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Worried: PCR RNA Viral Load Test

Dr,

I had a relatively low risk exposure that I couldnt get out of my mind.  (receptive protected anal without ejaculation and giving/receiving oral without ejaculation - but had a hole in my back gum from oral surgery 8.5 daysbefore.  No blood as it was healed and stiches out).  The surgery got me freaked out so I went to an online testing site and tested with the Elisa test and PCR RNA Viral load test (down to 48 copies) at day 21 (20.5 days post exposure).  Both of these results were negative and I was told at day 21 one or the other would be positive.  At day 29 I came down with a fever (around 100+) and coughing up dark green mucuous with a sore throat and bad headache.  Family Doctor gave me Zithromax.  At day 30 still had sore throat, headache and fever but very congested nasally with a fever.  At day 31 (today) fever seems to be slightly high and throat doesnt hurt but still congested with heachache.  No rash or swollen lymph nodes.  My forehead has been sweating.

1.  Do you agree that at day 21 either the viral load test or Elisa would be positive if I had contracted HIV?  So much information on internet that has me confused.  Some sites say you would be in millions by day 17 and that everyone would be detected by 14 days and others seem more CYA.
2.  Do my symptoms sound like ARS?
3.  Does my forehead sweating concern you or do you think it is the fever breaking?

Sorry for bothering you.
9 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
The counselor is right.  Move on.  This thread is over.
Helpful - 0
Avatar universal
Not sure this comment was meant for me.  Last question and I believe I can finally move on.  Took a rapid test (Trinity Unigold Recombigen) at local HIV Center at 37 days.  Counselor and company told me this Elisa test was 100% sensitive and 99.7% specific at 5 week.  In other words, a negative was 100% negative.  Does this seem right to you?  Counselor told me I was completely negative and need to move on but kinda worried about the 6 weeks you suggest.  Is that just because tests are different.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Your risk of having HIV is far less than the figures suggested by this comment.

williamnj, your comments are welcome, as you seem to be knowledgeable, although the current tests probably perform better than you state.  But regardless of that detail you you need to put things in context.  The risk someone actually has HIV is not based only on the test performance, but the prior probability that someone is infected, before testing.  For almost all exposures described on this forum the chance of catching HIV is low.  If that chance is, say, 1 in 10,000, then doing a test with 99% sensitivity translates into risk the person actually is infected to around 1 in a million.  In such a circumstance, further testing is unnecessary, unless dictated for anxiety relief only.

Thanks--
Helpful - 0
Avatar universal
Good point.  My anxiety is causing irrational thinking. Last question, is the PCR RNA viral load test the same as the nucleic acid test used by blood banks which states a 12 day window period for detection? Thanks
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Huh?  What is possibly unclear about "the negative results at 21 days are strong evidence you did not acquire HIV"?
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Avatar universal
Not to cross swords, but strong evidence could be interpreted multiple ways.  I assume you mean that it is extremely unlikely that I would test positive.  I would imagine the virus would have to be enough at day 21 to be detected.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Good for you.  Didn't mean to lecture you--but you didn't say anything about it.  His negative HIV history, even from last May, is highly reassuring.
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Avatar universal
I did ask his status and he did say he was negative but last tested in May.  I always assume someone is HIV positive for safety sake.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Directly to your questions:

1) Yes, I agree the negative results at 21 days are strong evidence you did not acquire HIV.

2) As I have said repeatedly, no symptoms are good indicators of HIV, because so many other things--all more common than HIV--can cause the same symptoms.   Yours sound like a virus with bronchitis; HIV doesn't cause nasal congestion or cough that produces mucus.

3) That is a very nonspecific symptom that could go with any garden variety virus, stress, or anything else.  There is nothing in it that particularly suggests HIV.

Bottom line:  Your HIV risk was low, even with the oral lesion.  Of course you should have asked and known your partner's HIV status; no man should ever have sex with another man without first asking and sharing HIV status.  There simply is no excuse for having sex with a new partner without first being assured that he is HIV-free, even when safe sex is planned.  Please take that as a lesson learned.  In the meantime, to maximize the asurance you weren't infected, have a follow-up antibody test at 6 weeks.  You can be sure of a negative result.

Good luck--  HHH, MD
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