HIV COMBO Test

[Sam1979]

Dear Dr. Hansfield

I would really appreciate it if you answered my question as I have searched your threads and not found an answer.

I am a student male from UK and had oral contact with a guy's penis (a few seconds of fellatio) with no ejaculation.  I had a negative HIV Ab/Ag COMBO test with a reading of 0.07 yesterday (9 weeks post-exposure).  I've seen a lot of people asking about the DUO test and wondered if the COMBO test has the same level of sensitivity in detection and timing.

Also I've started wondering that I might have an HIV-2 infection in which case the test would not have picked it up.  I think this because the incident happened in the US and I think the guy could have been Portugese and I've read that the HIV-2 strain has been found there and in Africa?!

Please give me your opinion on these issues as I really value your expert opinion (I really mean this).  It's not easy to seek doctor's opinions in the UK (it's mostly nurses) at the GUM clinics unless you go private.

Do you think I should just wait and go for the 13 week test anyway.

Thank you so very much,
Sam

[H. Hunter Handsfield, M.D.]

I think you need no further testing at all; there really is no reason for another test at 3 months, despite the fact that UK health authorities there typically recommend it.  The exposure you describe was zero risk for HIV, for pratcital purposes.  And don't worry about HIV-2.  Your test might have included HIV-2 anyway (ask the clinic that tested you).  And it's really a stretch to say a guy "might have been Portugese" and "I've read HIV-2 has been found there" to assume you could have been infected with HIV-2 in an exposure that carried a risk of 1 in 100,000 (tops) of transmitting HIV.

UK's GUM clinics are among the best in the world.  You can rely on their advice, whether by nurses or doctor.  But my advice is to get on with life and stop worrying about things that carry less risk than crossing the street.

Good luck--  HHH, MD

[freddy999]

Sam,

I think you would struggle to find a combo test that didn't also test HIV-2.

There have only ever been around a hundred or so HIV-2 cases in the states and they would most likely have been in people from or who have visited West Africa

[freddy999]

By the way COMBO = DUO

They are both 4th Generation Tests that combine HIV1+2 search for Ag (P24 Antigen) and Ab (Antibodies).

COMBO probable refers to the COMBI COBAS Assay by Roche Diagnostics
DUO probably refers to VIDAS DUO assay by BioMerieux

Just different brands like Coke and Pepsi that's all.

Both have very similar, if not identical, sensitivity and specificity.

[who_is_this]

Dr. HHH is going to tell you that you didn't need any testing in the first place, except to allay your own anxiety.