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HIV Testing and Symptoms Question
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HIV Testing and Symptoms Question

I had a low-risk exposure to HIV 8 weeks ago. At 10 days post exposure I had a PCR RNA test (negative), at 30 days DUO/p24 (negative).

I became worried at about 37 days (i.e. 7 days after my negative DUO test) when I had what I thought were symptoms. A runny nose, bit of a sore throat, NO fever (felt this was more like a cold) and a few days later what appeared to be a rash (small collection of 6-7 pimples on the back of my arm - no where else on the body) but again with NO fever. The rash cleared up pretty much in a few days with some anti-sting cream, and the cold lasted about a week.

1. Is a negative PCR RNA test at 10 days and a negative DUO/p24 4th gen at 28 days considered conclusive??

2. Is it possible to get symptoms 7 days after a negative DUO/p24 at 30 days?? Do my symptoms sound like symptoms, from what I've read the answer is no. I have seen the rash described as a collection of pimples though.

3. Is it necessary to test again at 6 weeks or 8 weeks??
Tags: HIV Testing/Symptoms
239123_tn?1267651214
Welcome to the forum.

The HIV tests collectively -- and most of the individual tests -- are among the most accurate diagnostic tests for any medical condtion.  If done sufficiently long after the last possible exposure, the results are always 100% conclusive, and negative results rule out all other considerations.  No matter how high the risk was, no matter what the symptoms, or anything else, the test results rule.  

1) Your negative PCR at 10 days was around 90% reliable by itself, and the DUO test 100% at 30 days.  Based on these results, it is 100% certain you did not catch HIV.

2) No, this is not possible.  Any symptoms you have had, and whenever they occurred, absolutely are not due to HIV from the exposure you have described.

3) No further testing is ncessary.  However, you may know that most official agencies in the US (but not in many other countries) still recommend a final antibody test at 3 months.  It really isn't necessary; see the thrtead linked below for further explanation of the discrepancy.  But it's up to you if you would like still more reassurance.  (Personally, I definitely would not do it if I were in your situation, and I would continue unprotected sex with my wife without worry.)

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

So no worries, all is well.  I hope these comments have helped.

HHH, MD
6 Comments
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239123_tn?1267651214
And by the way, your symptoms are not at all suggestive of HIV anyway.  ARS doesn't cause runny nose, and it doesn't cause sore throat without fever.  You had a cold.
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Avatar_m_tn
Thankyou Dr HHH

Your answer was very clear. Your forum is excellent and I think the service you are providing is great. So much mis-information out there.

Just a couple of points of clarification if you wouldn't mind....

1. Most sites quote a duo/p24 at 28 days as 99.89%.....and not conclusive.You have said it is conclusive. Am I right in assuming that the negative PCR RNA at 10 days (I have read this is 99.8% at 10 days) rules out the possible false negative of the DUO at 28 days? Or am I confusing too much here?

2. Also my symptoms (although I acknowledge you said they were probably not symptoms) were 7 days after my DUO test at 30 days.....even if they are after the test you would still be confident?

Thanks again
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239123_tn?1267651214
1) Most people would say that 99.9% is conclusive.  I certainly would.  Regardless of what the official data say, to my knowledge no HIV/AIDS expert has ever had a patient with negative duo at 28 days who turned out to actually have HIV.  In any case, with a "low risk" exposure, a result of 99.9% certainty means there is under one chance in many million you have HIV.

2) The onset of symptoms after the test result is evidence against HIV as the cause, not in favor of it.

Accept the science and the reasoned reassurance you have had, believe your test results, and do your best to move on.
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Avatar_m_tn
Thanks very much Doctor HHH.

I will accept the science and as you say "move on". It's just hard when you have so much conflicting and out of date information circulating, especially from official agencies.

Thanks again, you guys provide a great and trusted service.
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239123_tn?1267651214
Thanks for the thanks.  Glad to have helped.
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