HIV risk and Test results

[extremelyworried209]

Dear Dr,
On November 22, 2012 I had a high risk exposure with a massage parlour girl in Canada. I am a male and  was having abt 10 minutes cuninlingus (not inserted my tonge inside) and did the worst mistake of my life by having about 10 second unprotected sex with her (5 times in and out). About 18 days later I had sudden onset of fever, chills, tiredness,headache, muscle pain, feel like vomiting, etc. Then abt 12 days it turned to nasal congestion and headache with mind sore throat. On January 5, still I had  mild sore throat, red tonsils in the throat, nasal congestion and yellow mucus coming when I cough+ hoarse voice. Had ear pain too.
On January 15th (exactly after 7 weeks and 5 days from the exposure) I had 4th generation HIV ab/ag (p24) combo test and tests for all other STDs the results are negative. The nurse scheduled folow up tests in 3 monts and 6 months marks saying the test I had in abt 8 weeks (54 days after exposure) is not conclusive.

1. Can I consider the 4th generation lab test (HIV ag/ab combo, p24 anti gen) which I had in 54 days (7 weeks and 5 days) after the exposure is conclusive or do I need to have any more tests in 3 months mark.

I didn't have any more symtoms now apart from nasal congestion, mucus in throat and nose.
Thanks a lot

[extremelyworried209]

Dear Dr,
I have no words to thank you for your helpful reply. The rest I had was

"Abbott Architect HIV Ag/Ab combo chemiluminescent micriparticle immunoassy (Health Canada Licencsed 2008)" (that is what was writted in the paper)

Please let me know this is THE 4TH GENERATION TEST or not.

Thank you very much .....for your great work..!

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you for your post.  Here are your answers:

1. Can I consider the 4th generation lab test (HIV ag/ab combo, p24 anti gen) which I had in 54 days (7 weeks and 5 days) after the exposure is conclusive or do I need to have any more tests in 3 months mark.
YES, IT IS FINAL AND FULLY CONCLUSIVE.  YOU ARE HIV NEGATIVE WITHOUT ANY DOUBT.  NO NEED FOR FURTHER TESTS.

2. The reason I am asking is that could my result be a FALSE NEGATIVE (tested by 4th generation combo) and can sero conversion happen after 8 weeks ? i am an usually healthy person.
NO, THAT IS NOT POSSIBLE.  SERO-CONVERSION HAPPENS BETWEEN 2 AND 6 WEEKS.  IN ANY CASE, THE P24 ANTIGEN WOULD ALWYS BE DETECTABEL AS IT IS INDEPENDENT OF SERO-CONVERSION.

3. Can I continue unprotected sex with my regular partner?
THERE IS NO RISK TO YOUR PARTNER, PROVIDED YOU HAVE BEEN TESTED NEGATIVE TO ALL OTHER STDs.

4. How long does it take to develop P24 antigens from an exposure?
USUALLY 14 DAYS
Can it be delayed more than 7, 8 weeks so that neither anti gen nor anti body can be detected in a combo test performed in 7~8 weeks after an exposure (and perhaps able to detect after 10~12 weeks) ? NO, THAT IS IMPOSSIBLE.
Is there any chance my combo test done in 54 days after exposure to be a FALSE NEGATIVE? I DOUBT THAT VERY MUCH SO.

Best wishes,
Dr José

[extremelyworried209]

Dear Dr,
I have another question.  How long does it take to develop P24 antigens from an exposure? Can it be delayed more than 7, 8 weeks so that neither anti gen nor anti body can be detected in a combo test performed in 7~8 weeks after an exposure (and perhaps able to detect after 10~12 weeks) ?
Is there any chance my combo test done in 54 days after exposure to be a FALSE NEGATIVE?

Thank you..!

[extremelyworried209]

Dear Dr,
1. The reason I am asking is that could my result be a FALSE NEGATIVE (tested by 4th generation combo) and can sero conversion happen after 8 weeks ? i am an usually healthy person.

2. Can I continue unprotected sex with my regular partner?

Thank you