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Is HIV RNA Qualitative Test Done 21 Days After Exposure Conclusive?
Posted on
Sun, 20 Dec 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sun, 20 Dec 2015
Answered on
Tue, 12 Jan 2016
Last reviewed on
Question : Hi,
I had unprotected oral sex with a transsexual. Both received and gave. There was no direct ejaculation in mouth. However i remember that after she ejaculated i rubbed it on her penis and performed. After 2 weeks i got mild symptoms. I did a complete panel testing and got a rna qualitative test (aptima rna gen probe) and 4th generation anti gen and anti body test at 21 days all came out negative. Howver from 30th day i have full blow rash on my chest. I went to public health department and did another 4th gen test and waiting for results.
My biggest worry is that the test that i took at 3 week i.e 21 days post exposure will yeild false negative and the test i took after 30 days will turn positive.
I am very very worried.
My question is that hiv rna qualitative and 4th gen combined is conclusive after 21 days? In what situation can both the test yeild a false negative result.
I had unprotected oral sex with a transsexual. Both received and gave. There was no direct ejaculation in mouth. However i remember that after she ejaculated i rubbed it on her penis and performed. After 2 weeks i got mild symptoms. I did a complete panel testing and got a rna qualitative test (aptima rna gen probe) and 4th generation anti gen and anti body test at 21 days all came out negative. Howver from 30th day i have full blow rash on my chest. I went to public health department and did another 4th gen test and waiting for results.
My biggest worry is that the test that i took at 3 week i.e 21 days post exposure will yeild false negative and the test i took after 30 days will turn positive.
I am very very worried.
My question is that hiv rna qualitative and 4th gen combined is conclusive after 21 days? In what situation can both the test yeild a false negative result.
Brief Answer:
The expected result of test on 30 days will rule out HIV 1 infection.
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
Oral sex carries a low risk for HIV.
Although RNA Qualitative PCR and the antigen part of 4th generation tests can detect the presnce of HIV 1 infection as early as a week duration after the infection, it will be more conclusive by 3-4 weeks.
Moreover your RNA PCR and the antigen part of 4th generation tests can detect HIV 1 infection only (common > 90%)and not HIV 2 (rare < than 1%) infection unless it is specified. Antibody part of 4th generation test can detect HIV 2 antibodies, but only after the window period (could be extended upto 12 weeks).
Rashes could be due to various other causes also including allergy to exantheme etc.
Your present test result after 30 days will rule out HIV 1 infection beyond any doubt.
Dr S.Murugan
The expected result of test on 30 days will rule out HIV 1 infection.
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
Oral sex carries a low risk for HIV.
Although RNA Qualitative PCR and the antigen part of 4th generation tests can detect the presnce of HIV 1 infection as early as a week duration after the infection, it will be more conclusive by 3-4 weeks.
Moreover your RNA PCR and the antigen part of 4th generation tests can detect HIV 1 infection only (common > 90%)and not HIV 2 (rare < than 1%) infection unless it is specified. Antibody part of 4th generation test can detect HIV 2 antibodies, but only after the window period (could be extended upto 12 weeks).
Rashes could be due to various other causes also including allergy to exantheme etc.
Your present test result after 30 days will rule out HIV 1 infection beyond any doubt.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Folliculitis or acne are the possibility and not specific to HIV.
Detailed Answer:
Hi,
Welcome back to HCM.
I saw the pictures sent by you. There are no specific rashes to say it indicates HIV. Exantheme, allergy, exagerrated seborrheic, psoriasis, folliculitis , pruritic papules, fungal etc. and many more can occur with HIV. All these above mentioned rashes can occur in the absence of HIV also.
Your rashes seem to be either a folliculitis or drug induced acne. Are you on any other drugs?
Consult a Dermatologist who will have a close examination and investigations if necessary and he could be able to tell more about the rashes. Biopsy could be the final.
Dr S.Murugan
Folliculitis or acne are the possibility and not specific to HIV.
Detailed Answer:
Hi,
Welcome back to HCM.
I saw the pictures sent by you. There are no specific rashes to say it indicates HIV. Exantheme, allergy, exagerrated seborrheic, psoriasis, folliculitis , pruritic papules, fungal etc. and many more can occur with HIV. All these above mentioned rashes can occur in the absence of HIV also.
Your rashes seem to be either a folliculitis or drug induced acne. Are you on any other drugs?
