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Is An RNA 4th Generation Test Done At 55 Days Post Exposure Conclusive?

Posted on Tue, 30 Dec 2014

Question: I had unprotected vaginal sex with an unknown woman on Sept 16. I had an RNA test done at 24 days with a negative result. 3rd generation test done at 6 weeks with a negative result. 4th Gen/RNA test done at 8 weeks which was also negative. Do you consider these results conclusive?

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer:
HIV 1 free.Repeat antibody test by 12 weeks to rule out HIV 2

Detailed Answer:
Hi,
Welcome to HCM.

You are HIV free to the extent of 99%. That is your RNA test done on 24 th day and 4th Generation test ruled out the possibility of HIV 1 infection beyond any doubt. This is conclusive whereas most of the RNA test and 4th generation tests are able to detect only the HIV 1 antigen and not HIV 2. These test become confirmatory by 4 weeks, so your test ruled out HIV 1.
HIV 2 is very rare except in XXXXXXX Elsewhere its prevalence is less than 1%. Your third generation antibody test and 4th generation (combo) tests are able detect HIV 2 antibodies. But you had not crossed the window period totally. There is a possibility of sero-conversion (antibody formation) gets delayed up to 12 weeks. So it is better that you repeat the 4th generation test or any other rapid test after 12 weeks to be more sure that you are free from both HIV 1 and 2.
Dr S.Murugan

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

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

So, in your opinion, the RNA/4Th generation test that I had 55 days post exposure should be completely conclusive as negative for HIV1?

My 3rd generation test just came back as negative. I took the test at 83 days which is 11.86 weeks. 1 more day would have been 84 days or 12 weeks. Does the 1 day make a difference or should I consider myself HIV Negative?

Answered by Dr. Sankaranantham Murugan (1 hour later)

Brief Answer:
It is conclusive that you free from HIV 1 and 2.

Detailed Answer:
Hi,
Welcome back. You are absolutely free from HIV 1 infection.

In medicine there is no line of definite demarcation. Anyhow one day does not make much difference.Your result of 3rd generation test at 83 days not makes any difference from the result at 84 days. So you can take this result as very much conclusive and the negative test ruled out the possibility of HIV 2 also.
Relax and enjoy the days ahead.
Dr S.Murugan

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

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

The test I had on day 83 just shows to be Antibody hiv1/2 test. I am not sure of the generation. Is this still a conclusive result?

Answered by Dr. Sankaranantham Murugan (4 hours later)

Brief Answer:
All HIV tests are highly sensitive and specific

Detailed Answer:
Hi,
Welcome once again.

All test available in the market are very well sensitive and specific.You need not have any more suspicion about your HIV status.You are free from both HIV 1 and 2.
Dr S.Murugan

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

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

If i had a steroid shot for bronchitis, before any of my tests, would this have an impact on my results?

Answered by Dr. Sankaranantham Murugan (5 hours later)

Brief Answer:
Long Steroids could delay the appearance of antibodies

Detailed Answer:
Hi,
Welcome back.

It depends upon when you had and how long you had.

If you had steroid after your high risk contact during the window period it could delay the window period or delay the appearance of antibodies against HIV. But a single shot would not have much effect on this. Only when you had steroids for more than a week this could happen. Otherwise it would not have much effect on the HIV test.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sankaranantham Murugan (20 minutes later)

Would it have any impact on the rna test?

Answered by Dr. Sankaranantham Murugan (10 minutes later)

Brief Answer:
Steroid has no effect on RNA test

Detailed Answer:
Hi,
Welcome once again.
Steroid would have no effect on antigen based RNA test. So you are free from
HIV 1 infection in spite of taking steroid. That is final.Nothing to worry.
DR S.Murugan

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sankaranantham Murugan (13 hours later)

I have had to take antibiotics a couple f times during my window period for bronchitis. Would antibiotics have any impact on the outcome of my tests?

Answered by Dr. Sankaranantham Murugan (9 minutes later)

Brief Answer:
Antibiotics have no effect on HIV tests.

Detailed Answer:
Hi,
Welcome once again.

Antibiotics are given for infections caused by bacteria. It has no action over any virus. HIV is a viral infection. So your test would not get affected by antibiotics. Nothing to worry.
Dr S.Murugan

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

Follow up: Dr. Sankaranantham Murugan (4 minutes later)

Also, this week, 12 weeks post exposure, I have developed small red spots (have not a fever at all over the 12 weeks) on my body. Is it possible for HIV rash to develop after 12 weeks?

Answered by Dr. Sankaranantham Murugan (9 hours later)

Brief Answer:
Red spots are unlikely to be due to HIV.

Detailed Answer:
Hi,
Welcome once again.

Red spots over the body might be due to various reasons like drug allergy, food allergy, insect bite allergy and other skin diseases. It is quite unusual for an early HIV manifestation. Moreover your negative HIV test done on 83 days after the high risk contact ruled out both HIV 1 and 2. Then how could this be due to HIV?
Nothing to worry. You are safe. For the red spots consult a Dermatologist and forget about HIV and your risky exposure.
DR S.Murugan

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