Hard time moving on...COMBO test at 6 Weeks

[goingkuku]

Dear Doctors,

I recently posted this on the community forum (please see post there as I can't fit my story in the character limit here.)  PLEASE SEE MY NOV 02, 2012 post.

I am having a very hard time moving on from this and I keep thinking that I may be infected, AND that I have infected my spouse.  

I would love nothing more than to hear one of your classic "you cant have a negative P24 Antigen+Antibody combo test at 4+ weeks after exposure and be positive, but I would nonetheless like your brutally honest assessment.  I know that a lot of this is guilt  BUT I really am worried and feel it is more than that. The frottage with the menstral blood + vaginal fluid is hard to get over.

1. Should I trust my test 6 week P24 Antigen+Antibody negative results and move on?

2. This may sound silly but are you, and do you, consider yourself an expert in this field.

3.  What are your feelings on this so-called "second window period" where the antigen level is to low but the antibody has not built up yet....

4.  Is the Combo test MORE accurate at 28 days or does it become more accurate as time goes on?

5. I had another test taken at 10 weeks.... if It comes back negative should I just move on!

6. This may also sound silly... If you were in my shoes as a percentage how comfortable would you feel having intercourse with your spouse given the information that I have provided you with.


Thank you for your comments and time.

[Edward W Hook, MD]

This was a virtually no risk exposure which should not concern you.  there wass no medical reason for testing to start with.  

1.  Already answered -see above.  Beyond 4 weeks test performance does not change. Believe your results.

2.  For you to imply that I would say something different to you if you were my patient is a bit offensive.  Do you thiink I would not tell you the truth on line.  See above regarding risk.

Take care. EWH

[goingkuku]

Thank you for your prompt response.    Not sure if this changes anything...

My exposure...

- I am a hetro male and had exposure to middle eastern female in Canada.
- Deep tongue to tongue kissing (my gums bleed when I brush my teeth sometimes)
- Fingering during menstral cycle
- licking nipples
- performed frottage and had exposure of vaginal fluid and menstral blood on penis - including tip.

LAST 2 questions...
1. Is a COMBO test just as accurate at 6 weeks compared to 4 weeks?

2. What level of risk did I have... if I was your patient would you tell me to get tested for HIV.

p.s   LOL at me questioning if you are an expert or not...I could not be talking to more of one!

[Edward W Hook, MD]

Welcome to our Forum.  I will not review your comments on the Community Forum to help you circumvent the character limits on the site.  The limits have been thought out and are there for a good reason.  Thus, straight to your questions (also, I cannot repeat the questions as I need to work under the same space constraints.

1.  The results of combination HIV p24 antigen/HIV antibody tests provide definite results at 4 weeks.,  If your tests are negative at this time, you should believe them.

2.  You decide.  I've been in the field since the beginning of the HIV epidemic, have published over 300 paper, written several books and am on ( and have chaired) national and international advisory committees.  

3.  The so-call "2nd window" is an urban myth.

4.  No, an accurate test does not become "more accurate" with time.  Sounds like word games to me.

5.  It WILL show the same results that you already have.  If you wish to prove this to yourself, do so. I think you should move on now.

6.  I would be absolutely comfortable.  EWH