HIV Combo Test

[lezatdg]

Dear Expert and Doctor,
In my previous message, which i had the unprotected oral sex and blood in saliva from the girl. the date was on 14th Feb. After 11 days, i went to clinic for the Rapid HIV Combo Test - 4th generation (HIV p24 antigen + HIV-1/2 IgM/IgG antibody) and tested NEGATIVE on 25th Feb.

Questions:
1) I have the unprotected oral sex and found out that the girl have the blood in the saliva. What is the risk to me? if no, why? Can i have a bit more detail on this for my case (unprotected oral sex and blood in the saliva)?
2) I tested on 11th days (25th Feb), and the Rapid HIV Combo Test 4th generation showed NEGATIVE. How accurate is this?
3) Do i still need to go for another round of test on 28days?
4) After 28 days, do i still need to have another test after 6 weeks, 3mths and 6 mths?
5) I also requested to have my blood to send to lab for test and doctor told me that they will test it base on 3rd generation. Any possibility the result become different between Rapid vs Lab?
6) The doctor told me that 3rd vs 4th generation is only the methodology different, is this correct?

I know is a bit long but i hope doctor/expert to help me to peace my mind.

regards,

[Edward W Hook, MD]

You keep repeating the same questions.  This will not change the answers.  I have aleady told you you did not need testing to start with. You ignored this and now ask repetitive questions about tests that you do not need.  

18 day test.  I told you before, we do not know the proportion of combo tests that will be positive on a day-by-day basis before 28 days. Results are conclusive at 28 days. Earlier results, while reassuring, are not defintive.

I cannot tell you whether a 27 day test is the same as a 28 day test.  The recommendation is for 28 days.  In your case however, the results are unlikely to chance since you did not need to test in the first place.

This will be my final answer. there will be no further answers and further questions will be deleted without comment.

this thread is now over.  EWH

[Edward W Hook, MD]

There there are 4th generation tests that an give results in as little as 30 minutes.  I am not sure of your question however - are you referring to a type of  test called a RAPID test?  If so, I am not familiar with the test.  EWH

[lezatdg]

By the way, i forgot to mention that i am from Singapore and the CSW from China which holding a travel visa. Definitely she was in Singapore to work as freelancer CSW.

As i mention above, i got tested
11th day - negative --> Your comment: certainly >50% reliable.
18th day - negative --> What is your comment?

Right now, anxiety making me think all kind of problem until i can focus on my work, eat and sleep.

Regardless the event, tomorrow is 27th day after the last exposure which is only 1 day from 28th day.

Do you think i should go ahead for Rapid HIV Combo Test - 4th generation (HIV p24 antigen + HIV-1/2 IgM/IgG antibody) or should i wait for 1 more day?

Do you think 1 day different will give a significant % result?

Hope you can guide me on this.

[Edward W Hook, MD]

After testing with a 4th generation test at any time more than 4 weeks (28 days) after exposure ther is no needfor further testing- the results are conclusive.  EWH

[lezatdg]

Regardless of the event above, after the rapid combo test on 28th day, is that any further test again on week 6-8 or 3mths to re-ensure?

[Edward W Hook, MD]

Yes, this is a 4th generation test with performance equivalent to 4th generation tests performed in laboratories.  Results are conclusive at 4 weeks after exposure.  EWH

[lezatdg]

I am reffeeing to Rapid HIV Combo Test - 4th generation (HIV p24 antigen + HIV-1/2 IgM/IgG antibody) and it give a result in 20 mins. This is the 1 i had which give result in 20 mins.

Is urs 28th days is referring to Rapid HIV Combo Test - 4th generation (HIV p24 antigen + HIV-1/2 IgM/IgG antibody)

Please comment

[lezatdg]

1) 4th generation here u referring is referring to RAPID or LAB equipments?

2) is the RAPID the same performance as lab equipments?

[Edward W Hook, MD]

1) So for my case, you do not recommend to have HIV test right?
I have answered this question. The events you describe did not put you at risk for HIV.

2) Since after 11th day of exposure, should i go for test again on 28th days?
See above.

4) After 28th test result, can i have unprotected sex with my wife?
You are not at risk for HIV from the events you describe.  Since you are not at risk, there is no reason related to these events to abstain from unprotected sex with your wife.

5) After 28 days, do you think i still need to have another test after 6 weeks, 3mths and 6 mths?
See above- another repetitive question.

5) For all tests, is 4th generation rapid testis that good enough?
A 4th genration test is a test that tests for the p24 antigen and HIV antibodies at the same time.  4th generation tests give conclusive results at 28 days.

Please, no further repetitive questions. EWH

[lezatdg]

Dear Expert/Doctor,
Thank you very much of your reply.
1) So for my case, you do not recommend to have HIV test right?
2) Since after 11th day of exposure, should i go for test again on 28th days?
4) After 28th test result, can i have unprotected sex with my wife?
5) After 28 days, do you think i still need to have another test after 6 weeks, 3mths and 6 mths?
5) For all tests, is 4th generation rapid testis that good enough?

[Edward W Hook, MD]

Welcome to the Forum.  I'll be pleased to comment.  Despite the blood in your partner's saliva, there are no data to suggest that there is any risk for HIV from this exposure.  You do not know that your partner had HIV and, even if she did, there have been thousands, if not millions of instances in which persons with either blood in their mouths or poor dental hygiene and HIV have performed oral sex on uninflected partners yet there are not instances in which such exposures have been shown to lead to infection with HIV.  You are almost certainly not going to be the first to acquire HIV from such an exposure.  Thus, I see no need for HIV testing.

There are no good data to tell us what proportion of recent HIV infections would be detected by a 4th generation test at 11days.  Certainly such a test would detect over 50% of recent infections.

Your doctor is incorrect.  Third and 4th generation tests are different.  Third generation tests are only testing for HIV antibodies while 4th generation tests test for both HIV p24 antigen AND HIV antibodies.  It is for this reason the results of 4th generation tests become sensitive sooner (at 4weeks) than HIV antibody only tests which become definitive at 8 weeks.

I hope these comments are helpful.  EWH