bormal to have a decrease in CD4 and cd4 percentage within one week if the viral load is undetectable?
4) is it possible that i catch hiv 2 in indonesia and thats why the viral load test result is undetectable ?

thank you very much for your answer on this.

regards,

[H. Hunter Handsfield, M.D.]

The advice about 3 month testing being conclusive applies only to the antibody tests.  The combination of a negative antibody and PCR test at 40 days is conclusive.  (Even for antibody alone, actually 6-8 weeks usually is conclusive -- but official advice remains 3 months.  See the thread linked below.

http://www.medhelp.org/posts/show/1704700

[b3b3kterbang]

Thank you very much doc for your swift response, it really ease my mind. Everyone else that i ask, say that the only conclusive test is the three month test.

regards,

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

You have overreacted and have had much more testing than needed.  Most CSWs in Indonesia do not have HIV; even if your CSW partner was infected, the chance you would catch it from a single episode of unprotected sex is around 1 in 2,000; and most important, your test results prove you do not have HIV.

The 3 month testing window applies when only antibody testing is done.  The combination of negative PCR and antibody at 40 days is definitive.  No further testing is necessary.  Your CD4 tests were unnecessary and in any case your results were normal.  CD4 levels naturally vary within the same range as yours did.

To your specific questions:

1) Yes, your test results are conclusive.  You do not have HIV.

2) There is no need for further testing at 3 months or any other time.

3) CD4 counts can vary that much within a matter of hours.  There is nothing abnormal about your results.  Those tests should not have been done and you should ignore the results.

4) Your antibody test would have detected HIV-2.  Anyway, HIV-2 is very rare everywhere except in the relatively small area of Africa where it evolved.

So do your best to stop worrying.  You have overreacted and have been over-tested.  It is time to stop.

Regards--  HHH, MD