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Had Unprotected Sex, Abdominal Pain, Vomiting, Diarrhea. HIV Test Nonreactive. How Accurate Are The Tests?

Posted on Mon, 10 Sep 2012

Question: I am a 44 yr. old male from Chicago,il. I have a question about Hiv. I had unprotected sex on vacation with a female of unknown status. 36 days after my sexual encounter i woke up in severe abdominal pain and dry-heaving. A couple days later the pain came back again and this time along with vomiting & diarrhea as well. 2 weeks later it hit me again along with dry-heaving only. 3 episodes in 3 weeks. I went to the ER,they said there was inflammation in the small bowel and my platelets were low,down to 50,000. A few weeks later I had an HIV 1/2 AB screen at 87 days since possible exposure that came back NONREACTIVE result and an HIV RNA Quantitive HIV PCR Quant,Log 10 Hiv and the results came back Not Detected. This Viral Load test was 94 days after possible exposure.What generation are those tests and how ACCURATE are they???? I've read mixed comments on the "window period" and how accurate they are! Since i was in pain and had 3 episodes, 1 with vomit & diarrhea ,would that mean that if i was infected with Hiv that it would've been detected at 87 & 94 days of testing??? Can i have symptoms and be sick and the virus not show up yet in the test results??It's been over 9 months and still don't know why i had these attacks and why my platelets are still low. I still get mild abdominal pain and just a feeling that something is off.I have had no medical history before this....Some forums i've read say that my test at 87 & 94 days is conclusive and not to worry and others i've read said it could take 6 months to a year to be detected. I need my life back,please help......

Answered by Dr. Sankaranantham Murugan (1 hour later)

Hi XXXXXXX
Thanks for writing in.

Window period in HIV is usually 8-12 weeks after the infection. It may be delayed upto 3 months but never extends more than 6 months.
It is totally wrong that it may take 6 months or a year to be detected in blood. Manifestations or symptoms may be delayed up to even 10 years or more sometimes, but not the lab test results.
As you had the test after 87 days and 94 days your tests are conclusive and most of the screening test are 98% reliable and PCR test are almost 100% reliable. So you need not worry about HIV in your case.
The reason for your pain abdomen and Thrombocytopenia is some other cause and your surgeon will help you to arrive at the cause and you will get treated accordingly.
Get rid your fear of HIV totally. Also, try and use protection the next time around.
Let me know if you have any more questions.
Dr S XXXXXXX

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Sankaranantham Murugan (16 hours later)

So in your professional opinion, my HIV ab 1/2 test at 87 days and the Quantitive HIV PCR Quant,Log 10 done at 94 days both coming back non detected is totally accurate and no need to worry? Sorry for repeating the question just need reassurance if i'm good! Why is there so much confusion and conflict online about the window period? There's comments that say you need to get tested after 3 & 6 months and some say up to a year to be 100% certain.If my initial abdominal pain, vomiting & diarrhea was an early symptom would that mean the virus should be detected in the test since my body was reacting to something? Over the past 9 months (since Nov. 2011) I have been to a Hematologist,2 different rheumatologist,3 different GI's, my family Dr. searching for the cause of my abdominal pain and the low platelets. I had a CT scan,MRA and going for an MRI next weekend for my abdomen.I was also tested positive XXXXXXX 1:1280 in May and developed pain in the arches of both feet,fatigue,a couple canker sores and achey neck. I re-tested 6 weeks later and my XXXXXXX was down to 15. Is there any connection with HIV & a Positive ANA? My stomach pain went away from about March 2012 til XXXXXXX 2012 but for the past 2 months it has been a mild ache that just feels off to me. There has been no difficulty/pain or problem going to the bathroom.My weight and appetite are the same. I haven't noticed any rash,no fever,no night sweats, no swollen Lymph nodes.My whole medical history was nothing more than my school shots as a kid, i've barely even aspirin my whole life cuz' i never get sick and never take anything. Then all of the sudden Nov. 2011 changed my life all at once. Thank you for your help

Answered by Dr. Sankaranantham Murugan (7 hours later)

Hi,

Thanks again for the follow up.

Don't worry about the confusion among the physicians about window period.

Seroconversion after 3 months is extremely rare and like I said it is even rarer after 6 months. Only those who are handling lot of HIV cases and for a long time (more than 20 years) during research purpose can only identify a late seroconverter. So in all probabilities most clinicians including me take the window period as few weeks and at the most up to 3-6 months.

Hence I once again affirm you window period never goes beyond six months and your tests HIV Antibody test at 87 days and the PCR test done at 94 days are more confirmatory and there is no possibility you become sero-converted hereafter.

Positive XXXXXXX is not associated with HIV infection.

Regarding your pain abdomen and thrombocytopenia your surgeon and hematologist are more competent to diagnose the problem.

Hope this suffices.

Good luck to you

Dr SM

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sankaranantham Murugan (26 hours later)

Thanks for your help! Since i did have extreme vomit & diarrhea about 36 days after possible exposure,would that mean that the antibodies would be present and would've shown up in the test at 87 & 94 days? Is it possible to have symptoms and it not show in the test if it's too early to detect? Is the positive XXXXXXX i tested for the same as antibodies in HIV? Around the time i tested positive XXXXXXX is when i started to have extreme fatigue,feet pain in the arch,canker sores & spotty tongue and stomach with mild feeling of just being off.Are there multiple possibilities that can cause white patchy tongue or lesions?This occurred about 5 months after my ER visit. Since i had a high titre of 1:1280 in May 2012, does that mean there has to be something wrong? Is it possible to return to normal/negative XXXXXXX with no treatment or meds?Sorry if it seems that i'm repeating questions and are just re-worded, i'm just scared for my life and want to fully understand why i'm still sick after 9 months and no diagnosis other than ITP.Thanks again,you've been a big help!

Answered by Dr. Sankaranantham Murugan (5 hours later)

Hi,

Extreme vomiting, diarrhea, etc., are all NOT the manifestations of early HIV infection. They cam appear in HIV disease 8 years after exposure that is when your immunity go beyond the low level.
XXXXXXX antibody is different and not related to HIV.

So let me assure you that the symptoms you have are NOT due to HIV. Further the test at 87 days is accurate. I do not consider this early as to put you in window period and is sufficient to rules out HIV infection.

All the other symptoms you have are due to other causes perhaps associated with positive XXXXXXX Your examining doctors are competent to narrow down the possibilities.

Hope this answers your query.

Wish you a speedy recovery.

Regards
Dr. S XXXXXXX

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Above answer was peer-reviewed by : Dr. Prasad