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Are Negative HIV Tests After 60 Days Of Possible Exposure Conclusive?
Question: Hi ,
Had protected vaginal sex with a woman of unknown status. However i was under the influence of alcohol and i slept with the condom inside my underwear. Next morning I found the condom and it was intact(checked twice). Then irrational fears gripped me and I started worrying about the possible exposure of my uthera to the fluids on the condom and the inner side of underwear (when it popped out). I questioned the woman but she seems to be unaware of her status (she had multiple one-night stand partners in the past). Later I couldn't reach out to her , seems she left the city. This grew my concern.
Now after researching insanely on internet , I came to the conclusion that world wide most HIV specialist were talking about 4th Generation test (p24 + antibody ) test . Most are of the opinion that this test is conclusive after 4 weeks. Most countries like australia ,canada and france have accepted 6 weeks test norm.
Thus below are the test that I have conducted.
- 9 days – Ag/ab Combo CMIA
- 16 day- Serology (hiv1/Hiv2)
- 18th day - Ag/ab Combo CMIA
- 25th Day- Ag/ab Combo CMIA
- 29th Day- Ag/ab Combo CMIA
- 32nd Day- Ag/ab Combo CMIA
- 40th Day - Ag/ab Combo CMIA
- 42nd Day- HIV-2 RNA PCR ( Just for precaution measure)
- 60th Day- Serology Antibody Test (HIv1 /HIv2)
All of the above test have been NEGATIVE.
Still I would like to have your personal opinion.
q.1) Is it possible for Ag/ab Combo CMIA test to yield false negatives. Even though when the test's covers the entire window period of antigen detectable part ( as per CDC 1-7 weeks)
q.2 ) Do I still need to repeat test at 3 months mark even though most specialist are stating that CDC's guidelines are conservative and pertains to the data which are not relevant as per the newer generation test.
q.3) have you ever seen a 6 week negative( on duo test) or 8 week negative on antibody test turn positive later.
Thanks
Had protected vaginal sex with a woman of unknown status. However i was under the influence of alcohol and i slept with the condom inside my underwear. Next morning I found the condom and it was intact(checked twice). Then irrational fears gripped me and I started worrying about the possible exposure of my uthera to the fluids on the condom and the inner side of underwear (when it popped out). I questioned the woman but she seems to be unaware of her status (she had multiple one-night stand partners in the past). Later I couldn't reach out to her , seems she left the city. This grew my concern.
Now after researching insanely on internet , I came to the conclusion that world wide most HIV specialist were talking about 4th Generation test (p24 + antibody ) test . Most are of the opinion that this test is conclusive after 4 weeks. Most countries like australia ,canada and france have accepted 6 weeks test norm.
Thus below are the test that I have conducted.
- 9 days – Ag/ab Combo CMIA
- 16 day- Serology (hiv1/Hiv2)
- 18th day - Ag/ab Combo CMIA
- 25th Day- Ag/ab Combo CMIA
- 29th Day- Ag/ab Combo CMIA
- 32nd Day- Ag/ab Combo CMIA
- 40th Day - Ag/ab Combo CMIA
- 42nd Day- HIV-2 RNA PCR ( Just for precaution measure)
- 60th Day- Serology Antibody Test (HIv1 /HIv2)
All of the above test have been NEGATIVE.
Still I would like to have your personal opinion.
q.1) Is it possible for Ag/ab Combo CMIA test to yield false negatives. Even though when the test's covers the entire window period of antigen detectable part ( as per CDC 1-7 weeks)
q.2 ) Do I still need to repeat test at 3 months mark even though most specialist are stating that CDC's guidelines are conservative and pertains to the data which are not relevant as per the newer generation test.
q.3) have you ever seen a 6 week negative( on duo test) or 8 week negative on antibody test turn positive later.
Thanks
Brief Answer:
No need to go for further testing.
