Duo P24 Ag + AbTest at 4-6 weeks?

I am writing as I might of had exposure 21 Months ago now (I had a case of Diarreah (diarrhea) a few months ago but no other illnesses I can recall). The exposure was in Indonesia and it involved some hand to genital contact (Sorry to sound crude but fingering of a female to be exact, and there may have been some cuts around the cuticles but i cant be sure), She performed oral sex on me and then followed by protected sex.

I had the P24 Antigen + Antibody test approximately 4-6 weeks after this event which came back negative. But in recent months I have been feeling anxiety and just wanted confirmation of this test result... Was it to early to take it? At the time the doctor didn't recommend any follow up tests but I am now a little paranoid.

Now I am sure the condom did not break at any point so I guess I am ok there but I have questions regarding the Oral sex she performed and also the Hand to Genital Contact.

1: Am I at risk from Oral Sex?

2: I noticed that I had some tearing around my cuticles which could have been open but not entirely sure... if this was the case would the fingering put me at risk?


Now down to the test... I have read that the above mentioned test could be quite deceiving since there is a window period where the Antigens Disappear but it is still too early for the detectable antibodies to appear which would then produce a negative result which obviously could be wrong since it could have been in the window period i just mentioned.

Does this sound accurate at all to you or am I first of all just being paranoid about the exposure to start with and secondly about the method of testing.

So as i took take this test at say between 30-45 days could I be confident in its result?

I would really appreciate an answer since this is driving me in sain.

Thank you in advance and kind regards

[mike_no]

1: No you're at no risk, whatsoever

2: Doesn't matter, you used a condom, you were protected.

3. Actually, your testing quieries stands immaterial since you never had a risk to begin with however FYI: P24 Ag and AB test taken at the 4th week is very reliable because if the body has not produced detectable amount of antibodies by that time and seroconverting the p24 (proteins) would be definelty be detected and if the antibody is produced Ab would be detected.

P24 AG & Ab (Duo Test) is a great test and at it's best if taken at the 28th day.

[hypercondria]

You mentioned in your answer to question 2 that it doesnt matter sonce I wore a condom and was protected but the question was actually related the possibility that I had tiny cuts around the finger nail area...

Would that mean I had a risk?

YOu mention that the test is best at 28 days... but what if it was say between 38-40 days how is the reliability different?

Thanks you

[hypercondria]

you mentioned that in answer to question 2 that it doesnt matter since I was protected and wore a condom.

But the question was actually if I had slight cuts around the fingernails would that mean that I was at risk because of the fingering episode...


Also regarding the test results you mention the duo is very reliable at 28 days... but what about between 28-40 days... how does its reliability change?

[hypercondria]

Do you have any comments at all please?

[mike_no]

"But the question was actually if I had slight cuts around the fingernails would that mean that I was at risk because of the fingering episode."

Slight cuts around the finger nail can't get you the virus, I don't see any risk associated.

One needs to have a fresh gapping wound  which has to be severely bleeding for any kind of risk to be present.

Please move on, you are in the clear.

[mike_no]

Nothing, negative at the 40th day for the kind of incidence that you've mentioned is conclusive , actually to be very honest with you, you didn't even require any testing at the first place.

[hypercondria]

Thanks mike I really appreciate it...

Just lastly how does the effectiveness of the test change for say somewhere between the 28-40 day mark?

Thanks so much...

[hypercondria]

Hi mike,

Thanks for the feedback... I know you say in my case it is none... but just generally... you say that the 28th day is best so what is the difference after the 28th day... like the 34 or 38 etc... why do thet make a difference?

I am just trying to educate myself

[mike_no]

'Duo tests looks for both HIV antibodies as well as the 'HIV P24 antigen'. The HIV p24 antigen is a core HIV viral protein which becomes detectable at approximately 10 days post exposure, peaks at 16 days and disappears as soon as the detectable amount of antibody is present in the body.

hence, a duo test taken at the 28 days can be very reliable, if the body has already seroconverted the antibody result by then would be positive and if the body did not seroconvert the antigen would be positive.

However if a duo test is taken at the 34/38....days the Antigen part of the test is incompetent and only the antibody part of the test is functional.

[hypercondria]

OK so if I understand this right... It is only less effective because in the average person there would have been enough antibodies to render the antigen part ineffective...

So hence once there are enough antibodies to bind the antigen, the antigen dissapears from the body, but of course at this point there would be enough antibodies to be detected... is this right?

Have you heard the talk about this 2nd window period whereby th antigens have been bound but there is not yet enough antibodies to be detected?

Is this theoretical and unlikely or is this a real issue?

[mike_no]

Correct.

2 window period, no thats not real.

[hypercondria]

Thank you for all your feedback...

Do you mind if I ask why you are so knowledgeable?

We could really do with people like your elf running clinics in the UK!!!!!!!

[mike_no]

There are two ways to gain knowledge;

1. Book knowledge ( Deliberate effort )
2. Street knowledge ( Learning the hard way)

I learnt the hard way cuz it can't get more stupid than me to be there twice and thats some thing, I'm not proud of, sucks!

[hypercondria]

Oh really... I'm sorry to hear that...

I hope everything is ok!!!

[mike_no]

So far so good, my PCR & duo was negative, looking forward to the 8 weeks test tomorrow, I'm hoping it turns out to be okay.

[hypercondria]

I hope all goes well for you...

Just a quick question back to the duo... If for example there weren't enough antibodies to cover the antigen and hence make the antigen disappear then the antigen test would show up positive if indeed there was an infection?

So the great thing with the duo is either one or the other should show something is that right?