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Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks (3 months) after having protected vaginal sex.
Posted Mon, 17 Feb 2014 in General Health
 
 
Answered by Dr. Sanjay Kumar Kanodia 6 minutes later
Hi XXXXXXX HIV 1/2 and P24 combo test (CMIA) is 100% conclusive at 12 weeks (3 months) after having protected vaginal sex. It is considered to be the longest time as international guidelines to be cut off limit of time to declare it as negative or postive. A negative result at 12 weeks means negative for HIV. If you have any further queries then can ask me directly on : bit.ly/drsanjaykanodia
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Follow-up: Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex? 43 minutes later
Dear Dr, On 31Oct13 I was in Antwerp Belgium and visited the legal red light district there. I ended up with a CSW. She put on a condom on my penis the very first thing and gave me an oral erection with condom. Then with the same condom we had 5-10 min of protected sex. Before vaginal penetration she put on a lubricant on her vagina. After the even the condom was intact and she rolled it off my penis. I did not wash off my genital area immediately and just dressed up and left back for my hotel where I had a thorough bath. However, I noticed burning sensation in my inner thighs a couple of hours after taking the bath. My dermatologist said it was a fungal infection. Does my not washing my genital area immediately put me in trouble? I am quite depressed at my actions and took a HIV 1 RNA RT-PCR quantitative test at 14 days after exposure which came stating target not detected (negative). On the 28th and 40th day I took the HIV 1/2 & P24 combo test done by CMIA method and the index value was 0.19 and 0.21 non reactive respectively for these tests. My doctor says that these tests are 4th gen and are conclusive and I need no further testing for HIV. I wanted to as your opinion whether these can be considered conclusive (CMIA) method at 28 and 40 days after exposure and do I need further testing? In between I had all urine analysis and culture tests done at 40 days and my sample was sterile. I also did the VDRL(RPR) test for syphillis at 40 days which was negative. I had a surgery done to remove piles (hemorroids) 19 days after the incident in Belgium. I was discharged the mext day and was put on cefixime 200 mg twice a day and paracetamol twice a day for 9-10 days. Will that have an effect on HIV / STD testing? To be on the safer side, I repeated the HIV 1/2 and P24 combo test done by CMIA method after 55 days (almost 8 weeks), 65 days and 84 day (12 weeks). All negative and the index value was 0.21 for the 12 week test. The RPR VDRL was also non reactive at 12 weeks. I would like to ask your opinion on my situation and whether you think I need further HIV testing at 6 months. s
 
 
Answered by Dr. Sanjay Kumar Kanodia 22 hours later
Brief Answer: HIV negative; no furhter tests required Detailed Answer: Hi, Welcome and thanks for posting your query to healthcare magic. I can understand your concern for the interpretation of results of HIV RNA-PCR and antibodies in addition. I first of all want to reassure you that you are not at all suffering from HIV or any other type of sexually transmitted diseases, so just relax first. Let me simplify the things and give you medical and scientific facts behind my firm declaration- Let you know about HIV infection: In an unprotected intercourse with a HIV positive person the HIV viruses gets entered into the body and divides in innumerous numbers(millions of viruses per ml). After a period of 2-6 week there is mounting of antibodies against the viruses. These antibodies can take at the maximum of 8-10 weeks of the period to get expressed. There fore the infection can be analyzed by two ways - -A): By HIV virus detection: done by RNA- PCR. It tells us the number of copies of virus present in per ml of blood. By the latest of methods the viruses can be detected within 2 weeks of period. B): By HIV antibody Detection: AS told earlier once the antibodies appear maximum of 8-10 weeks then these antibodies to HIV virus persist throughout life. The protocol of the antibody tests done for HIV is as follows: One HIV antibody test at 6-8 weeks and then a follow up final test at 3 months (84 days or 12 weeks). Antibodies once formed to HIV can never disappear. So if a person has HIV infection, 3 months of period is the time when we say to be fully sure of whether HIV is present or not. Now correlating all the facts and interpreting with your situation: 1. The very first thing of most help is using a condom. It is rarest or rare chance in our medical science to get HIV infection despite using condoms that too by improper use. This is one of the safest methods which we know in this world. Just think of the other person (CSW) who is equally vigilant for all her clients and therefore used condoms during oral sex too. So use of condom was the most crucial of part in deciding whether you had chance of any type of STDs even by oral sex or not. Not washing the area after proper use of condom does not make any difference. 2. A RNA PCR test is of best help in all the anxious cases who do not want to wait till even till 6 weeks. Your test was negative giving you a great relief. None of the antibiotic in this world can hamper with HIV virus detection and only direct anti-HI drugs can interfere with the results. Cefixime is of no correlation with your virus detection. 3. The test done at 84 days is most conclusive of all. To tell you a great sign of relief that - in my experience of last 12 years I have never seen any case which is negative at 8 weeks and became positive after 8 weeks any time after any time beyond 3 months. There are no further tests required and so do not to worry at all. I have many times seen your kind of cases getting depressed due to so many type of worries which actually interfere in the days to day life and even there is correlation of all minor to minor things with HIV. SO my dear young man, just relax and relieve all your stress regarding the issue. We always guide to use the best protection in form of condoms for safer sex. I hope these information will help you. If you have any further queries I will be glad to help. "Just enjoy the day with great enthusiasm of the good news for yourself" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology and Sexually transmitted diseases)
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Follow-up: Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex? 9 minutes later
thank you so much doctor, I just realized that I took the final combo test on the 83rd day. Can one day make a difference, I hope not. also, I have a family, can I resume unprotected relations with my wife and start planning a family. do you think I can forget about this incident now? Also, since the last four weeks I have some kind of burning sensation and some red foliculitis dots on my abdomen area. Dermatologist told me that it is due to dryness of the weather and the skin. nothing to do with this incident in Belgium. he gave me xceptional moisturizing lotion and acutret 10 for a month and told me not to worry. just wanted to ask your opinion on that. thanks doctor.
 