Detailed Answer:
Hello thanks for asking from HCM for your health related doubts
I have gone through the query and I can understand your problems. Its common to develop fear and anticipatory anxiety after unknown sexual encounters. You had protected sexual intercourse and the condom was intact next morning so the risk of transmission is very less. Still as the condom was there theoretically there is some risk especially if you had any broken skin in groin areas. But that risk can be assumed only if we assume that female was carrying the infection. So benefit of doubts goes towards negative side. Coming to your questions directly-
1) The combined CMIA antigen/antibody test has accuracy to detect an infection close to or more than 99%. These results has been reproduced by various different studies. In most cases 6 weeks time is taken as standard time, though it may vary. So no need to worry at all.
2) No need to go for repeat tests any more. You have been to multiples of tests and most of these tests have sensitivity close to 99% so there is no risk of any infection in your case.
3) No the possibility of such assumption is very rare. In my practice I haven't seen any such incident in which an individual who tested negative for so much test becoming positive in future testing at 8 weeks time.
So just remain relaxed. Don't search for symptoms and don't anticipate anything. No need to go for further testing in my opinion.
Thanks, I hope this will help you. Please feel free to ask further doubts.
No need to go for further testing.
Detailed Answer:
Hello thanks for asking from HCM for your health related doubts
I have gone through the query and I can understand your problems. Its common to develop fear and anticipatory anxiety after unknown sexual encounters. You had protected sexual intercourse and the condom was intact next morning so the risk of transmission is very less. Still as the condom was there theoretically there is some risk especially if you had any broken skin in groin areas. But that risk can be assumed only if we assume that female was carrying the infection. So benefit of doubts goes towards negative side. Coming to your questions directly-
1) The combined CMIA antigen/antibody test has accuracy to detect an infection close to or more than 99%. These results has been reproduced by various different studies. In most cases 6 weeks time is taken as standard time, though it may vary. So no need to worry at all.
2) No need to go for repeat tests any more. You have been to multiples of tests and most of these tests have sensitivity close to 99% so there is no risk of any infection in your case.
3) No the possibility of such assumption is very rare. In my practice I haven't seen any such incident in which an individual who tested negative for so much test becoming positive in future testing at 8 weeks time.
So just remain relaxed. Don't search for symptoms and don't anticipate anything. No need to go for further testing in my opinion.
Thanks, I hope this will help you. Please feel free to ask further doubts.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks for the response dear Doctor,
our assurance has calmed me . However I would like to ask you a few more questions...
q.4 ) I never seroconverted/ had any ARS in the past 10 weeks . But still I am very very worried. The last Serology Antibody test which I took looks for : HEP B/C , VDRL , Syphillis and HIV-1/2 . Except for the HIV segment ,the test report showed ELISA Kit is being used. For HIV segment it was written done by Immuno Concentration Test . When I enquired they told me they have blood testing kit.
What I know is except 1st generation test all the other generations of tests look for both the antibodies. So either Immuno Concentration test was a 2nd generation test or 3rd Generation Test. So what is this Immuno Concentration Test. Is it reliable too ?
q.5) All the eminent professionals of your field ( Dr H.H.Hansfield, Dr EWHook, Dr XXXXXXX Cummings , Dr XXXXXXX , dr XXXXXXX Garcia , dr XXXXXXX dr S XXXXXXX etc) were of the opinion that :: Any Combo test done after 4 + weeks = 'IT is impossible to have HIV. Either the antigen or antibody or sometimes both will show positive' . However if only the patient is displaying severe seroconversion symptoms along with a previous negative duo after 4 weeks, test can be repeated after 7-10 days. Is this the extremely rare case you are talking about (FYI I never any symptoms , though research led me to a fact that only 80 % have symptoms ). So can You be ABSOLUTELY sure that I can never ever .. ever..ever.. catch it because of this Episode. (It has been 2 more weeks( 10th week) , I am still not able to concentrate on Real life) thus I would like your assurance that my test are final and conclusive ?
q.6) Why Do all doctors say there is a a rare chance of missing diagnosis ? Say taking into consideration my situation wouldn't it be unbelievably impossible for medical science to explain this.
a) Virus was never found not in it's intial detectable stage(CDC : 4-7 days), peak time ( 16th Day-18th Day ), generalised last stage before being undetetable for some time (4th- 6th Week ) : The only explanation would be virus was replicating slowly (which should not be the case because the virus would die- dr HOOK).
