Antibodies become detectable 22 days after infection i.e . seroconversion on a fourth generation HIV test for antibody[enzyme immunoassay (EIA)].
Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Seroconversion-HIV infetion

Detailed Answer:
Yes,it is possible.Rarely infected individuals with HIV may have window period up to 3 months i.e the period between infection and the development of antibodies.
Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
It seems most likely you are not having HIV infection (so far fourth generation HIV test for antibody by enzyme immunoassay /EIA and HIV RNA negative)

However the commercially available RNA detection tests have a sensitivity
of 40–8100 copies of HIV RNA per milliliter of plasma. Research
laboratory–based RNA assays can detect as few as one HIV RNA copy
per milliliter.
Thus, RNA detection tests are extremely sensitive.
However one frequent consequence of a high degree of sensitivity
is some loss of specificity, and false-positive results have been
reported with each of these techniques. For this reason, a positive EIA
with a confirmatory Western blot remains the “gold standard” for a
diagnosis of HIV infection, and the interpretation of other test results
must be done with this in mind.

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
Welcome back,

It's Unlikely to be false negative.

Retest EIA, Enzyme immuno-assay twice at 3-month intervals to rule out HIV infection.

Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Acute Mono

Detailed Answer:
Some of the features you have mentioned are suggestive of Acute HIV infection (acute clinical syndrome ~3–6 weeks after primary infection) e.g sore throat (Pharyngitis), lymph nodes swollen (Lymphadenopathy ),red rash (Erythematous maculopapular rash),lot of muscle pain (myalgias ),some electric shocks all over my body (Peripheral neuropathy),feel very sick and tired (Lethargy/malaise ).
Alternative possibility is an acute viral syndrome due to acute infectious mononucleosis.
Please do visit your physician for clinical evaluation and undergo further tests as required to come to a conclusion about your present symptoms.

However you can also undergo other laboratory tests as potential markers of HIV disease activity e.g . quantitative peripheral blood resting CD4+ T cells count.
Discuss with your doctor.
Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
In view of your present symptoms and history of high risk exposure false negative tests are quite possible,particularly detection of antibodies against HIV which can be delayed and it is quite well known.
RT-PCR assay generates data in the form of number of copies of HIV RNA per milliliter of serum or plasma and can reliably detect as few as 40 copies of HIV RNA per milliliter of plasma. It is common practice to describe levels of HIV
RNA below these cut-offs as “undetectable,”/negative.This leaves the false impression that the level of virus is 0. Research-based assays can detect down to one copy per milliliter.
Wait and retest at 12 weeks.

Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
Acute HIV syndrome occurs along with a burst of plasma viremia.
HIV RNA measurements may fluctuate.
Decisions based on HIV RNA levels should never be made on a single determination.Measurements of plasma HIV RNA levels should be made
at the time of HIV diagnosis and every 3–6 months thereafter in the untreated patient.
Moreover you have undergone HIV- 1 RNA Qualitative only.The report is not quantitative .
Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
HIV RNA qualitative assays give the result as positive or negative.
HIV RNA viral load assays give the result of RNA copies/ml.
Techniques followed by some laboratories :-
HIV RNA by PCR- Target amplification of HIV-1 RNA via reverse transcription
followed by PCR (polymerase chain reaction) .

HIV RNA by NASBA (nucleic acid sequence–based amplification)- Isothermal nucleic acid amplification with internal controls.

The NASBA technique involves the isothermal amplification of a sequence within the gag region of HIV in the presence of internal standards and employs the production of multiple RNA copies through the action of T7-RNA polymerase. The resulting RNA species are quantitated through hybridization with a molecular beacon DNA probe that is quenched in the absence of hybridization.

It is difficult to oversimplify.

You may clarify with the pathologist/technician at laboratory..

Regards
Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
It is up to you. In any case you have to undergo retest for HIV after 12 weeks.

Brighter side is that you may have other acute viral syndrome .One of them is acute infectious mononucleosis [caused by Epstein-Barr virus (EBV)] as discussed earlier.Most cases of IM (infectious mononucleosis) are self-limited.

Regards
Dr. T.K. Biswas M.D. XXXXXXX

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Brief Answer:
Diagnosis of HIV infection

Detailed Answer:
You are most welcome!
Please feel free to ask any further question to HCM.
Regards
Dr. T.K. Biswas M.D. XXXXXXX

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