HIV Subtypes

[researched80]

I have done lots of research on your site as well as others and I am sure that you will probably tell me that I do not need to worry.  However, given your expertise I am hoping to get a couple of questions answered that I am having a hard time getting answered via other avenues.  I had sex with a CSW of African decent in Europe about 13 years ago and I am 70% sure condom was used properly.  I have recently found out that my wife is pregnant and I took a HIV test just to be sure our first born could not possibly be infected.  My test history is as follows:
2006 - HIV 1 EIA negative
2009 - HIV 1 EIA negative
2013 - ICMA HIV 1/o/2 (Labcorp) & HIV-1 RNA Qual non-reactive, not detected

In the process of taking this test I have been doing some research on HIV and, consequently, filled with extreme anxiety over the demographic of the woman I had this exposure with in 2000.  According to the pamphlets on the FDA site my test covered HIV1 types A-H, O, N, and HIV -2. It seems as if none of the tests available in the US test for subtypes J, K, and P.  Since J and K are found only in Africa I realize that there would typically not be a need to test for these in the US, but since my exposure was with an African female I am worried that these tests would not pick up these or any other subtypes found predominantly in Africa.  I realize that since my exposure was protected (70% sure) properly with a condom you may tell me that it was no risk.  But please help to put my mind at ease and let me know that if there was a condom malfunction and I was infected by subtype J, K, or another mainly African subtype that these tests would have picked up my antibodies.  I realize that you may point out that I would probably be fairly sick at this point if I was infected in 2000. So really my question is would the antibody tests I took pick up HIV1 subtypes that are not A-H, particularly J and K?  Can I rest assured that I was not infected by some rare strain back in 2000?

[Edward W Hook, MD]

Yes, these labs woul dhave detected infection if present.  Please believe your test results.  I will accept this as your last question.  There will be no more follow-ups.  EWH

[researched80]

Ok.  Thanks Sir.  Last post.  Is it safe to assume that Quest and Labcorp would have made this determination?  But regardless, you are saying that there is really no way that this exposure would not have turned up on one of these test, correct?  

[Edward W Hook, MD]

This is more of a matter for the lab to determine than you to worry about.  The most common indeterminant is a reactive test such as a ELISA or other test followed by an indetreminant Western Blot.  EWH

[researched80]

Thank you for your response Doctor.  I have a follow up question to your response... What would an equivocal result entail?  Would it read reactive and then have an indeterminate Western Blot?  Or would it be close to the cut-off of 1.00?  If it is in fact the ladder, would the lab definitely have brought it to my doctors attention?  I ask this more out of general knowledge than worry, but I was looking for a little more detail to your response.  Thanks.

[Edward W Hook, MD]

Welcome to our Forum.  You are worrying needlessly.  Please realize that the FDA uses criteria for backing up their statements that allow then to believe that there statements are absolutely correct.   The fact is that the testing you have had would have detected, or at least provided equivocal test results which would have lead to further testing and diagnosis of HIV if you were infected.  That your tests were negative is conclusive and you should believe you test results.  Further as You point out, had you been infected with HIV 13 years ago, you would have become quite sick due to advanced infection by now.

It is time for you to believe you test results, to not worry further about this exposure 13 years ago, and look forward to fatherhood.  There is no reason for concern and certainly no reason for further testing . EWH