HIV1 & HIV2 Antibodies, Combo Test Includes p24 Antigen

[crazyrahul75]

Dear Doctor. I live in India and had sex with a Russian commercial sex worker initially with a condom which she took off mid way stating that it was safe as she just got her tests done last week and was negative. In a state where we both were high on alcohol, i couldn't really figure out the blunder that i was committing. I later questioned her that she would be allowing other men too to do the same and she replied that she was choosy and could differentiate amongst her clients, to which i have my doubts. She even told me that she could get me her last week hiv reports if i was so messed up in the mind. I got an HIV1 & HIV2 Antibodies, Combo Test Includes p24 Antigen (Chemiluminescent Microparticle Immunoassay) done on 16th day which was non reactive and measured 0.16.

Today is the 28th day and i went in for another test, the result for which would be out today in the evening. I am a married man and don't want to pass any infection (god forbid) if any to my wife and she has already been questioning me as to why i have been using a condom all throughout for the last couple of days as she is a bit allergic to latex and says she wont let me use it anymore. My whole world has turned Topsy Turvy (A) because of guilt (B) due to fear of contracting / passing a dreaded disease.

Is the above mentioned test on the 28th day reliable and accurate in India ? In case i am negative, Can i carry on my life with my spouse like any normal person. ? The guy who draws blood samples at the center told me that 3 months was conclusive. Upon asking him why not 28 days he had no answer to that. My question is do we really need to wait that long (3 Months) wherein each morning we rise is the begining of another day full of anxiety and fear ....???? I have absolutely no symptoms whatsoever.

Your help and suggestion will be highly appreciated. GOD BLESS !!

Warm Regards
Rahul

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  I'll try to help.  The bottom line is that it is quite certain you did not catch HIV.

First, it is unlikely your partner has HIV. Most sex workers are not infected -- and her negative recent HIV test should be very reassuring.  Can people lie?  Sure.  Can people have a new infection that hasn't yet shown up on a blood test?  Of course.  But the statistical odds of those occurrences are low.  And remember that even when a woman has HIV, the chance of transmission through unprotected vaginal sex is around 1 for every 2,000 sexual exposures.  Finally, it is almost impossible that you have HIV in light of negative tests for both HIV antibody and P24 antigen at ~2 weeks after exposure.  (India is a medically sophisticated country.  The tests used and their results are just as reliable as anywhere in the world.)

The time frame of 3 months until completely reliable testing is standard advice.  But it is hyper-conservative.  The modern HIV antibody tests almost always are positive within 6 weeks.  And as I said above, the combination of negative antibody and negative P24 antigen at 16 days is highly reliable.

Can you "carry on with your spouse"?  Of course no distant online expert can guarantee you are not infected with HIV.  But I can tell you if I were in your situation, knowing what I know, I would continue unprotected sex with my wife without any concern for her health.

Finally, don't pay any attention to the index value of the antibody tests.  There is no difference between 0.16, 0.22, and any other value up to the positive cut-off value.  All are equally negative.

All is well.  You aren't infected.  Feel free to have a final antibody test in a few weeks, for reassurance.  But in the meantime, don't worry so much.  Almost certainly you weren't infected.

Regards---  HHH, MD

[crazyrahul75]

I Just received the result of the 28 day HIV 1, HIV 2 and p24 antigen and the index value is 0.22 and non reactive don't know what to make out of the tests.

[crazyrahul75]

Dear Doctor. Thanks for replying back. It is so important & relieving to speak with someone at such a point in one's life but unfortunately u see none that you would be comfortable sharing your anxiety with. Not even your spouse.

I do understand your reply, like i mentioned it was my wife that i am scared for more than myself. I am unable to answer as to why i'm using the condom at all. I have never strayed outside my marriage except for the last instance that i mentioned which will always be regretted. I forgot to mention that approximately on the 10th day i saw little red swelling at the tip of my foreskin which looked a lot like an insect bite but disappeared on a single use of canesten ointment. Is that a relevant symptom.?

My major question is whether i need any further testing after the HIV 1 / HIV 2 & p24 combo was negative after 28 days ? Is this test conclusive on day 28 ? Can i just be the way i was with my wife prior to the episode as i have two little kids and want her to live long if not me.

I am grateful for your time spared and appreciate all the help that you have made available.....!! Thank You So Much.  

[H. Hunter Handsfield, M.D.]

The penile red spot does not change my opinion or advice.

The combo test, which detects both HIV antibody and p24 antigen, is considered virtually 100% reliable at 4 weeks.  Still, some experts recommend a final antibody-only test as late as 3 months, although 6-8 weeks really is sufficient.  As things stand now, based on the combination of all information (low chance your partner had HIV, low chance of transmission even if she was infected, plus the test results), the chance you have HIV is zero for all practical purposes.  It is up to you whether you need the additional reassurance of additional tests despite this reassurance.

That's all for this thread.  Take care.

[crazyrahul75]

As you had advised, i went in for the 6 week Combo test with a negative result of 0.12, the lowest in all tests that i have taken so far, dunno if that makes any difference. Anyways i have been intimate with my wife 3 to 4 times (without protection) in the past three weeks and am much at ease after your support. Would the 6 week test be conclusive or do i need the 3 month test (not that i wanna get tested any more), just that i want her to be safe. Can i simple be at ease and think i was never at threat anyways....??  

[H. Hunter Handsfield, M.D.]

Of course your repeat test was negative.  As discussed above, that was the only possibility.  Please go on with your life with 100% confidence you don't have HIV and that there is no health threat to your wife.

That is truly the last comment on this thread.  I'll have to delete any further comments.