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Had unprotected sex. HIV Rapid Tri Dot Test negative. Concerned about HIV?

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General & Family Physician
Practicing since : 2005
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I had unprotected sex with my boyfriend last year in August (2012). Soon after I came to know he was dating another girl at the same time as me, and consequently we broke up. Worried about possible HIV exposure I got a HIV Rapid Tri Dot Test done in September 2012 (about a month after exposure) which came out as Negative.
I got tested again on 19th July 2013 with HIV I/II Rapid Spot Serum Test that came out Negative as well.
On 26th July 2013, I got injured and had to be admitted in a hospital (for stitches) which conducted its own HIV test using the CMIA method. The test was Non Reactive but the Optical Density for HIV Ag/Ab read 0.21 while HBs Ag read 0.00 and HCV Ab read 0.7. I need to know what does a reading of 0.21 imply. I know it has been an year since the exposure and a non reactive result is confirmatory. But the fact that the Optical Density didnt read 0.00 like for HBs is getting me worried. I haven't had sex with anyone since then but I'm now dating someone and would like to know that there is nothing to be worried about.

Correction to my HCV Ab reading. It was 0.07.
Thank You
Posted Wed, 11 Sep 2013 in HIV and AIDS
Answered by Dr. Prasad 1 hour later
Brief Answer:
Do not be very concerned...

Detailed Answer:

Thanks for sharing your concerns here.

Before I begin to address your primary concern about the latest semi quantitative test results I shall begin by saying, from the outset, you do not seem to carry the risk of HIV infections. The chances of HIV from a single unprotected sexual intercourse are remote. This is backed by the fact that two HIV tests done over a period of 12 months are negative. So you can be rest assured that you are not dealing with HIV per se.

Coming back to your concern, the latest test is many a time confusion both to the patient as well as doctors. This is because, the reference ranges are not constant and differ from each laboratory standards. Therefore you are requested to cross verify reference limit of each values and confirm that they are under normal limits. If they are normal, it means values are insignificant to be considered.

Now why the titres values are not “0.00” as seen in HbsAg; each of these tests is designed to pick up individual antibodies against specific HIV and HCV. However it is well known that sometimes the test can pick up other non HIV and HCV antibodies producing a false negative report. Therefore any titre values under reference limit is considered as false and hence considered insignificant.
In simple terms, the results that each test results revealed are false positive ones produced from reacting with other antibodies (NOT HIV / HCV specific). Therefore you can feel very assured with "non reactive" prints on the reports and the titre values are produced from false reaction.

I hope I make sense. Please feel free to write back if things are not very clear.

Above answer was peer-reviewed by
Follow-up: Had unprotected sex. HIV Rapid Tri Dot Test negative. Concerned about HIV? 25 minutes later
Thank you Doctor. That definitely was helpful. The reference range indicated on my report says that <1.0 is Non Reactive. I'd also like to add that I had unprotected sex with my ex-boyfriend a couple of times but the last was in August 2012.
Also, I did a little online research and came across Vancouver AIDS online forum where quite a few people had posted similar concerns and the replies all indicated that the optical density value does not matter and can vary but what matters is that the result was non-reactive. Your answer does put me at a peace but would you recommend that to be completely sure I go for a Western Blot test?
Answered by Dr. Prasad 18 minutes later
Brief Answer:
Western Blot is more of a confirmation test...

Detailed Answer:

I was really hoping that you understand the lengthy theory I wrote earlier!! I am glad that it helped you.

Couple of unprotected sexual exposures doesn't elevate the risk of HIV to any significant level. I don't think you need to be thinking of testing further to clarify whether or not you have any chance of HIV. They are proved to be negative on more than two occasions.

Now about Western Blot, this is more of a confirmation test. We rely on this test for confirmation when initial HIV elisa tests are positive. To all my patients who doubt and suspect presence of HIV, I suggest HIV DNA PCR instead of repeating Elisa/western blot. They are more sensitive than other HIV tests. Negative DNA PCR is close to 100% reliable report. That being said, in any circumstance, you need not repeat the tests again.

I recommend you forget your past and move on with present and future. Practice safe sex with known partners only.

Hope this is assuring. You can write back for clarifications.
If all your queries are addressed, please close this discussion.

Good luck!!
Above answer was peer-reviewed by
Follow-up: Had unprotected sex. HIV Rapid Tri Dot Test negative. Concerned about HIV? 8 minutes later
Thank You so much Doctor. The theory does make sense. I don't think I'll get tested again except at my annual health check ups. I know this is more of a psychological fear. I do intend to practice safe sex only now and not repeat the mistake I made earlier. Thanks again.
Answered by Dr. Prasad 31 minutes later
Brief Answer:
Wish you good health....

Detailed Answer:
You are welcome.

If you have no more queries to discuss, please close this discussion and review this service. I would appreciate if you can do that.

Thanks and Best Regards...
Above answer was peer-reviewed by
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