Consult a Dermatologist who will have a close examination and investigations if necessary and he could be able to tell more about the rashes. Biopsy could be the final.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
After my test on 21st day i went to an urgent care clinic. They precribed me following medecines
Clindamycin - regimen incomplete
Hydroxyzine - regimen in complete
Methylprednisolone - regimen complete
Cobetasol - oinment now stopped after aggrivated rash
During these tablet regimen i see these rashes which came out in a aggrivated way.
I went to urgent care doctor there refered me to dermatologist. However i did not yet got an appointmemt as they are not taking new patients.
My sore throat issue was resolved.
After taking these medicine but during this time rashes came out. I was put on anti amxiety medication paroxetine. Currently i am only taking paroxetine at night before bed.
This ia the complete medicine i was/am on right now. Kindly advise.
Clindamycin - regimen incomplete
Hydroxyzine - regimen in complete
Methylprednisolone - regimen complete
Cobetasol - oinment now stopped after aggrivated rash
During these tablet regimen i see these rashes which came out in a aggrivated way.
I went to urgent care doctor there refered me to dermatologist. However i did not yet got an appointmemt as they are not taking new patients.
My sore throat issue was resolved.
After taking these medicine but during this time rashes came out. I was put on anti amxiety medication paroxetine. Currently i am only taking paroxetine at night before bed.
This ia the complete medicine i was/am on right now. Kindly advise.
Brief Answer:
Clobetasol and Methyl prednisolone will induce such lesions.
Detailed Answer:
Hi,
Welcome back.
Application of Clobetasole propynate cream without any appropriate indication and tablets Methyl Prednisolone both can induce such eruptions. It would get settled after sometime. A Dermatologist will treat with appropriate treatment.
Dr S.Murugan
Clobetasol and Methyl prednisolone will induce such lesions.
Detailed Answer:
Hi,
Welcome back.
Application of Clobetasole propynate cream without any appropriate indication and tablets Methyl Prednisolone both can induce such eruptions. It would get settled after sometime. A Dermatologist will treat with appropriate treatment.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor, i have got white spots on my left tonsil, does it indicate viral infection?
Brief Answer:
White spots over tonsil is not specific to HIV.
Detailed Answer:
Hi,
Welcome back.
White spots over tonsil are also common problem with tonsillitis. Tonsillitis can affect anybody without HIV.
Not to worry.
Dr S.Murugan
White spots over tonsil is not specific to HIV.
Detailed Answer:
Hi,
Welcome back.
White spots over tonsil are also common problem with tonsillitis. Tonsillitis can affect anybody without HIV.
Not to worry.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor.
One last question, i took rna and 4th gen test 3 weeks after exposure all result were negative. I was not on medication then. After i took the test i went to a doctor when they prescribed methylprednisone, cyndamicine, etc medecine after completing 6 days of methylprednisone and at the start of 4 th week i took another 4th gen test.
I realised that methylpredisone is a steroid and steroid and immune supprants so will the 6 day course of medecine and 4th gen hiv test after 2 days of course completion affect the outcome of the 4week results?
One last question, i took rna and 4th gen test 3 weeks after exposure all result were negative. I was not on medication then. After i took the test i went to a doctor when they prescribed methylprednisone, cyndamicine, etc medecine after completing 6 days of methylprednisone and at the start of 4 th week i took another 4th gen test.
I realised that methylpredisone is a steroid and steroid and immune supprants so will the 6 day course of medecine and 4th gen hiv test after 2 days of course completion affect the outcome of the 4week results?
Brief Answer:
Sreroids would not affect the antigen detection of the 4th generation test.
Detailed Answer:
Hi,
Welcome back.
Methyl prednisolone in a short course would not have much influence over the test results. Moreover the immuno-suppressive drugs like Steroids have effects only on antibody formation and not on the detection of the antigens. At 4 weeks duration, we are aiming to look for the antigen and not the antibodies as they would form only after 6-8 weeks (window period). So your 4th generation test result after 4 weeks would be highly reliable as far as HIV 1 infection is concened.
Dr S.Murugan
Sreroids would not affect the antigen detection of the 4th generation test.
Detailed Answer:
Hi,
Welcome back.
Methyl prednisolone in a short course would not have much influence over the test results. Moreover the immuno-suppressive drugs like Steroids have effects only on antibody formation and not on the detection of the antigens. At 4 weeks duration, we are aiming to look for the antigen and not the antibodies as they would form only after 6-8 weeks (window period). So your 4th generation test result after 4 weeks would be highly reliable as far as HIV 1 infection is concened.
Dr S.Murugan
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Above answer was peer-reviewed by :
Dr. Raju A.T
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