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Avatar universal

HIV Duo test Combined With NAT Test Accuracy

Hello Dr.

During sex with a (Sex Worker- Unknown Status) i had my condom teared, and i was exposed for not more than a 1 min or MAX 2 min. I had a test for HIV and all STD exactly at 48 days (6.8 weeks) after the exposure. All tests where negative and  and below are my results for HIV Testing:

- HIV 1/2 AB, P24            NON REACTIVE
- NAT-B,C, HIV                NON REACTIVE

I am emotionally tired and stressed, thinking of the result turning positive at 12 weeks mark.The Dr. in the Lab told me that the testes are very accurate and i do not need further testing.

My Questions:

1) How accurate do you think the combination of these tests (Combo Test and NAT test) at 48 days.
2) Are these tests conclusive?
3) Do you recommend to take another test at 12 weeks mark or should i consider my self clear.
4) If yes, is it possible that i would turn positive at 12 weeks mark.

Thank you so much in advance.
6 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.

Your doctor is correct.  Your test results prove you did not catch HIV and no further testing is necessary.

The notion that an HIV test may be negative early and then become positive at 3 months was something that applied ONLY when the antibody tests were the only ones available.  Very rarely, it was thought it could take that long for measurable antibody to appear. Even that was primarily an issue for the older antibody tests, no longer in use.  With current (3rd generation) antibody tests, almost all infected persons have positive results by 6-8 weeks.

When combination testing for the virus itself is done -- antibody plus either HIV DNA/RNA (i.e., a NAAT test) or p24 antigen -- the combination of a negative result plus negative antibody is 100% conclusive any time 4 weeks or more after the last possible exposure.  In other words, it is not possible to have HIV and have negative results on both antibody and NAAT.

Those comments address all your questions, but to be explicit:

1,2) Your results are 100% accurate and conclusive.

3) You don't need any more testing.

4) There is no chance your tests will become positive at 3 months or any other time.

Official advice (from CDC and some other health agencies) is for final testing at 3 months, with an antibody only test, but it really isn't necessary.  If your doctor recommends it, you should do so for peace of mind.  But I certainly would not do it if personally I were in your situation.  

Best wishes--  HHH, MD
Avatar universal

Thanks Dr.

One last question. is it possible that the tests would neither pick both (antigens  and antibodies) when the antigen levels are really low, and there is no enough antibodies to be caught by the test, and thus a false negative test result?

Please advise.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Nope.  Never happens.  Your test results are reliable.  Stop worrying about it.
Avatar universal

Hello Dr,

First of all I want to thank you for your help. Seriously i have been through a hard time, and you have helped a lot.

I would like to ask a final question, and please do let me know if i should pay for this...No issues.

I had two additional Tests:

- 11 weeks Combo                         Negative
- 13 weeks or 90 Days Combo     Negative

God has been so merciful...

Should i move on with my life? So far I have had:

- 7 weeks Combo            Negative
- 7 weeks NAAT              Negative
- 11 Weeks Combo        Negative
- 13 Weeks Combo        Negative

Would you suggest to have a final test at 6 month, or i can go back to my life and family? I am asking this not of anxiety, but out of cautiousness, as me and my wife are planning for a baby.

Thank you and this forum again and god bless.
239123 tn?1267651214
MEDICAL PROFESSIONAL
All by itself, your first combo test at 7 weeks (48 days) was conclusive.  All other tests were superfluous and you have been seriously overtested.  You could have started having sex again with your wife at that time and you certainly should do so now.  Do not have any more HIV tests!

Thanks for the thanks about the forum.  I'm glad to have helped.  But that will end this thread; I won't have any further comments or advice.
Avatar universal
Thanks and regards Doctor.
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