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Possible HIV exposure, PCR test and rapid blood test negative. Sore throat, ulcer and diarrhea now

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General & Family Physician
Practicing since : 1978
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I might have had exposure to HIV 31 days ago. I took XXXXXXX at 7 days, XXXXXXX at 15 days, hiv-1 rna pcr test at 18 days and now a rapid blood at 25 days. All negative. Friday went to enter for sore throat (29 days). He said I have small ulcer in throat probably due to stress not HIV. He said rna pcr at 18 days is as close to 100% accurate and that I don't have HIV. Labcorp did test. Today I wake up with diarrhea am I worrying too much OS rna pcr 100% accurate 18 days post exposure.
Posted Wed, 23 May 2012 in HIV and AIDS
Answered by Dr. Pavan Kumar Gupta 42 minutes later
Hello and thanks for the query.
I understand your concern as there is XXXXXXX anxiety about the HIV infection post any unprotected sexual exposure.
HIV testing at an early stage is imperative in order to limit further onward spread of HIV and also to facilitate potential early HIV treatment and screening for other sexually transmitted diseases which may co-exist.
Plasma HIV RNA PCR testing allows for very early identification of new HIV infection well before antibody tests may become positive. Typically, after HIV infection, HIV antibodies take 2 to 6 weeks to form and be detectable. The detection of antibodies will vary depending on the individual patient's immune system but also on the quality of the HIV test and which generation HIV test is used. Modern third generation HIV tests will identify more than 99% of newly acquired HIV infection by 6 weeks post exposure.
The acccuracy of HIV RNA PCR testing dramatically shortens the interval from infection to testing from 28 days to a minimum of 7 days following exposure. 
Your symptoms of ulcer in throat and diarrhea seem to be coincidental and have no relation with HIV and also your all the tests are negative proves that you are not suffering from any HIV infection and you must stop worrying.
I hope to have answered your query however you can revert to me for any further query.
Thanks and best of luck.
Above answer was peer-reviewed by
Follow-up: Possible HIV exposure, PCR test and rapid blood test negative. Sore throat, ulcer and diarrhea now 22 minutes later
So an rna pcr test at 18 days post is very accurate 100%?
Please I need to know if an rna pcr would be very reliable at 18 days my doc said yes almost 100% but I need another doc to reassure me he also said I shouldn't worry about hiv-2 pcr because very rare in USA. Help please
Answered by Dr. Pavan Kumar Gupta 8 hours later
rna pcr test done at 18 days is abdolute reliable and is prevelant in usa in less than 5% cases.
Although both HIV1 and HIV2 are very much similar, as far as transmission modes, as well as symptoms are concerned; there are a few major differences. The following are some of the major differences between the two strains:
1 The first major difference between the two strains lies in the number of cases reported under each strain. While HIV1 is the most common strain and is found in the majority of HIV infection cases, HIV2 is the less common strain and is not found very often.

2. Another major difference between HIV1 and HIV2 is in relation to the areas of prevalence. While HIV1 can be found across all the places of the world, the less common HIV2 is mainly concentrated to areas of Western Africa. HIV2 cases are mainly found in countries like, Senegal, Nigeria, as well as the Ivory Coast. Apart from this, it has also spread into countries like France and Portugal, as a result of economic relationships with these countries.

3. Apart from that, another important difference lies in terms of clinical research, as well as medical facilities available for each strain. Although, we may have a number of antiretroviral therapies, which are there for the treatment of HIV; these antiretroviral therapies mainly focus on the HIV1 strain, since it is most common. HIV2, being less common had less scope for clinical research. Due to this reason, there has not been much medical development, as far as HIV2 is concerned.

4. Also, HIV2 has been found to be slow in progress and has been found to weaken the immune system at a much slower rate, than the HIV1 strain. It has also been said that, HIV2 is less infectious in the earlier stages and is also said to be less easily transmitted. 
There is no need to worry and rna PCR test for HIV 2 is done either at blood donation centers or if there are sufficient grounds for doubts regarding suspicion of HIV in persons having negative HIV 1 rna PCR test.
Above answer was peer-reviewed by
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