So that's why I took a HIV 2 RNA PCR Test (after 6 weeks) as I heard that this virus replicates very slowly( viral load is 28 folds lower than hiV-1) and also followed up with an serology antibody test after 2 weeks ( as recomended by CDC: PCR test followed by an antibody test ).
b) Late seroconverters are generally those who are/have either terminal illness or regular IV drug user or On chemotherapy or have used PEP or already have HIV. I am none of the above how can a normal body not produce antibodies ? And If Antibodies are the problem the Viral load should be exceptionally high correct.
I have done everything to remove any doubt that the testing 'procedure' I conducted was full proof. That By no means , I should live my life without updating my status.
Hence dear Doctor , Please let me know any loophole that You have seen in my testing procedure. Please let me know If I can completely , in full faith of God and You ( and all those Doctors) can conclusively rule out the infection, forget about the incident and move on in My Life ?
Thanks
Worried Soul
our assurance has calmed me . However I would like to ask you a few more questions...
q.4 ) I never seroconverted/ had any ARS in the past 10 weeks . But still I am very very worried. The last Serology Antibody test which I took looks for : HEP B/C , VDRL , Syphillis and HIV-1/2 . Except for the HIV segment ,the test report showed ELISA Kit is being used. For HIV segment it was written done by Immuno Concentration Test . When I enquired they told me they have blood testing kit.
What I know is except 1st generation test all the other generations of tests look for both the antibodies. So either Immuno Concentration test was a 2nd generation test or 3rd Generation Test. So what is this Immuno Concentration Test. Is it reliable too ?
q.5) All the eminent professionals of your field ( Dr H.H.Hansfield, Dr EWHook, Dr XXXXXXX Cummings , Dr XXXXXXX , dr XXXXXXX Garcia , dr XXXXXXX dr S XXXXXXX etc) were of the opinion that :: Any Combo test done after 4 + weeks = 'IT is impossible to have HIV. Either the antigen or antibody or sometimes both will show positive' . However if only the patient is displaying severe seroconversion symptoms along with a previous negative duo after 4 weeks, test can be repeated after 7-10 days. Is this the extremely rare case you are talking about (FYI I never any symptoms , though research led me to a fact that only 80 % have symptoms ). So can You be ABSOLUTELY sure that I can never ever .. ever..ever.. catch it because of this Episode. (It has been 2 more weeks( 10th week) , I am still not able to concentrate on Real life) thus I would like your assurance that my test are final and conclusive ?
q.6) Why Do all doctors say there is a a rare chance of missing diagnosis ? Say taking into consideration my situation wouldn't it be unbelievably impossible for medical science to explain this.
a) Virus was never found not in it's intial detectable stage(CDC : 4-7 days), peak time ( 16th Day-18th Day ), generalised last stage before being undetetable for some time (4th- 6th Week ) : The only explanation would be virus was replicating slowly (which should not be the case because the virus would die- dr HOOK).
So that's why I took a HIV 2 RNA PCR Test (after 6 weeks) as I heard that this virus replicates very slowly( viral load is 28 folds lower than hiV-1) and also followed up with an serology antibody test after 2 weeks ( as recomended by CDC: PCR test followed by an antibody test ).
b) Late seroconverters are generally those who are/have either terminal illness or regular IV drug user or On chemotherapy or have used PEP or already have HIV. I am none of the above how can a normal body not produce antibodies ? And If Antibodies are the problem the Viral load should be exceptionally high correct.
I have done everything to remove any doubt that the testing 'procedure' I conducted was full proof. That By no means , I should live my life without updating my status.
Hence dear Doctor , Please let me know any loophole that You have seen in my testing procedure. Please let me know If I can completely , in full faith of God and You ( and all those Doctors) can conclusively rule out the infection, forget about the incident and move on in My Life ?
Thanks
Worried Soul
Brief Answer:
You are safe and no risk of HIV in your case.
Detailed Answer:
Hello again and thanks for asking a follow up
- Seroconversion test is a rapid test for HIV. It detects anti bodies of both HIV 1 and HIV 2. Most of studies have shown its sensitivity and specificity close to 100%. So the test is reliable.
- As you have been to multiple tests at multiple times and never tested positive so in my opinion you are absolutely safe with regard to that particular episode. No need to worry at all.
- Any person is at risk of HIV. Nothing is absolute so this is the reason they cite there is rare chance of missing the diagnosis but in reality this is not true. You are absolutely safe. Try to divert your attention away from all these things.
- There is nothing like that the virus is replicating slowly. In reality virus is not there. Remain relaxed. PCR is a definitive test and this was also negative.
- You will not produce antibodies because you are not infected. How can you produce antibodies without infection.
So just remain relaxed. You have been to multiples tests already and every thing was negative. All these tests are confirmatory. So no need to remain tensed. You are negative and safe.
Thanks.
You are safe and no risk of HIV in your case.
Detailed Answer:
Hello again and thanks for asking a follow up
- Seroconversion test is a rapid test for HIV. It detects anti bodies of both HIV 1 and HIV 2. Most of studies have shown its sensitivity and specificity close to 100%. So the test is reliable.
- As you have been to multiple tests at multiple times and never tested positive so in my opinion you are absolutely safe with regard to that particular episode. No need to worry at all.
- Any person is at risk of HIV. Nothing is absolute so this is the reason they cite there is rare chance of missing the diagnosis but in reality this is not true. You are absolutely safe. Try to divert your attention away from all these things.
- There is nothing like that the virus is replicating slowly. In reality virus is not there. Remain relaxed. PCR is a definitive test and this was also negative.
- You will not produce antibodies because you are not infected. How can you produce antibodies without infection.
So just remain relaxed. You have been to multiples tests already and every thing was negative. All these tests are confirmatory. So no need to remain tensed. You are negative and safe.
Thanks.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks A lot Doctor Bishnoi,
Your repeated assurance had a very calming affect on me. However I would like to ask you one final question before I go ahead and close this threads.
How should I deal with This post traumatic experience. MY hands are shaking inconsistently , In the morning I get panic attacks with heart palpitation going up, Body starts shaking and gives weird body movements whenever I am in horizontal sleeping position (this happens generally when I am sleeping). All of these because of thinking about this disease for 24 X7 ? Plus I don't feel like eating , only thing I do is take stress. And yes I smoke a lot and drink at least 10-15 cups of tea daily. Lost a bit of weight .
Again Thanks a lot for any help that you can render.
Your repeated assurance had a very calming affect on me. However I would like to ask you one final question before I go ahead and close this threads.
How should I deal with This post traumatic experience. MY hands are shaking inconsistently , In the morning I get panic attacks with heart palpitation going up, Body starts shaking and gives weird body movements whenever I am in horizontal sleeping position (this happens generally when I am sleeping). All of these because of thinking about this disease for 24 X7 ? Plus I don't feel like eating , only thing I do is take stress. And yes I smoke a lot and drink at least 10-15 cups of tea daily. Lost a bit of weight .
Again Thanks a lot for any help that you can render.
Brief Answer:
These are symptoms of anxiety only
Detailed Answer:
Hello again
Persistent anticipation regarding the illness has resulted in symptoms of panic and this is causing palpitations, shakiness of body, weird body movements etc. Best treatment for these symptoms is to distract your self. Try not to think about getting HIV and reassure yourself repeatedly. This will help you to remain relaxed. Smoking and drinking excessive tea are trigger for panic. Try to avoid excessive use till you become relaxed. So just reassure yourself again and again. You are totally safe. You will not have HIV.
Thanks, Hope this helps. Take care
These are symptoms of anxiety only
Detailed Answer:
Hello again
Persistent anticipation regarding the illness has resulted in symptoms of panic and this is causing palpitations, shakiness of body, weird body movements etc. Best treatment for these symptoms is to distract your self. Try not to think about getting HIV and reassure yourself repeatedly. This will help you to remain relaxed. Smoking and drinking excessive tea are trigger for panic. Try to avoid excessive use till you become relaxed. So just reassure yourself again and again. You are totally safe. You will not have HIV.
Thanks, Hope this helps. Take care
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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