Medical advise HIV testing

[drakkarnoir]

Hello Doctors,

Due to the abundant information you provided in the previous threads I will refrain from asking questions or topics already answered or debated in detai by you. However, like everybody else in this forum I have my own worries concerning possible exposure to HIV risk.

I am 30 y old white male, residing now in Eastern Europe (EU). in May 2011 I had a brief (10 sec) vaginal unprotected intercourse with a straight 20 y old girl of unknown HIV status. The action ended up with partial vaginal ejaculation.

In September 2011 I had a short (10 sec or so) oral, unprotected sex and vaginal protected sex with a girl, from what I learned later, was a "free lancer" sex professional, again of unknown health status.

I have read many threads concerning the HIV risk infection by giving oral sex so I am not going to address this question again. Despite the fact that in my mind it is not yet settled why the differences in doctors' opinions that some state oral sex is safe and others however agree with low risk.

I took an ECLIA (HIV1 and HIV 2) test in November 2011, respectively at 6 months after the first exposure and 8 weeks after the second one. It came back negative.

Here are my questions:

1. Does ECLIA standardly check for HIV1 and HIV2 antibodies and antigen? Being a 4th generation type test is it more reliable than ELISA?

2. Does the time of exposure, vaginal or oral and the presence of ejaculation count for estimating the risk of a possible HIV infection?

3. In many threads I have read I understood that an ECLIA test at 8 weeks after a risk exposure would be realiable as much as "near" 100% or 99.89%. Does this mean the existence of 0.01% risk of possible seroconversion beyond 8 weeks?

4. Having in view the described experience should I have further concerns as far as a risk exposure to HIV infection or should I put this unhappy experience behind my back and move on with my life?

I appreciate your expert opinion on this matter.

[drakkarnoir]

Thank you Doctor! I appreciate all your answers.

[H. Hunter Handsfield, M.D.]

I consider it conclusive and would not normally recommend any further testing.  However, because I have no experience with ECLIA, I cannot say for sure you do not need a 3 month test.  If it were me, I wouldn't do it -- but you'll have to make your own decision.

[drakkarnoir]

Thank you for your answers.

In other words, you consider a 8 weeks period ECLIA test conclusive and you would not recommend retesting after 3 months past last exposure, as doctors recommend here in this instance?

Please advise and thank you!

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.  I'll go straight to the specific questions.

1) ECLIA is not used in the US and I have no personal experience with it.  To the best of my knowledge, it is a highly reliable test and I believe it covers HIV type 2 as well as HIV-1.  But that's almost irrelevant, since HIV-2 is almost absent in all areas of the world outside it's African area of origin (including Eastern Europe, I believe).

2) Your exposure is irrelevant.  No matter how high or low the risk, your test results prove you were not infected.

3) I believe ECLIA is a test for both HIV antibody and p24 antigen, i.e. equivalent to the "4th generation", or "duo", or "combi" tests produced in North America and western Europe.  As such, a negative result is probably 100% reliable any time 4 weeks or more after exposure.  However, I do not know what actual research studies show with this test (if any have been done).

4) Based on all you say, I believe you can and should indeed "put this unhappy experience behind [your] back and move on with [your] life".

I hope this has helped.  Best wishes--  HHH, MD