RNA+Antibody Test at 7 weeks post exposure -definitive result?

[atom2727]

At 7 weeks post last possible exposure would a combination of a RNA test and a separate antibody test provide a definitive result if both were negative?  Put otherwise if there were no virus detectable on the RNA test and no antibodies on the more standard AB test, would further testing be required?  No combo test with p24 antigen seems conveniently available. There was already a negative AB test at 6 weeks post last possible exposure.

[atom2727]

Just a note to post final 7.5 weeks post exposure tests:

HIV 1/2 index Value <1.0 Non-Reactive
HIV-1 RNA Non-Reactive HIV - 1 RNA not detected

Thanks Drs. Handsfield and Hook for facilitating such an informative forum. I must say that as I waited through this period after a silly mistake, it rekindled my awareness of this dreadful condition, the progress that has been made in treatment and all that remains to be done. While I avoided a personal confrontation with this disease, I am now a more vigorous supporter of the resources which must continue to flow to prevention and research so that it can finally be overcome.

[H. Hunter Handsfield, M.D.]

Your symptoms started way too late to be due to ARS from an exposure more than 6 weeks earlier.

That will end this thread.  Trust me on this:  assuming the basic facts of the case don't change, there is no information that can come to light or that you might think of that would possibly change my opinion or advice.  So no point in askin!  Move on without worry.

Happy holidays.

[atom2727]

One last question as I anxiously await the results of the RNA + AB tests. As to the swelling noted above that started at about 6.5 to 7 weeks and was not associated with any fever, is that generally too too late for association with ARS or would it be in scope.

Thanks.

[atom2727]

Thanks you, Dr Handsfield for the additional information and recommendations. I particularly appreciate the commentary on how you would personally treat a similar situation. While most of the symptoms come and go, I think I am overly focusing on new symptoms and perceptions, including some swelling and numbness radiating from in front of the ear to my mouth just above and below the jaw line and down my neck on the left side. While I understand this is not specific or unique to early HIV and, perhaps, started a bit late at 7 weeks for a symptom of ARS, I decided the way to firmly resolve was to take both the RNA and AB test which I did this morning.

Thanks again for your thoughts and recommendations.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks, and for the additional details.  Actually, I don't recommend an RNA test.  Your negative antibody test is 99% proof you don't have HIV, and it is 100% proof your symptoms are not caused by ARS.  It is not possible to have ARS symptoms more than a few days and have a negative antibody test.  (It is the body's immune response to HIV, including antibody, that causes the symptoms -- not the virus itself.)  If you want a final round of reassurance, Iw would suggest just another antibody test -- although if I were in your situation, personally I would not feel a need for any more testing at all, and I would be coninuing unprotected sex with my wife without worry.

The threads linked above go into all this in greater detail.  But whatever you do, feel free to post your final test results -- which willl be negative.

[atom2727]

Thank you, Dr. Handsfield for your very prompt, clear and helpful answer. Just to amplify, my question was directed toward confirming that I should take both tests and not that I had taken them when I asked the question. I had only had the 6 week post last possible exposure AB test at the time I asked and it came back negative last week. I have a persistent set of symptoms which have come and mostly gone over the last month, but due to the excellent information on the forum, I won't bore you with them as testing is clearly the only way to tell - and I freely acknowledge that I may be hypersensitive to them or, perhaps, contributing to them directly with weeks of anxiety and stress. By taking the RNA, plus the standard AB (again for the AB) at 7.5 weeks post-exposure, I hope to know definitively one way or the other in terms of the single silly mistake. So, a few more anxious days of waiting, but I take some reassurance in my negative 6 week stand alone AB test and your thoughts regarding it..

Thanks, again and best wishes for the holidays and the new year.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

Sometimes the title of a question gives all the information necessary for an accurate result.  The combination of negative RNA and antibody at 7 weeks (any time beyond 4 weeks) after the last possible exposure is definitive proof against HIV.

Now having looked at the question:  the RNA test is even more valid than p24 antigen.  In other words, the combination of tests you had is, if anything, even more reliable than if you had had a combo test.  As a matter of fact, your standalone antibody test at 6 weeks was also virtually conclusive.

Here are a couple of other threads that discuss these issues in greater detail, in case you are interested:

http://www.medhelp.org/posts/show/1704700
http://www.medhelp.org/posts/show/1855891
http://www.medhelp.org/posts/show/1891685

Best wishes and happy holidays--  HHH, MD