Event:
About 12 weeks ago, I spent the evening at a sauna and received unprotected oral sex (I was the insertive partner) from 3 different men at about 45 minute intervals. Had been drinking, but am near certain that the exposure was limited to receiving oral sex. However, there is an outside chance that a high risk exposure with one of the men may have occurred, namely unprotected insertive anal intercourse (me being the insertive partner). Although I have no specific or for that matter even vague recollection of it actually happening, just an abiding and I hope irrational fear, that has caused great anxiety.
Symptoms:
- At week 2 post exposure I developed an oral herpes sore (have had oral herpes for decades). Unusual in that it appeared on both lower and upper lips, when I only normally get it on my upper lip. The sores disappeared within the usual 10 days.
- At week 4 post exposure my tongue started to feel raspy and the tip became both sensitive and somewhat numb. This lasted about 1 week.
- At week 6, my groin glands (especially the right one) became quite sensitive for about 2 days, then subsided into a dull morning ache for about 5 days before disappearing.
Tests:
- At week 7 post exposure, tested NEGATIVE for the usual STD's; chlamydia, gonorrhea and syphilis.
- At week 8 post exposure (actually 55 days) tested NEGATIVE for HIV, using the 4th generation combined P24 antigen, Hiv1/2 Antibody test.
The tests were done through a government licensed community health center here in Canada. I beleive the lab uses the Abbott Axim test kit for the HIV Duo test.
The Health center Hiv counselor says that with 4th generation testing, waiting 3 months is no longer necessary. They test at week 6 post exposure onwards and consider the results very reliable and conclusive.
I am vaccinated against Hep A & B, and am circumcised since birth.
Questions:
1- Considering my known (and possible) exposure risks as well as my symptoms, do you consider my 8 week post exposure, 4th generation NEGATIVE HIV test result as final and conclusive?
2- Am told that at 8 week post exposure there is a vanishingly small chance that an HIV infection could be missed or go undetected using the 4th generation P24Ag, Hiv1/2 Ab test, and that cases of people testing Positive at 12 weeks post exposure, after having tested Negative at 8 weeks using the 4th generation test are basically unheard of.
Do you concur, any comments or reservations?
3- Is there any reason I should retest at 12 weeks?
4- What is the occurrence or percentage of 4th Generation HIV False Positive test results?
Hello,
Thank you for your post and welcome to our forum. I am afraid that it is going to be me replying to your queries, instead of my colleague, Dr Sean. I will answer each of your questions here below:
1- Considering my known (and possible) exposure risks as well as my symptoms, do you consider my 8 week post exposure, 4th generation NEGATIVE HIV test result as final and conclusive? Yes, it is final and fully conclusive. You are HIV negative without any doubt.
2- Am told that at 8 week post exposure there is a vanishingly small chance that an HIV infection could be missed or go undetected using the 4th generation P24Ag, Hiv1/2 Ab test, and that cases of people testing Positive at 12 weeks post exposure, after having tested Negative at 8 weeks using the 4th generation test are basically unheard of.
Do you concur, any comments or reservations? In the UK, this test (HIV Duo) is considered conclusive after 4 weeks of any possible exposure. In fact the p24 antigen is already detectable after 14 days.
3- Is there any reason I should retest at 12 weeks? No, there is not.
4- What is the occurrence or percentage of 4th Generation HIV False Positive test results? We see a fair number of false positives with the 4th generation Duo test, around 2%. However this is irrelevant in your case as your test result was negative anyway.
I hope this helps to reduce your anxiety. It is very possible that some of your symptoms are related to the worry and anxiety about the whole situation.
8 week Duo test reliability
Linear Mode
