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Avatar universal

Reliability of Hiv Test

Hello Dr. HHH,

I have recently undergone a series of tests for HIV. I have been sexually active and should have been tested years ago (due to several potentially unsafe sexual encounters in my past) but never mustered up the courage to do so until a recent "incident" where i could have possibly been exposed. I say possibly  because i dont even know for sure that i had sex with anyone, in fact i suspect that i didnt, but i was very drunk and blacked out the night and i decided to treat it as a high risk exposure as i am in a relationship right now and i wanted to be safe for me and my partner. I should mention i am bisexual, and the previous potentials were sex with men of unknown status.
3 weeks post this incident i had a rapid hiv1/2 anditbody test (negative) and what is called an acute hiv test at one of the nyc department of health clinics here in new york, which i gather is an rna pcr test, which came back negative. I was told that after this test there was no need for any further testing, as this would have caught any virus in my blood at the time due to it's sensitivity.
regardless, i also had another antibody test 10 weeks after the "incident" and that was also negative.
My questions are the following:
1. I have seen that many sites and experts recommend testing to 12 weeks, do you think this is required?
2. If i had had an infection from an earlier time, is it possible that i would have shown negative on both these tests? i have seen online that some ppl who have advanced into aids will have negative antibody tests. I recently had a routine physical and my doctor said all my bloodwork was normal. is this something i should worry about, being as i had both the virus and antibody tests and feel pretty healthy??  Is there anything you can recommend to rule this out?
12 Responses
300980 tn?1194933000
Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

I agree with the comments that you have received several weeks ago on the international HIV Forum.  You can be confident that you do not have HIV.  Both your 10 weeks antibody test and your PCR test combine to prove this and while theoretically one of the tests might be wrong, there really is just no way that both would be wrong.  You do not have HIV.  Now, straight to your questions.

1.  No, on this forum we do not subscribe to the 12 week recommendation for most clients and certainly not for you.  The 12 week test reflects old, conservative thinking based on older studies performed using older tests.  With the tests currently in use, virtually all persons who acquire HIV develop positive tests within 8 weeks.  I know of no expert who has seen a person develop positive antibody tests in more than 8 weeks unless that person was taking medications to try to prevent HIV (i.e. medications for HIV treatment).  The PCR test becomes positive well before the antibody test. thus, as AI said before the combination of the two tests serves to prove that you did not get HIV, if you had sex at the time you describe.
2.  No, your tests rule out more long standing infection.  Again, while a VERY small proportion of persons in the most advanced stages of AIDs who are sick and malnourished rarely have negative antibody tests, the PCR test would still be positive.  it sounds as though you are not severely ill or malnourished and, once again even if you were, the PCR test would be positive.

I hope these responses will help to subdue your concerns.  I urge you to believe the test results you have and not to worry.  You do not  have HIV from the possible exposure you describe, nor from prior encounters.  EWH
Avatar universal
Thank you Doctor Hook. I have been struggling to believe what my doctors tell my but i cant shake the anxiety for some reason. I guess i have to keep thinking positive and stay off the internet because it seems all the conflicting information out there does nothing but add fuel to the fire when i start thinking worst case nightmare scenarios.
Anyway, thank you for taking the time to answer my questions and all the good work you do on the site!
300980 tn?1194933000
Glad to help.  I urge you to work to stay off of the internet.  For the most part while there is much good information available, it is often presented in a way which is alarming and which does not provide full information about things.  Take care.  eWH
Avatar universal
Im sorry to be back so soon Doctor Hook, but i just wanted to shoot a quick question at you that has been bugging me a bit. The main reason i have not been able to let this go for the past couple of weeks is that i feel my apettite has been off since this whole saga of getting tested and waiting and researching started. My doctor thinks i have developed depression, but today, the monday before the 11th week mark which is friday, i have developed a pretty nasty sore throat with coughing and mucus and the whole nine yards. I know this is probably just a cold, but would you think this might be a reason for concern, could i be experiencing this now somehow due to a missed infection? I know you say that i should be sure of my test results, its just really bad timing, for my mental state to be feeling sick today. Any thoughts? i appreciate your time very much. Thanks.
300980 tn?1194933000
No change in my opinion.  Your doctor may be correct.  You are clearly worried about this.  EWH
Avatar universal
Hi Dr. Hook, I just wanted to give you a quick update, i went for my 11 week test (i guess two days shy of the mark) and it was negative. I know you already advised me to drop this, but you know, what can i say? hehe i want to be sure. I just have one more question for you, if you dont mind my asking on the same post, for the past 11 weeks or so i have felt like i have such a decreased appetite, but i eat, and i haven't lost any weight, i just dont really get hungry the same way as i did before all this. Is this by any chance a symptom of a possible infection, or do you think this might be something else entirely? its kinda like the one thing that continues to bug me and i cant tell if its physical or mental. I guess my question is, is not having an apetite something that could happen for almost 3 months from the infection or is this just part of my anxiety, in your medical opinion?
300980 tn?1194933000
No, your loss of appetite is not attributable to HIV.

furthermore, I can assure you that further testing will not change your result- you did not get HIV fro the exposure you describe.

it is time for you to move on.  This thread is now over-be confident that you do not have HIV.  EWH
Avatar universal
Hi Dr Hook,
I just wanted to update my thread and let you know i got my 12 week test on saturday and it was negative. I am so happy with this result. I have looked through your other posts, and it seems you and Dr. HHH seem to think that regardless or the risk, the 3 month/ 12 week test is close to 100% that i am not infected, Have i understood this correctly? I just want to know that i can be confident that this is all over with and start living again! Thank you for your time and your advice through all of this. You have been a great help to me.

Avatar universal
I know you said this thread was over, and i understand you reasoning, my anxiety was driving me to ask a million and one questions. I am ready to put this behind me, i just want to know if i understood correctly from your other posts. I just want to know im clear for my partners sake more than anything. I guess just let me know if i need to start a new thread, but it would be wonderful if you could just answer this one last question for me. Thanks Doc!
300980 tn?1194933000
No, this is not 100%. there are extraordinary situations in which persons may be needed to be followed for longer periods.  The most common of these is when someone has taken medication for HIV in an effort to keep from becoming infected.  For the vast majority of situations however, you are correct, a 12 week test is absolutely reliable.  This includes the situation you describe.  

This thread will now end and further anxiety-driven questions will be deleted without response.  You really need to move on.  EWH
Avatar universal
Hey Dr. Hook,
Non-anxiety driven question for you, i hope you might give me one final bit of advice, as i am ready to never return to this forum again.
Quick recap of my tests:
Week 3- Negative RNA PCR and Negative Oraquick hiv1/2 blood Rapid test
Week 6- Negative Oraquick hiv1/2 blood Rapid test
Week 8- Negative Oraquick hiv1/2 blood Rapid test
Week 10- Negative Oraquick hiv1/2 blood Rapid test
Week 11- Negative Oraquick hiv1/2 blood Rapid test
Week 12- Negative RNA PCR and Negative Oraquick hiv1/2 blood Rapid test
Week 13- Negative HIV 1-2-0 EIA Blood draw test
Week 14- Negative Oraquick hiv1/2 blood Rapid test

Negative RNA PCR and all those antibodies out to week 14, can i confidently move on? No more testing, correct?
300980 tn?1194933000
You do not have HIV.  This has been clear since your 8 week test. EWH
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