Hiv Testing- New FDA approved VS antibody

[insearchofrelief]

Dr's.  My situation is like all the others on this forum.  I strayed in marriage, had unprotected sex, vaginal and anal with a csw.  I feel horrible as I should and just want to move forward.  I have tested for all stds approx 5 weeks after the encounter and all were negative.  I have multiple hiv antibody tests at 6,7,8,9.5, and 14.5 weeks post exposure and those to have been negative.  I hear today of a new test, antigen antibody combo approved by fda.  Should i now use this test to be sure I haven't contracted hiv?  I am now at the 8 month mard and still cannot shake the fear.  Should I just do a standard antibody test at this point?  I have seen that some say 6 months is the final icing to be negative, just dont know what to do or believe and I hope you can shed some light on this.  I do not know this gir, her status or anything else.  I tried to assume worst possible scenario that she was pos, so thats why i tested so much.  I just cant pass this to my wife. I felt somewhat better after my 3.5 month result, but than the 6 month number haunts me.  What are the chances that a 3 month test would miss an infection, on one recent article related to this new test it states that antibody tests miss about 10% of infections, is this true?  What would cause a later than 3 month conversion?  Thanks for your help, hop to move forward soon.  

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I'm glad you took the time to read the forum so that you understand your "situation is like all the others".  But the whole point is that people are supposed to see the answers to their questions without having to ask them again, saving the posting fee.

I'm paying no attention to the nature of your exposure.  It wouldn't matter if you had mainlined HIV infected blood.  Your test results prove you weren't infected.  It never takes 6 months for the antibody tests to become positive.  That's an urban myth, left over from older HIV tests that haven't been used for over 10 years.

The newly approved (in the US) combo test (HIV antibody plus antigen) isn't new at all.  It has been used in several countries for 3-4 years. It's probably the test of choice, but its advantage is in the first 4-6 weeks after exposure, because it picks up some newly infected patients before antibody can be detected.  It would make no difference in your case and you do not need that test.

You don't have HIV and do not need further testing.  You can safely have sex with your wife without putting her at risk.  If I had been in your situation, I would never have stopped having unprotected sex with my wife -- and certainly you need not worry about it now.

Best wishes--  HHH, MD

[insearchofrelief]

Thank you for such a fast and straight forward reply.  So this other test is for earlier detection therefore I dont need it?  After my lest HIV test, and this may sound completely insane, but I was concerned even about the needle I was tested with.  They were busy and I went in immediatley after some lady, I was talking to the tech and didnt notice a clean needle or not.  It was a vacume tube at a Labcorp facility, is this concern just irrational to say the least?  Its amazing how the mind can keep going on the what if's this and that?  That was another reason for considering another test believe it or not.  You provide a wonderful service Dr., and I send you many thanks and blessings for what you do.  I just want to move forward with a normal life once again, this will not happen to me again as an important lesson was learned.  Just one last question, would anything cause a delay with current tests?

[H. Hunter Handsfield, M.D.]

Nothing delays positive HIV test results except terminal illnesses and potent chemotherapy, and maybe not even those.  As for being infected during the tested process, your words cover it well ("irrational to say the least").

Otherwise you are re-asking the same questions as above in different words and asking me to repeat myself.  I have not changed my mind.  I have reassured you in the strongest possible terms.  Move on.  If you cannot, professional counseling is the next logical step.  It is not normal to be so resistant to such overwhelming facts and evidence.

Thanks for the thanks about the forum.  But that's all for this thread.

[insearchofrelief]

Thank you for your reply and patience.  -just to save the trouble and posting fee from another forum, would say I am negative for all other stds as well?  I Tested for all at 4 weeks, all negative. I Did a single dose of azithromiacin just to be safe. I Once again tested neg for hep b at the 15 week mark with my last hiv test. I Have just not felt well since thus happened and point all symptoms at this.  Thanks again, last post!

[H. Hunter Handsfield, M.D.]

With your negative tests plus prophylactic azithromycin, you can be confident you have no STD.  My guess is that your not feeling well is primarily psychological, i.e. the physical manifesations of stress over this event.

Please accept the reassurance and move on -- and see my comment above about the likely benefits of professional counseling.  That's definitely all for this thread.