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Test Results

You may remember that I had two potential exposures with escorts in Latin America in the month of July (one oral, one vaginal b/c of broken condom for about a minute).  I just got the antibody test results from LabCorp taken 20 days from 2nd exposure and it was negative.  I am awaiting the reults of a PCR test that arrive on Thursday.  My questions are:

1) how reliable is an antibody test after 20 days?  The lab mentioned that it was not reliable at all and that no data was available to support any kind of estimate.

2) Is it safe to assume that whatever "symptoms" I may have had over the last two weeks were not related to HIV as antibodies would have shown up with or shortly after the symptoms?  (If so, how long after symtoms?)

3) How reliable is a PCR test after 20 days?

4) I have developed a very light almost under the skin looking "rash" on my back.  Is this something that would be consistent with HIV acute symptom rash or does that rash typically differ.

Thanks again for your responses.  Your forum is invaluable to those of us dealing with anxiety.
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Avatar universal
On this thread you posted the following:

"I did a little searching and also got in touch with some colleagues doing research on speed of seroconversion, i.e. development of postive HIV antibody test in people with ARS. The test doesn't become positive as soon as I thought. Few have positive tests before 10 days; at 11-14 days it's about 40%, but by 17 days it's almost 100%. In other words, slow trend through 2 weeks, then almost everybody gets a positive test over the next 3 days.

HHH, MD"

Was this timeline based on the ARS, or the date of the HIV exposure?

Thank you for clarification.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
A negative PCR at 20 days is definitive.

HHH, MD
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Avatar universal
Good info to know.  Seen nothing on the net on that point.  By the way, PCR test came back negative (as you expected).  Do you think a negative PCR at 20 days is dispositive (or darn close?), or should I get another test at some juncture? I am told that at 11 days it is already 90% accurate since it searches for the virus not the antibodies.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
I correctly remembered your username but not the timing or the specifics of our earlier exchange.  As you suggest, the similar questions do blend together!  Since you started a new thread, I assumed it was farther back in time.  I didn't mean to appear insensitive to your concerns.  Apologies.

The symptoms of acute retroviral syndrome (ARS) associated with primary HIV infection are due primarily to the immune system's response to the virus.  Therefore, most people who present with ARS already have positive antibody tests.  But beyond "most" I can't give a percentage or the exact timing; I just don't know.  But the large majority of people with ARS undoubtedly have positive antibody tests within a few days of onset, probably usually within a week.  I'll look at the data or ask an HIV specialist colleague and will come back with a clarification if my estimates are wrong.

HHH, MD
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Avatar universal
Doc, I think you have me mixed up with somone else that had a similar name.  I only corresponded with you this past weekend and my greatest concern is that after the condom broke I was inside a professioinal for an appreciable amt of time.  I realize the stats you quote but that is certainly not a good position to be in and in my mind it is a significant exposure (especially considering that prior to July I had never done it before).  I appreciate your responses and patience with those of us that did something stupid or unfortunate and have anxiety.  I know it must be mundane and repettetive to you.  

As for the question, I just wanted to know how soon after "ARS symptoms" would antibodies be produced?  Would they definitley be produced by the body by 1 week after symtom onset?  2wks?
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Avatar universal
I did a little searching and also got in touch with some colleagues doing research on speed of seroconversion, i.e. development of postive HIV antibody test in people with ARS.  The test doesn't become positive as soon as I thought.  Few have positive tests before 10 days; at 11-14 days it's about 40%, but by 17 days it's almost 100%.  In other words, slow trend through 2 weeks, then almost everybody gets a positive test over the next 3 days.

HHH, MD
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Avatar universal
Some of the archives here say that at 20 days the hiv-eia test is about 60-80% reliable and at 6 weeks it approaches 100%. I have read that PCR's are extremely sensitive, but have a much higher false positive rate.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
See MANY other threads on this; search "HIV anxiety", "HIV diagnosis", and "time to positive HIV test".  Also, I thought I answered pretty much the same tests a couple of weeks ago.  Your risk of HIV was extremely low from the exposures you describe.  You wasted your money--probably a lot of it--on the PCR test, which was not necessary.

1) Most people who catch HIV, probably around 80-90%, will have a positive antibody test by 20 days.

2) It is safe to assume you don't have HIV, and therefore that any symptoms you have had were due to something else.

3) PCR is reliable at 20 days, but I can't give you a percentage figure.

4) A rash you have to put in quotes--meaning you're not even sure it's abnormal--doesn't suggest HIV.  But of course I can't tell from your description.  Did you show it to the provider who did your tests?  If not and you're concerned, see a healthcare provider about it.

Sorry if the opening sounds impatient--but you are overreacting.  Because the official recommendation remains 3 months as the time to a positive HIV test, you should be restested to help deal with your anxiety.  But until then you can be confident you don't have HIV.

Regards--  HHH, MD
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