HIV Testing - Window period

[pontingfan]

Hello Dr - Posting this question on behalf of a friend. Thanks for taking the question

I had an unprotected oral / vaginal exposure a month back. I had the following tests at 4 week mark:

1. HIV-1 Antibody - < 1 - Negative
2. HIV 1/O/2 Abs, Qual - Non Reactive - Negative
3. HIV-1 DNA - Negative

I have the following questions:

1. Do I need further testing or can I take these results conclusive? I have seen some websites claim that if you are negative at 4 weeks for a combination of DNA and antibody testing, no further testing is required. Is this correct?

2. If answer is yes to Question no:1, the DNA test does not cover HIV 2? So, do I still need to test further?

3. Are there any strains / versions of HIV other than 1 and 2 that these tests do not cover.

Thanks for your time

[H. Hunter Handsfield, M.D.]

RNA testing is the same as DNA testing, discussed above.  That particular test does not detect HIV-2, but the combination of tests you had cover all strains of both HIV-1 and 2.

Tell your friend to accept the scientific evidence and reasoned reassurance you have had and stop worrying about it.

That is definitely the end of this thread.  There will be no further replies.

[pontingfan]

Sir - 1 Last Question. I read that there is another test named RNA Test. Does that cover HIV 1 and HIV 2 and all other strains?  Thanks for your time

[pontingfan]

Thanks Doctor for your prompt comment. As I had mentioned in the beginning of this question, I posted this question on a friend's behalf as he could not speak English. Thanks again.

[H. Hunter Handsfield, M.D.]

I just noticed your recent thread on the STD forum.  If all this is related to the same sexual non-exposure event described there, your HIV testing was a waste of money.

There will be no further comments or discussion.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

Almost all the discussion online and elsewhere about "window period" is in relation to the antibody tests.  Indeed, it can take up to 6 weeks (maybe up to 3 months, but very rarely if ever) for detectable HIV antibody to develop.  However, the combination of a negative DNA test and a negative antibody test at 4 weeks (you had two of them) is 100% proof positive you were not infected with HIV.

Those comments answer your questions, but to be explicit:

1) No further testin is negative.  What you found on "some websites" is exactly correct.

2) HIV-2 is essentially absent from North America, Europe, or virtually anywhere in the world except in parts of tropical Africa, except in immigrants from that area or their sex partners.  It's not an issue.

3) No, there are no such strains in industrialized countries -- at least not in measurable numbers.

Do your best to stop worrying.  Your test results prove you did not catch HIV.

Regards--  HHH, MD