HIV Testing questions.

[clarence123]

Dear doctor,

I had my last sexual exposure 11 months 2 weeks back  that was unprotected oral with a women of unknown status and then again 8 months back i had unprocted anal intercourse for about less than a minute with a girl of unkown status , i later asked her she said she does not have HIV.
I am a future doctor , being studying medicine for the last 4 years at university.However i have the following questions to ask you -

1) I Had a duo test done for p24 antigen and antibody to hiv 1/2 , twice.I heard this has a high false negative rate.Is the test conclusive at 7 months post exposure ? And if i was positive but still in my window period ( a rare late seroconverter) my p24 antigen would still have been detected right ?

2)I had a proviral pcr dna test done , it was negative , this was 7 months 2 weeks post exposure.is this test conclusive this late or only detects virus at earlier times ? And is it possible for my viral load to be under 100 copies at 7 months 2 weeks post exposure without me taking any HIV medicine ?

3)What is the range for a healthy CD4 and CD8 count in a HIV negative person ? I am male , 20 years old and i do smoke i went for the test at 6 months 2 weeks post exposure.My result was cd4 count 527 and cd8 count 421.Is this normal for a negative person ?

4)Do x-rays and antibiotics affect the conclusiveness of the HIV tests ? And I had 2 CBC counts they were all normal , does this indicate i do not have any infections in the body ?

5)Have you ever seen anybody have a negative PCR test and antibody test at 8 months post exposure but seroconvert later ?

6)I have a feeling of weakness and fatigue for 2 months now , don't know what is causing it . Do ARS symptoms occur 7 months post exposure ?
And does a HIV related fever dissapear in 3 days of having medicine ? the fever was around 101 then went down on me having crocin.

Thanks sir
Clarence

[Edward W Hook, MD]

You do not need fuirther testing. The window period is in the early weeks following exposure, not months later.

There will be no further answers.  EWH

[clarence123]

One last question ,  what is the window period and when can one be assured completely they are negative ?
Do i need further testing ?

[Edward W Hook, MD]

No.  If your p24 was positve your PCR would be positive as it is a more sensitive test than the p24.  If you had untreated HIV, you antibody test would be postive, your PCR would be positive and your p24 antigen would probably be positive.  

Why do you keep asking the same question again and again?  It suggests that you anxiety is out of control.  Your tests show that without a doubt that you did not get HIV from the exposures you described.  That was your question. This is the answer. Please stop asking the same question again and again in slightly different ways or the entire thread will be deleted.  EWH

[clarence123]

But as per my question number 2  , Does the viral load remain very low like below 100 copies after 8 months post exposure without having any HIV medicine ?
And even if i had not seroconverted my p24 antigen would have remained in the blood right ? So eiter the p24 antigen or the antibody would be detected ?

Thanks

[Edward W Hook, MD]

Welcome to the Forum.  I will go directly to your questions.

1.  What you have heard, and wherever you heard it is incorrect.  There is NOT a high false negative rate for the DUO test at  any time more than 8 weeks after exposure.  Two negative tests provide proof that you do not have HIV.

2.  When a person gets HIV their PCR test will remain positive from there forward unless they are on therapy for HIV.  Your negative proviral PCR proves that you do not have HIV and confirms the result of the DUO test.

3.  Your CD4 counts are in the low normal range.  Checking a CD4 test to evaluate risk for HIV is a waste of time.

4.  x-rays and antibiotics have no effect on the performance of diagnostic tests for HIV.  Normal CBC's in no way reflect the presence or absence of HIV.

5.  NO

6.  Your symptoms are not due to HIV. The ARS does not occur at 7 months following exposure.

Your questions suggest that you are inappropriately worried about HIV. All of the test results you mention indicate that you do not have HIV and need not worry about it.  I suggest you go forward and stop worrying about HIV.   Please do not follow this post with further "what if" or "could this effrect the test" questions.  You do not have HIV from the exposure you mention.   EWH