 
Answered by Dr. Sanjay Kumar Kanodia 14 minutes later
Brief Answer: Plan your baby and start normal life Detailed Answer: Hi young man, The test on 83 or 84 day do not at all make any difference. As I said earlier that in may clinical practice I have never seen any negative test at 8 weeks becoming positive after that. So just relax dear. As family man you can very well resume your normal relationship with your wife and she requires your full support with normal behavior now!! You can very well plan your family and all my best wishes for your healthy baby in future. For your red folliculitis- it has no relationship with any type of STDs and not at all to HIV. Your dermatologist has very well prescribed you good treatment and do follow the same. I hope these information will help you. If you have any further queries I will be glad to help or if not then can close the query and rate the answer. "Best wishes for your healthy life ahead" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology and Sexually transmitted diseases)
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Follow-up: Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex? 7 days later
Dear dr, for my peace of mind, i did the following tests on the 92nd day after exposure (3 months) 1. HIV 1/2 P24 combo (CMIA) 0.51 non reactive 2. VDRL non reactive 3. Hep B surface antigen - negative 4. CBC - all ok but low platelet count (117000) 5. Anti HCV negative I am worries because the HIV combo test i had done just one week back had an ondex value of 0.21. Why has the index balue increased to 0.51. Does this mean that i am a late converter? I am quite worried. As international guidelines mention 3 month for a fully conclusive HIV test, i took it. Do you think i need to retest at 6 months? Also do you think my piles surgery at 19 days post this oncident would weaken my immune system so as to delay antibody production? I am worriedand have not resumed normal relations with my wife.
 
 
Answered by Dr. Sanjay Kumar Kanodia 33 minutes later
Brief Answer: Each test kit has different index value Detailed Answer: Hi, Let me relax your worries young man- there are different sets of kits for every test. These tests vary to each other in its value of sensitivity, so each test is marked with different index value for its positivity. There is a cut off value for each test and below that the test is negative and above that the test is positive. So you can probably get that there is no correlation of the value of 0.21 or 0.51. These two values are individual values and are marked according to the tests and the kits. Even these value may vary daily. Further, your piles surgery has no correctional at all with weakening of immune system. Piles surgery is one of the very simple surgeries and never ever in medical science there had been any case with weakning of immune system due piles surgery. So do not correlate any of these things with your state. You are clear means CLEAR and there si no doubt about it. To say it very franly needs a lot of scierntifc basis and I means it what I say. "Best wishes for your healthy life ahead" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology and Sexually transmitted diseases)
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Follow-up: Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex? 7 minutes later
But doctor i did the HIV combo tests from the same Dr lal path labs in the same place (lab near my home), the test was same (CMIA) and my index value used to hover between 0.19 to 0.21. I was worried as the value increased all of a sudden in a week to 0.51. Since you are the expert, i will take your word for it and not lose any further sleep. I still havent resumed normal relations with my wife due to this incident? I know WHO and all international guidelines say one single test at 90 days or 12 weeks is conclusive. I want to lead a normal life now doctor and would not like to retest at 24 weeks (6 months). Final word doctor- i shall follow your advice
Follow-up: Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex? 5 minutes later
I forgot to add that all the tests were the same and named HIV1/2 and P24 combo test. The index value for positive was set at >1.00 for all the tests I took as there were the same test. Hence they were not different test kits with different cut off values for positive. My results were between 0.19 to 0.21. Never at 0.51.
 
 
Answered by Dr. Sanjay Kumar Kanodia 2 hours later
Brief Answer: value below 0.51 is always negative Detailed Answer: Dear young man, As I told earlier, there are different index values for each test. Every day when the test the done then there is control been set. It may vary from one test to other and even one day to other. It hardly matters that you presently have 0.1 or even even 0.80 or higher. A value below 0.51 is always negative. You know the matter of HIV is so sensitive that none of lab can give you any type of false reporting. So a negative is negative even if you test for 100 times. Do not put your mind in index values and these are meant for our reference of interpretation. For the further of brotherly suggestion- your test will always be negative. You are totally clear and remain so if you do not get involved in further any type of extra marital sexual activities. So relieve all your fear and anxiety. "Best wishes for your healthy life ahead" Regards, Dr Sanjay Kumar Kanodia MD (Dermatology and Sexually transmitted diseases)
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Follow-up: Is an HIV 1/2 and P24 combo test (CMIA) conclusive at 12 weeks after sex? 22 minutes later
Thank you doctor. I understand you meant anything less than 1 is negative (not 0.51). Please tell me if i understood correctly- for the CMIA test, each day a new control point is set and an arbitrary index number is given (like 0.51) and all values below that number are negative. It does not have anything to do with my blood sample at all. The spectral line from my sample would have been below that sample? They could have selected any other index value (like 0.3) as set point and the result would have been different. I promise to myself that i will never ever repeat this mistake in my life. I love my family a lot and have always been monogamous. I wont repeat any tests and remain thankful to you for your help, patience and guidance. Thank you so very much doctor.
 
 
Answered by Dr. Sanjay Kumar Kanodia 23 minutes later
Brief Answer: no further requirement for any testing Detailed Answer: Hi dear, You got it right anyway. These are so complicated tests that need a lot of indexing and further specifications which has nothing to do with your sample as a control is set before doing the tests. You should forget any of these things except that you are negative for HIV and there is no further requirement for any testing. My all best wishes for your lovely family and future best of life. will be glad if you have any further query or if not then can close the discussion and rate the answer. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)
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