Accuracy of HIV-1 DNA RT- PCR with HIV Antibodies Test

[Regrets2010]

I had unprotected vaginal and oral sex nine weeks ago with a woman I did not know well (one night stand). After the possible exposure, I completely freaked out emotionally and had numerous STD and standard HIV tests performed.  I also had a HIV-1 DNA RT- PCR with HIV Antibodies test thirty-two days after possible exposure.  All tests including the DNA test were negative.

As I mentioned, it has been nine weeks since possible exposure. Should I still be concerned about being infected with HIV?  I have not shown the normal symptoms (fever, enlarged lymph nodes, diarrhea, nausea, etc.). However, I have had a sick weak feeling throughout my body for about two months since the incident and all the of the doctors I have visited (General Doctor, Urologist, Nurse Practitioner, Neurologist, and a physician’s assistant) say it is related to stress and anxiety.

Should I still be concerned about HIV or should I concentrate on moving on (mentally) with my life?  I have read that the HIV-1 DNA RT- PCR with HIV Antibodies test is the most advanced test in the world for early detection of HIV. Should I take a rapid HIV test tomorrow to ensure I am not infected (positive)?

Thank you and please advise.

[H. Hunter Handsfield, M.D.]

I already said "the negative tests you have had prove 100% that you were not infected".  Obviously that means the these test results are conclusive.  Any more anxiety-driven questions that ignore previous replies will result in immediate deletion of the entire thread.

[Regrets2010]

Doctor, I should have phrased my question as simple as this: How conclusive is the HIV-1 DNA RT- PCR with HIV Antibodies test thirty-two days after possible exposure?

Thank you.

[H. Hunter Handsfield, M.D.]

This is purely "nerves".  See my advice above about professional psychological/psychiatric care as the next step.

That will be all for this thread.  There is nothing you can add that could possibly change my opinion or advice, so I will have no further comments.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  However, your questions partly duplicate those you asked on the HIV international forum, following the same exposure and some of the same test results.  I agree with the reassuring responses you had then from Dr. Gonzalez-Garcia.  You don't have HIV.

HIV is rare in women in the US and other industrialized countries; and when a woman has HIV, the chance of transmission from a single episode of vaginal sex averages 1 in 2,000.  That's equivalent to having unprotected sex with infected women once a day for over 5 years and maybe never getting infected.  Most important, the negative tests you have had prove 100% that you were not infected.  This means that HIV is not a possible cause of your symptoms.  I agree they sound most consistent with a psychological origin -- and since at least 3 health care providers have told you the same thing, you can take it to the bank.  Rather than pursuing further HIV testing, if your symptoms continue, or if you find yourself continuing to obsess about HIV, the next step is to get professional mental health care.  I suggest it from compassion, not criticism.

Regards--  HHH, MD

[Regrets2010]

I forgot to mention that within the last three weeks, I have experienced hot heat sensations throughout my entire body.  The sensations can last for several hours and can go away on their own.  Some days are better than others. I have taken my temperature several times a day with a thermal thermometer and my body temperature is normal. No fever since this mess started over two months ago.

Could this reaction be related to HIV or is it my nerves?  I was prescribed 5mg of Buspirone 2x a day to settle me down.  I think it may have started working today but I still feel hot.  Should I get tested again for HIV and if so, should I do the rapid test?