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Took Antivirals, Aptima Few Days After Exposure, Got Negative Qualitative RNA Test. Is This Due To Medicine?
Question: Hi, I took the FDA approved Aptima qualitative RNA test for HIV 14 days after exposure and it came back undetected. My concern is that 3 days after exposure I took the antivirals that make up a PEP Regimen, they were combivir and Kaletra, but I stopped taking them after only 3 days because I couldn't take the side effects. I then took the Aptima test 9 days after stopping this brief course of antivirals and I am worried that the 3 days of taking them gave me a false negative test result. What is your opinion? Can I trust the negative test result? Keep in mind that I did wait 14 days from possible exposure before taking this test. I also wanted to know what the difference is between an HIV qualitative RNA test and an HiV quantitative RNA test. Thank you.
I mentioned in my last query that i started my brief course of PEP 3 days post exposure, but it was technically 60 hrs post exposure, I wasn't sure if that made a difference. I also did research on the test I took and it's to detect early hiv infection before anitbodies would be produced. I thought this additional info could help. But again, only one test was taken and that was exactly 14 days post exposure, I hope that I'm not confusing you, lol.
I mentioned in my last query that i started my brief course of PEP 3 days post exposure, but it was technically 60 hrs post exposure, I wasn't sure if that made a difference. I also did research on the test I took and it's to detect early hiv infection before anitbodies would be produced. I thought this additional info could help. But again, only one test was taken and that was exactly 14 days post exposure, I hope that I'm not confusing you, lol.
Hello and welcome to XXXXXXX
Thank you for writing to us.
In order to explain things well enough, I will have to answer your query about HIV quantitative and qualitative RNA tests first and take it from there. And do not worry, none of this was confusing. :)
A HIV qualitative test helps in detection of the HIV infection; whereas the HIV quantitative test helps in monitoring the effect of anti-retroviral drug therapy, progression of the infection and to asses prognosis. I hope this is clear.
Now coming to the test, and my opinion. A HIV-PCR test (which is the one you have taken) is used for early detection of HIV (i.e. before the antibodies are produced). This test can be used to detect HIV around 2-3 weeks (14-21 days) post-exposure to a HIV-infected individual. So, as you were tested 14 days (the lower limit) after exposure, there could still be a chance that the test reported negative (as in some individuals it does take more time for a positive result than others). I hope you are getting this?
But, if it has been more than 4 weeks since contact with a HIV-infected person, then this test cannot be repeated, and you can now only go for an antibody test, which is best taken at 3 months and 6 months after exposure. If it has not been more than 4 weeks, you could repeat the same test you first took.
But, in my opinion it is highly unlikely that you have contracted the virus. I hope that I have not confused you. :)
If you wish to clarify further, please feel free to write back to me and I would gladly help.
Best wishes.
Thank you for writing to us.
In order to explain things well enough, I will have to answer your query about HIV quantitative and qualitative RNA tests first and take it from there. And do not worry, none of this was confusing. :)
A HIV qualitative test helps in detection of the HIV infection; whereas the HIV quantitative test helps in monitoring the effect of anti-retroviral drug therapy, progression of the infection and to asses prognosis. I hope this is clear.
Now coming to the test, and my opinion. A HIV-PCR test (which is the one you have taken) is used for early detection of HIV (i.e. before the antibodies are produced). This test can be used to detect HIV around 2-3 weeks (14-21 days) post-exposure to a HIV-infected individual. So, as you were tested 14 days (the lower limit) after exposure, there could still be a chance that the test reported negative (as in some individuals it does take more time for a positive result than others). I hope you are getting this?
But, if it has been more than 4 weeks since contact with a HIV-infected person, then this test cannot be repeated, and you can now only go for an antibody test, which is best taken at 3 months and 6 months after exposure. If it has not been more than 4 weeks, you could repeat the same test you first took.
But, in my opinion it is highly unlikely that you have contracted the virus. I hope that I have not confused you. :)
If you wish to clarify further, please feel free to write back to me and I would gladly help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for getting back to me Dr XXXXXXX The place I went to to get the test said that the window period for testing is 9 to 11 days post exposure and on the CDC website they state the same thing. My test was an RNA qualitative test, not a DNA qualitative test. My main concern is if you think that the 3 days of anti retrovirals that I took could have affected my test result and made me test negative by suppressing the virus. What do you think? Thanks again.
Hello once again.
There could be a chance of the anti-retroviral drugs effecting the test result, but for this, a longer course will be required. A course of 3 days, will most probably not lead to a false-negative result.
Do not worry about this. As stated by you and your research, the window period for an RNA qualitative test is indeed 9-11 days. But, each individual is different, and there are chances that the window period be longer for a few individuals (although very rarely seen).
In my opinion, why don't you repeat the test after 21 days since exposure and before the completion of 30 days since exposure. If it returns with a negative result, then you need not worry any further. HIV confirmation and ruling out is best supported by multiple test results.
I hope this information helps, do write back to me for any further clarifications. I would be happy to help.
Best wishes.
There could be a chance of the anti-retroviral drugs effecting the test result, but for this, a longer course will be required. A course of 3 days, will most probably not lead to a false-negative result.
Do not worry about this. As stated by you and your research, the window period for an RNA qualitative test is indeed 9-11 days. But, each individual is different, and there are chances that the window period be longer for a few individuals (although very rarely seen).
In my opinion, why don't you repeat the test after 21 days since exposure and before the completion of 30 days since exposure. If it returns with a negative result, then you need not worry any further. HIV confirmation and ruling out is best supported by multiple test results.
I hope this information helps, do write back to me for any further clarifications. I would be happy to help.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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