HIV Tests

[Mikey019283]

Hi Doctors, I had a brief exposure of insertive anal probably less than 10 seconds before I realized I had entered my partner (of unknown status, although he says he is negative).  I quickly pulled out and put a condom on before going any further.  Anyways, about 15 days later I was hit with a pretty high fever and what I consider symptoms consistent with ARS (fever, rash, swollen glands, viral meningitis, many other symptoms that seemed a lot like mono).  Fever lasted about 4 days, other symptoms persisted for about 3 weeks.  I was pretty concerned and at 5 weeks after exposure, 3 weeks after onset of symptoms, I had blood drawn and an antibody test along with full STD panel done at labcorp.  Results came back negative for everything.  

I thought this may have been too early, especially with the symptoms, so at about 8.5 weeks I had a RNA PCR test done, which came back <20 copies/ml, HIV-1 RNA not detected.  I was scared however because I had to do a re-draw of blood for this test and no one could tell me why, they guessed it was a lab error.  I was scared thinking it was to confirm a positive test, but that didn't seem to be the case.  I feel better, but I can't stop running scenarios through my head I guess my question is, Is it possible that antibodies weren't detected at 5 weeks, but RNA wasn't detected at 8.5?  I feel like I should have had these tests taken in reverse, or at the same time, but my doctor isn't too concerned, even with my symptoms.  

Anyways, I plan to test at the 12 week mark, which is next week, and I'll update the post regardless, but I just wanted to know 1) is the scenario above possible/likely? and 2) am I going crazy? haha (don't answer this one!).  For your info, I feel pretty sure that I don't have HIV, but my doctor isn't really helpful in figuring out what is going on, which is frustrating in itself.

Thanks!

[Mikey019283]

Thanks for your reassurance doctor - I will be going in for my 12 week test next Friday and I'll post the results, but I am feeling better about it now and have definitely learned a lot about the disease and about myself during this whole process.

PS - you indirectly answered my second question, but in a very tactful way, so thank you!  Everyone's allowed to be a little crazy, right?

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.

While I can understand your concern when your symptoms came on, most people don't lie when asked directly about HIV status, so your partner probably wasn't infected; and even if he was, the transmission chance from such a very brief exposure undoubtedly is very low.

But in fact both your exposure history and symptoms are now irrelevant.  The HIV tests, both individually and especially in combination of variout test types, are among the most accurate diagnostic tests ever developed, for any medical condition.  Your test results to date amount to absolute, 100% conclusive evidence you did not acquire HIV during the exposure you are concerned about; and that something other than HIV was the cause of your symptoms.  It is simply impossible to have HIV and also have negative results like yours -- both antibody and PCR testing at the times they were done.

So all is well:  I agree with your own "pretty sure" conclusion.  You do not actually need your planned test at 3 months, although I understand your likely desire to have a final test at the officially recommended time.  If you do so, you can definitely expect another negative result.

I hope this has helped.  Best wishes--  HHH, MD