Are Negative HIV PCR And Fourth Generation ELISA Test Results Reliable?

Posted on Tue, 5 May 2015

Question: On Feb 7th I had unprotected sex with a female I know of unknown HIV status, but has claimed she gets tested and is clean. I went to my urologist and got a full panel testing done on March 11 (4 weeks and 5 days after exposure) that included a 3rd generation HIV test and everything came out negative.

I continued to be paranoid and got some additional testing done on March 28th (7 weeks or 49 days after possible exposure). Those test were HIV RNA, QL TMA and a HIV 1/2 Antibody/Antigen 4th generation test and both came back negative. I was told that the RNA test is considered conclusive after 28 days with an accuracy of 99% and the HIV 4th generation test is 97% to 99% accurate at 7 weeks and considered conclusive at 12 weeks. I was told that with both test taken at the same the 4th generation test confirms the RNA and that I am HIV negative. Can someone please confirm this? I am very paranoid and I feel like have something and don't know if it's just anxiety.

Answered by Dr. Sheetal Verma (28 minutes later)

Brief Answer:
99.99% chances of HIV negative

Detailed Answer:
Hi
Thanks for your query at HCM.
I understand your concern and situation.

There is no need for you to worry. The information which you have been given is completely true. HIV PCR to detect RNA and 4 th generation ELISA TEST are highly reliable. I suggest you can get tested at 12 weeks again by 4 th generation ELISA.
But according to international guidelines you will need to get tested at 3 -6 months for seroconversion to rule out any doubts. In your case as initial tests are negative so the possibility of HIV is highly unlikely. You must relax and remove the fear or anxiety from your mind. If you are unable then you can take the help from a psychiatrist.

Take care.
You can take a follow-up query.
If no clarifications then you can close the discussion and rate the answer.
Dr. Sheetal Verma

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Sheetal Verma (42 minutes later)

I dont know if it is the anxiety but about 5 days before took both test i lost my appetite and dropped weight that scared me. About 3 weeks before i had some yellow color coating on back of my tongue. I thought it was thrush or fungal but i went to my doctor and dentist and said it is not thrush or anything STD related. I also started having rashs on my legs on the calf muslces but would literally disappear maybe less than half sometime even 5 mins. Is that just all anxiety of thought that i could have had hiv? If the RNA test is conclusive at 28 days with 99% accuracy what are the odds it turn positive? I mean does it ever after a test like that?

Answered by Dr. Sheetal Verma (18 hours later)

Brief Answer:
See detailed answer.

Detailed Answer:
Hi
Welcome back.
I understand your problem.

It is possible that you could have contracted some infection which could also have such presentation. Yes HIV RNA test is highly reliable and window of error is too narrow. But if a patient has very low viral load it could be possible that in rare case it may come positive but I again say it is highly unlikely. I request you to be patient and not to be scared. As far as your tongue lesion is concerned it could be poor oral hygiene related but if you feel you can get tested for scrapping done for fungal microscopy examination and culture.
Take care.

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Sheetal Verma (24 minutes later)

Would it be possible to sneak by the RNA and HIV combo test atken at the same tim? It seems like from you tell that is really hard to do like almost hitting the lottery.e

Answered by Dr. Sheetal Verma (6 minutes later)

Brief Answer:
Be optimistic.

Detailed Answer:
Yes when 2 tests are used together the sensitivity of the test increases. It is 99.99% chance that you are negative. So be happy that you are not positive.

:):)

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Sheetal Verma (13 minutes later)

I think the issue i made a huge mistake and i really want to make sure that I don't put my partner at risk for any XXXXXXX issues. She wants to have kids really soon. Do i pose any serious danger to her? And if so how long should i wait?

Answered by Dr. Sheetal Verma (3 hours later)

Brief Answer:
See answer.

Detailed Answer:
Hi
I think it must be your decision to get married or not. As a doctor I have tried to guide you my best. I have explained that you practically have nil chances of HIV transmission. But just to follow international guidelines a person is required to get tested after window period. It is starting of a beautiful life don't waste precious moments. Trust in God. You pose no chance to her if protected intercourse. As for confirmation if 3 months test is negative then it is sure that the case is negative.
Take care.
God bless you both.

Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj