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Is HIV 4th Generation Test Done 4 Years Post Exposure Conclusive?

Posted on Fri, 21 Apr 2017

Question: Hello sir,i had a high risk exposure 3 years ago(nov 2013) and after 1.6 year(may 2015) after exposure got tested with TRIDOT(3 rd generation) and the result came back non reactive and again due to some doubt i got tested again twice in july 2016 and march 2017 and the test used was 4 rth generation ag/ab test and both the results came back non reactive.my question to you sir is how accurate are these tests and do i need any further testing or these test results suffice? Also does pollen allergies,pcos,hypothyroidism and its medications like metformin,synthroid,provera,clomid,OCPs and antihistamines-can they affect my test results ? can vaccinations like flu shots and hepatitis vaccinations alter my test results? i got tested for STDs(syphillis,herpes,chlamidea and gonnerhea) all the results came back non reactive.does this rule out any possibility of having hiv?

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer:
you are free from HIV infection. It is very much conclusive.

Detailed Answer:
Hi xxxxxx
Welcome to HCM.
Thanks for posting your query.
All the tests for HIV available in the market are highly reliable up to the extent of more than 97% including TRIDOT test. Whereas 4th generation Ag/Ab HIV DUO test is reliable up to 99% 12 weeks after the exposure. When you had multiple nonreactive results with different tests 12 weeks after the exposure (you had after 1.5 years, 2 and 3 years), they will be reliable up to 100% beyond any doubt. You had ruled out important STDs (not mentioned anything about Hepatitis B and C. Rule out these possibilities also). Presence of other conditions or taking some other medicine also never delay the window period of these tests beyond 6 months. All your nonreactive tests were done beyond 6 months. None of the condition or drug mentioned by you would have any influence on your tests. Vaccination can cause false positive,but not false negative results. So you can relax and forget that incident once for all.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (50 minutes later)

So sir do I need any further testing ? Can I forget that undortunate incident and move on with my life? Also sir tests for hep a, b n c are also done and the results were non reactive. Sir I was diagnosed with hypothyroidism 5 months ago(August 2016) and my last hiv test was in march 2017.that is why I am asking if I need any further testing or the tests I have done are conclusive? Also sir I heard a internal medicine doctor say that in a few cases hiv can have an incubation period of 5-10 years and if tests are done during that period the tests can't detect the ag/abs. How far is this true doctor?

Answered by Dr. Sankaranantham Murugan (7 hours later)

Brief Answer:
Your HIV reports are conclusive, no further test is necessary for HIV.

Detailed Answer:
Hi,
Welcome back.
I am happy that you are also nonreactive for Hepatitis A, B and C. You are absolutely free from HIV 1 and 2. You need no further testing for HIV. It is very much conclusive.
Incubation period is different from window period. Incubation period is the time between the entry organism and appearance of the symptoms, whereas window period is the time taken for the appearance of antibodies against that organism in the body.
Incubation period for HIV can be as long as 7-10 years or more, but window period never extends beyond 6 months. Any other information about HIV in this regard is false. So your test reports are final and conclusive.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (3 hours later)

Sir can you please be more clear on this part of the answer "Presence of other conditions or taking some other medicine also never delay the window period of these tests beyond 6 months. All your nonreactive tests were done beyond 6 months. None of the condition or drug mentioned by you would have any influence on your tests".so I should count the window period of 6 months from the time of exposure right? And irrespective of what other conditions I am diagnosed with after that 6 month window period would not have any influence on the test results I have got recently( march 2017)is that what you meant?.As I mentioned before I was diagnosed with hypothyroid recently(August/sept 2016)and I don't know from how long before I had it. Sorry for repeated questioning it's just that I am worried.So I don't require any pcr test further ?

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer:
Once again I ensure that you are free from HIV infection.

Detailed Answer:
Hi,
Welcome back.
I already assured you that you are free from HIV. Avoid unnecessary doubts about the same.
Normal immuno-competent individuals will become sero-positive (test positive) within 3 months duration from the time of exposure in the presence of an HIV infection. If that individual was on some immuno-suppressive drugs or ART drugs then there may be a chance for this sero-conversion could have delayed further and never after 6 months after the risky act. This is the meaning of contents.
Hypothyroid state, even if it persisted earlier, would not have any influence on the formation of antibodies againt HIV infection, if there is infection.
Relax and enjoy your day today activities forgetting that incident.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sankaranantham Murugan (5 hours later)

Sir I was on metformin,synthroid,clomiphene citrate and on oral contraceptives for a few months (2 months before ) when I gave blood for testing.Can any of the mentioned drugs influence the test results ? This is my final question sir I Will close by your response to this question. Thank you so much for being patient.

Answered by Dr. Sankaranantham Murugan (4 hours later)

Brief Answer:
Metformin, Synthroid,Clomiphen citrate have no influence on HIV reports.

Detailed Answer:
Hi,
Welcome back.
Not to worry. You are welcome to ask if you have more queries.
You had already mentioned about the drugs those you were already on. I mentioned already those drugs would have unlikely to have any impact on the results of your HIV tests. I endorse once again that your results are very much conclusive and you are free from HIV infection.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sankaranantham Murugan (43 hours later)

sir i have been on and off on oral contraceptive pills/birth control for the last 8 years and was taking provera(medroxyprogesterone acetate) and Dronis 30(Drospirenone and ethinylestradiol)tablets for polycystic ovarian syndrome at the time of testing.so i would like to know if pcos or the above mentioned drugs will affect/influence the hiv testing(4 rth generation ag/ab and TRIDOT(3 rd gen) and its results? can you please give a detailed answer that would ease my anxiety.

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer:
Either PCOD or the drugs would have no effect on your test reports.

Detailed Answer:
Hi,
Welcome back.
PCOD is not an immune suppressive condition and Hormonal drugs taken by you for the PCOD are also not having any impacts on the HIV tests or on formation of antibodies against HIV. Whatever may be the drugs (even immuno-suppressive) taken will not delay the appearance of HIV antibodies beyond 6 months in the presence of an infection.
So your test reports are conclusive. Not to have any doubts on the results.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (11 hours later)

Sir what about pollen allergy can this affect / influence the test and its results? Is pollen allergy a hypersensitivity reaction of the immune system or a hyposensitive reaction? Can pollen allergy produce false negative results? Why is that some people are allergic to pollen and the others not ?

Answered by Dr. Sankaranantham Murugan (4 hours later)

Brief Answer:
Your results are final.

Detailed Answer:
Hi,
Welcome back.
Pollen allergy is a hypersensitive reaction of the body to certain types of pollen.
Hypersensitive reaction (allergy) can develop to anything other than pollen also (food items, drugs, plants, sunlight, dust, insect sting or contact etc.) to anybody at anytime. Certain people's body will react over for certain antigens and not all.
Hypersensitive reaction of pollen would not have any effect on HIV antibody formation and also over the outcome of HIV tests and it would not lead to false negative results.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (3 hours later)

So any of the conditions and drugs I mentioned would not have any influence on the test or its results IRRESPECTIVE OF WHEN THE EXPOSURE WAS AND WHEN THE TESTS ARE DONE ? EVEN IF THESE CONDITIONS EXIST ON THE DAY OF TESTING THE RESULTS ARE STILL TO BE TRUSTED WITHOUT ANY FURTHER TESTING ? Sir I just want to be sure of everything so that I can start a family and be happy without any regrets. You probably can imagine how stressed I am so would you please ease my anxiety by answering this specific question in detail. Thank you.you have been really patient all along and I appreciate it sir.

Answered by Dr. Sankaranantham Murugan (4 hours later)

Brief Answer:
Your results are very much conclusive.

Detailed Answer:
Hi,
Welcome once again.
Yes, I can understand your concern.
Once again I affirm you that the conditions mentioned by you (pollen allergy, PCOD, Hypothyroidism) and the drugs you are on like Synthroid, Metformin, Clomid, Provira and antihistamins have no effect on the test outcome. Immaterial whether you had them at the time of testing or prior to testing, as well it is applicable also to the drugs you are on.
You can forget that incident and resume your normal family life without any hesitation.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (14 hours later)

Sir I forgot to mention DRONIS 30(Drospirenone and ethinylestradiol)tablets while writing up the profile can DRONIS 30 affect/influence the hiv test results if taken on the day of testing? Can alcohol, tea and coffee/ caffeine affect/influence the test results if taken on the day of testing? I might sound stupid but knowledge is the only way I can ease my anxiety and coming from an expert would help me a lot.thank you

Answered by Dr. Sankaranantham Murugan (42 minutes later)

Brief Answer:
You are free from HIV infection.

Detailed Answer:
Hi,
Welcome back.
Dronis 30 also would not interfere the HIV test outcome.
Alcohol, tea, Coffee all won't affect the results. Not to worry
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (10 hours later)

Sir I got some new doubts.. sir can ORGAMED AND FOLIC ACID AND VITAMIN D SUPPLEMENTS also known as PRENATALS IF TAKEN ON THE TEST DAY or BEFORE TESTDAY affect/influence the test and its results? And is medroxyprogesterone and medroxyprogesterone acetate the same or are they different ? If they are different what is the difference ? I was on and off on prenatals so just want to know if they can affect / influence the tests and it's results ?

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer:
No drug can delay HIV antibody test results beyond 6 months after exposure.

Detailed Answer:
Hi,
Welcome back.
Orgamed is a hormone tablet. It also has no much influence on HIV sero-conversion in the presence of an infection. If there is slight influence on the test report, it would be never beyond 6 months after the exposure. Foilc acid and Vitamin D are food supplements, they will help to boost immunity, rather fasten the immune process and antibody formation. There is nothing to delay the antibody formation or for a false negative results. Medroprogestron and Medroprogestron acetate are the same.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (3 hours later)

Sir "slight influence" is making me nervous now when I took the first test TRIDOT 3 Rd gen I was on ORGAMED and DRONIS 30 at the time of testing so may 2015 result not conclusive ? And when I took the second test July 2016 I was on again on MEPRATE AND DRONIS 30 at the time of testing as I have pcos from age 16 so is that result not conclusive ? I have taken MEPRATE ( medroxyprogesterone acetate) as a substitute to ORGAMED And when I took the 3 Rd test march 2017 I was on hepatitis a,b and c 2 nd dose of vaccination ,synthroid, provera, clomiphene citrate and metformin and prenatals... DOES THIS MEAN ALL MY TEST REPORTS ARE NOT CONCLUSIVE?? are my test reports conclusive? Do I need any further testing ?? IS PCR TEST REQUIRED FOR ME SIR ? DO I HAVE TO GET PCR TEST DONE FOR CONCLUSIVE REPORTS ???

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer:
You are HIV free. It is conclusive.

Detailed Answer:
Hi,
Welcome back.
I already told that no drug can delay the sero-conversion beyond 6 months. You had your test only after 1.5 years after the exposure. Then how comes that it would have affected your results.
Progesterons are sex steroids produced in the body which has a distant relation to corticosteroids which can delay the sero-conversion to an extent, but never after 6 months. Sex hormones are not having such effects.
In your case there is no question of false negative results and your results are very much conclusive.
DR S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (6 hours later)

So any hiv test after 6 month window period(maximum time limit under any circumstances) is considered conclusive irrespective of what drugs the patient is on and what medical conditions they have ? AFTER 6 MONTHS FROM THE TIME OF EXPOSURE ALL TESTS AND RESULTS ARE CONSIDERED CONCLUSIVE .. can I take this as the conclusion ?

Answered by Dr. Sankaranantham Murugan (7 hours later)

Brief Answer:
Your HIV reports are conclusive, no further test is necessary for HIV.

Detailed Answer:
Hi,
Welcome back.

Yes, absolutely. Now you had caught the point.
Your results are final.

No further test or discussion are necessary.

Regards
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Sankaranantham Murugan (25 hours later)

Sir you said " No drug can delay the sero-conversion beyond 6 months " Is this applicable even if the patient is on drugs like orgamed/provera/ meprate ( MEDROXYPROGESTERONE ACETATE) and DRONIS 30 drugs throughout that 6 month window period ? Should I count the 6 month window period from the day of exposure or should I count that 6 month window period AFTER THE LAST DAY OF TAKING PROGESTERONE DRUGS.Are the RESULTS CONCLUSIVE after 6 months from the time of exposure if the patient is on PROGESTERONE DRUGS THROUGHOUT THAT 6 month window period and ON AND OFF BEFORE THE WINDOW PERIOD ?? Kindly answer this in detail sir

Answered by Dr. Sankaranantham Murugan (39 minutes later)

Brief Answer:
Your results are conclusive only

Detailed Answer:
Hi,
Welcome back.
Window period is normally less than 12 weeks from the day of the risky contact. Only in rare cases who are on immunosuppressive drugs would likely to have the delayed or extended window period, that too, not beyond 6 months from the date of exposure, even if the individual on the drugs continuously for 6 months from the date of the exposure.
Dr S Murugan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar