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Avatar universal

2 HIV Test Results

In South Eastern Europe I tested for: Anti HIV 1&2 Antikor/p24 Antijen My test was "reactive"  less than 1,0 being negative. I was: 2,1 S/CO. Test was completed exactly 1 month after what I thought was exposure via receptive, unprotected anal sex, unknown status. 3 weeks after I had: fever fatigue loss of appetite tongue coating/spots,very bad sore throat & night sweats. After 10 days symptoms faded but some tiredness night sweats & going to the bathroom at least twice or more/day and sense of "not well" continued. Finally back in the US I retested.  At 2 months (61 days) after assumed exposure and a 1 month after the start of the flu-like symptoms I had a Uni-Gold rapid blood test that came back negative. I realize that false negatives on an antibody test at 8 weeks happen. But what is the accuracy of Uni-Gold rapid blood test of HIV 1 & HIV 2 antibodies at 8 weeks (61 days) post exposure? Would it not be likely to have antibodies 1 month post start of illness? Is act of seroconversion and ensuing illness mean that the body has produced detectible antibodies? Ora gold rapid blood test was performed in 1 of the top free clinics in NYC, so I imagine quality is high. On the paper, it said Test for HIV 1 &  2 antibodies. Clinician testing said there had been false negatives before (but where these likely after 1 month or less of exposure w/ ARS symptoms, and not after 2 months, 1 month after start of symptoms? If 1st test really had been a true positive result another antibody test one month later would also be positive, no, if Ora-Gold lists nearly 100% accuracy.  What are the chances this test did not catch HIV 2 or a rare strain? I am mortified that over the next few days optimism will get the best of me, and then I will have to go though this all over again. I know my (amazingly stupid) act was very high risk, in your professional, clinical experience/observation what is the % accuracy of an 8 week ora-gold blood test? Thank you very, very much.
7 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the HIV forum.

You had an accurate reply from Vance on the community forum.  Almost certainly your initial test result was falsely positive.  Standard practices is for automatic Western blot for all initial positive results.  Was that not done?  That should have told immediately whether the initial positive result was true or false.

Even if WB was not done, your more recent results strongly suggest a false positive initial test.  With the modern HIV tests, including the ones you had (e.g. Unigold and Ora gold), negative results at 8 weeks are 100% accurate, or very close to it.  There are no HIV strains not detected with these standard tests.  That's an urban myth, except perhaps in a very few parts of Africa; such HIV strains have not yet been known to be circulating anywhere else in the world.

Therefore, you can be certain your symptoms were not due to HIV.  Test results always overrule symptoms and exposure history.  However, if you would like still more security about it, you could have a final antibody test 3 months after the exposure.  You can expect it to also be negative.

If you are interested, here is another thread that goes into detail about the window period and HIV antibody test reliability at various times after exposure.  Read the entire discussion; the most important information is in the follow-up comments:    http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755

I hope this helps.  Best wishes--  HHH, MD
Avatar universal
Dear Dr. H,

Thank you so much for your reply. I am again starting to cry as I write this, as for the last month I was sure I was HIV positive, and in all honesty my life had stopped. It is so hard to believe that my horrible mistake has not cost me my life. I am scared to say: "trust me when I say I have learned my lesson," however, you reply of 100% certainty is pushing me to believe that I have been spared this one major, major mess up.

If I can bother you with just two follow-up questions: 1. as I saw on the sheet from the foreign hospital (the 1st test, which I am hoping was a false positive now included p24 antigen testing). Is it at all possible that as this was one month after exposure this is what reacted (as I have read that this usually is present a few weeks to a month after exposure, and then diminishes as antibodies are produced, and then at the 61 day mark (and 1 month after what I thought was ARS mark) the uni gold blood test was not reactive for antibodies? Have you ever heard in records or seen in your own clinical experience seen this happen: i.e. negative a 2 month, and positive thereafter?

I will be getting more testing to confirm, but as I mentioned above, I had in fact been going through a grieving process, and had even signed up for an ASO in New York the day I arrived before the test. So I wanted to know if I will safely be able to 'restart' life without the fear of having to go through a grieving process again at 3 months. I'm not sure I could handle that.
Also to answer your question, no, no follow-up test was offered, and I did not even think of it as I put a. high risk act b. strong ARS symptoms in the correct timeframe and c. reactive test result to mean HIV positive.  I was simply handed an envelope at the foreign hospital, walked out onto the street, opened the envelope and almost collapsed when I saw the result. It is just amazing that so many things could have come together to 'teach me a lesson' without actually being infected...My god what are the odds....
239123 tn?1267651214
MEDICAL PROFESSIONAL
I don't know the numerical interpretation of the results of the test you described.  But it is not possible that the p24 antigen component was positive at 4 weeks, with a negative antibody test at 8 weeks.  I have never heard of a circumstance like this in which someone turned out to have HIV.

Given the discrepant test results and the high risk nature of your exposure, I do agree it is reasonable for you to have a final HIV antibody test at 3 months.  For the reasons discussed, I expect it to remain negative.
Avatar universal
Dear Dr. H.

I greatly appreciate your time and know you are busy, so I will just ask one final question: if I had indeed begun experiencing symptoms of ARS aprox. 1 month after exposure, would the uni gold test pick up antibodies 4 weeks after the onset of symptoms? If the body is reacting to the virus by producing symptoms, would antibodies definitely be present one month later?

Thank you again for your help and the wonderful service you are providing people here (especially uninsured people like me).
239123 tn?1267651214
MEDICAL PROFESSIONAL
HIV antibody tests always will be positive within a few days of start of symptoms of ARS.  A negative test 4 weeks after onset indicates that ARS is not the cause.
Avatar universal
Dear Dr. Handsfield,

I really do promise this as a last question without starting a new thread. And I know this is a somewhat subjective question, but in your experience, how often do free clinics 'mess up' on rapid Uni gold tests?

What are the chances GMHC in New York could have messed up a rapid uni gold blood test? They must do a ton of these every day, and before they share results the onsite Dr. also looks at the test result and signs off on the paper along with the guy who performed the test.....

What is driving me crazy is the question of who messed up - the foreign hospital or the clinic in New York?

I even asked in NY for another test, and the guy said no need, the (negative) result would remain the same. He said the way to know was to have a viral load test. I had not really discussed the 8 week timeframe with him, he knew I had been at recent risk.

Do you have an idea how often free clinics/testing centers in New York make the wrong call on rapid test results, i.e. do not see a faint line on the test, or any other number of reasons ........

Thank you very, very much for humoring my questions in what is a crazy situation and difficult time.
239123 tn?1267651214
MEDICAL PROFESSIONAL
It is rare if ever that someone "messes up" a rapid HIV tests.  They are so foolproof that some experts hope they will someday be available for self-testing by patients at home, i.e. with no professional training.  And probably nobody "messed up" on your test results so far.  Weakly false positive or indeterminate results just occur from time to time, without explanation.

Try to accept the reassurance and advice you have had.  Stop trying to look for explanations for the initial false test result or for reasons that I (and the other doctors and counselors you have seen) are wrong.  Lay off the internet. I know the initial test result was shocking and painful -- but it's time to suck it up and get over it.  Have a final HIV test at 3 months, just to be extra sure.  Then put these events behind you and move on.

That will be all for this thread.   You may post a closing comment in a few weeks to report a final test result at 3 months.  Any other comments will be deleted without reply.  And please do not be tempted to start a new thread to ask the same questions or continue this discussion.  It would only be deleted without reply (and without refund of the posting fee).
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