HIV Tests

Greetings Dr's,

I have had a 4th gen ab/ag test at 95 days which came back negative, - this is one of several tests I have had up to this point.

My exposure would probably be classed as low risk although the ex and my new girlfrind have had some "symptoms", I have too, they have varied from recouring mouth ulcers etc.

At 95 days, can I take this test as conclcive & move on?

Is there ever a need to test past 95 days (virtually 14 weeks) with modern testing?

I used Prednisilone steroids for four days a week after teh exposure, I also use steroid creams for excema daily, - could these perhaps have given a "false negative"?

Everyone around me is telling me to move on and forget about this, my GUM clinic have discahrged me but I am still worried.

Is there a ) a need for any further tests & b ) if so, what kind of test shoudl I have?

Thank you DR HHH or EWH.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

Stopping to comment after the opening lines:  The combination tests for HIV antibody and p24 antigen ("4th generation" tests) are 100% reliable any time 4 weeks or more after the last possible exposure to HIV.  The results always overrule exposure history, symptoms, or anything else.

Now I have read the rest.  The additonal information doesn't change anything.  There are no medications or illnesses that delay HIV test results or otherwise alter the reliability of testing.  The only possible exceptions are immediatley life-threatening illnesses, such as terminal cancer; certain diseases with profound immune deficiency; and very potent chemotherapy or immunosuppressive drugs.  Even these are mostly theoretical, with few if any actual reports that any of them actually altered test result for HIV.  Steroid creams absolutely can have no effect.

Therefore, I agree exactly with the advice you had from the GUM clinic.  There is no need for further HIV testing.  If you continue to have symptoms that concern you, see a health professional about them (your GP probably would be best) -- but you can be 100% confident HIV is not the cause.

Regards--  HHH, MD

[lfeinastar]

Thank you for your prompt response Dr.

I notice from some posts (Dr EWH) where he mentions taht "potentially", steroids could effect the test only for the time you are taking the medication?

If I may draw on your experience here please Dr, - in terms of Seroconversion, have you ever seen anyone Seroconvert past twelve weeks?  Maybe if you could identify this alongside the 4th gen tests that would be helpful?

In terms of the "window period", When I was at six weeks I was angry that some forums / sites advised twelve weeks, now I am at 97 days (not 95, my mistake...) negative, I still find it hard to move on wirth absolute certainty, - the CDC still mentions six months, - could you possibly share your opinion on this, - they say 97 percent of people have ab detectable by three months, - 3% seems like a huge void to me...

Noticing that you reassuring words say "tests alwyas overule symptoms and exposure", - if I had say preseneted myslef as having had sex with a known HIV+ lady (that is not the case) - would the tests upto and including 97 days still stand as final or would you seek more testing?

I appreciate these questions are some what in depth but ansers to them are very hard to come by so I would sincerely appreciate your thoughts please Dr.

You do great work here Dr, your time and effort is really appreciated..

Thank you :)

[H. Hunter Handsfield, M.D.]

Very high dose steroids IV or by mouth, maybe; I include those in my comment about potent immunosuppressive drugs.  Steroid creams cannot possibly have an effect.

The notion of 3% false negative antibody tests at 3 months is old information, preceding the modern HIV antibody tests in use the past 10-15 years.  And even 20 years ago, 3% probably was too high.  And in any case, that's why the combo test was invented and is now in routine use in many places; in the extremely slim chance antibody were undetectable, p24 antigen would be.

And yes, you could have penetrated 10 HIV infected women, or you could have injected yourself with HIV positive blood.  If you had a negative combo test more than 4 weeks later, and certainly at 3+ months, I would have said exactly the same as I did:  the test result proves you were not infected.

Thanks for the thanks.  But that will have to end this thread.  Please do your best to accept the science and the reasoned reassurance you have had, both here and from the GUM clinic.