timing and sensitivity

Hi Doc,
Here is the story
Protected sexual intercourse, unprotected **, kissing.
The girl originates from Central Africa.
Got her and myself tested at day + 2 (Immuncomb and another test I dont recall) : neg
Got myself tested at day + 25 (Immunocomb + the other one I dont recall) : neg
Idem at day + 29 (Vidas duo AG P24 + Immunocomb) : neg
Lastly at day + 38 and 41 (by single Elisa test) : neg

I would like to know whether these tests are sensitive to a potential HIV-1 subtype O (endemic in Central Afr) ?
I would like to have a clear advise about the delay in testing (heard potentially everything even from different physicians ... 6 weeks, 3 months, 6 months, 12 months). The last doc I met - head of the biological institute where I got tested told me that at 6 weeks the tests are pretty reliable.

Do I need to undergo another test ? AG P 24 (or is it too late anyhow for this).
If yes which one's and when ?

Many tks,

P.

[Edward W Hook, MD]

We get many questions about the utility of various HIV blood tests for different HIV serotypes.  Virtually all are answered in the same way- currently available HIV tests are highly accurate for all HIV serotypes.  When there are problems the problems due to rare virus changes, they manifest themselves as indeterminate responses which, in turn lead to further evaluation and accurate diagnosis. This answer holds for your question as well.  You and your partner were negative for HIV - she does not have it and therefore you are not going to get it from her (and the chances that she was in the "window period" in which tests have not yet become positive are extraordinarily low and really not worth worrying about).   Given your history exposure, the information you have provided on your partner and your own test results through nearly 6 weeks, you do not need any further testing. If you choose any further testing, it will be to help calm your own anxieties, not for any realistic medical reasons.  EWH

[patlarson]

Hi Doc,
thank you for your answer on my concern.
A very last question on this topic :
Should we go to the worst scenario ;-) : since it is said that tests at exposure +6 weeks (42 days) are pretty reliable, what about my case where I did the last test at day +40/41 ?
Could it virtually be that one test turns out positive only at day lets say 43 ...
Just, hopefully, to be fully reliefed ...
Many thanks

[Edward W Hook, MD]

A day or two makes no difference.  You really do not need to worry.  EWH

[patlarson]

Hi Doctor,
based on the exposure history above (but also adding that I have a broken tooth that could bleed a little at times I suppose) do you as a prof consider my exposure as a low risk one ? Actually re-reading this threat I realize that I had posted the fact about my tooth in the public forum post but not in my post to you. Reason why I add it and ask whether you would consider the whole story as a low risk exposure.
I'll be on duty abroab by the end of next week, so I'll go for a last test by day +50, if negative, I think I'll be able to forget about all this.
Anyhow, many thanks for your clarif and support. Really a great site.
P.

[Edward W Hook, MD]

No, your broken tooth does not change my assessment of your risk form this low risk exposure.  EWH  

[patlarson]

Hi Doctor,

went as foreseen this morning for an Elisa at exposure +51 : negative as you had foreseen.
in your first reply (sorry for being oh so silly ...) you had told me already not to retake a test but just to be fully sure : can I close this HIV file or out of security a test at +90 days is adviseable ? Seen the numerous tests I have undergone these last weeks ... I guess that if it were negative it should have come up already right (taking into account that I am perfectly sure of the date of this low risk exposure) ? Many thanks again. This is my last post about this (rest assured ...). Patrick

[patlarson]

sorry, correction, read 'positive' iso 'negative' in the sentence "I guess that if it were negative" ...