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Is HIV Duo Test Taken 39 Days Post Exposure Through Fellatio Conclusive?

Posted on Fri, 23 Nov 2018

Question: hi doctor, I had an insertive oral sex episode with a woman of unknown status. I did the following tests: 39 days: elisa duo test hiv 1,2 and/or P24 42 days: meia hiv1,2 44 days: alere rapid duo test antibody and/or P24 the tests were in different labs and they came back negative. i am extremely worried.

Answered by Dr. Dr. Monika Dede (1 hour later)

Brief Answer:
Please don't worry!

Detailed Answer:

Hello,

You should know that the risk of HIV infection for the insertive partner in oral sex (fellatio) is thought to be very low or close to zero (virtually nonexistent).

So, based on this fact and in your negative results of HIV duo test I think you shouldn't worry because you are free of HIV.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Monika Dede
Infectious Diseases Specialist

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Monika Dede (25 minutes later)

I did another Elisa Duo test at 45 days and it is negative. I read that the duo test is conclusive post 28 days. is that right?

Answered by Dr. Dr. Monika Dede (56 minutes later)

Brief Answer:
Please don't worry!

Detailed Answer:

Hello,

This is a good news and I emphasize again that you are free of HIV. HIV duo test after 28 days and 45 days is very accurate and conclusive in your situation (very low risk).

But in other situation, such as after risky behavior like unprotected sexual intercourse, a HIV duo test is considered conclusive after 3 months from exposure.

I hope my answer helps you. Let me know if I can assist you further.

Regards,
Dr. Monika Dede
Infectious Diseases Specialist

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Monika Dede (19 minutes later)

thank you for your quick answers. I do not understand why for one exposure it would be conclusive after 28 days and for another it would be at 3 months? if I have symptoms would the Duo test pick it up?

Answered by Dr. Dr. Monika Dede (14 hours later)

Brief Answer:
You don't need any other HIV test.

Detailed Answer:

Hello,

This is because your situation has a low to zero risk chance of getting HIV infection and there is no need for other confirmation tests.

The duo test is very accurate even if you have symptoms.
For high risk situations (unprotected vaginal or anal intercourse) a HIV duo test is needed after 3 months as a conclusive test, because 5% of the people take this long to show a positive result.

I hope my answer helps you. Let me know if I can assist you further.

Regards,
Dr. Monika Dede
Infectious Diseases Specialist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Monika Dede (43 minutes later)

a newly infected person with high viral load does it mean that this person will have high antigens and antibodies? does the CDC advise duo testing at 28 days and if negative no need to retest?

Answered by Dr. Dr. Monika Dede (19 hours later)

Brief Answer:
Antibodies can be detected usually 1-3 months after infection

Detailed Answer:

Hello,

It is true that having high viral load means that the person has high antigens level (HIV) detectable from duo test usually in first weeks.

But, the immune system reacts to viral load in the blood by producing antibodies to fight HIV that usually takes 1-3 months after infection to be strong enough to be detected on an HIV duo test.

During this time viral load could decrease.

According to CDC, a HIV duo test after 28 days is very accurate but it depends on the risk level of sexual behavior. It is recommended to go through an HIV duo test after 3 months of exposure as a conclusive test.

I hope my answer helps you. Let me know if I can assist you further.

Regards,
Dr. Monika Dede
Infectious Diseases Specialist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Monika Dede (3 hours later)

so someone could have high levels of P24 and not show any symptoms? and the symptoms probably starts showing when the antibodies starts producing? the duo test will detect either P24 or antibodies or both right? lastly in my case do you suggest I repeat test?

Answered by Dr. Dr. Monika Dede (23 hours later)

Brief Answer:
You don't need to repeat the test.

Detailed Answer:

Hello,

Yes, some people can have high level of p24 without symptoms. The HIV duo test can detect p24 or antibodies in different period of time.

Furthermore, I emphasize again that you don't need to repeat the test.

I hope my answer helps you.

Regards,
Dr. Monika Dede
Infectious Diseases Specialist

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Above answer was peer-reviewed by : Dr. Raju A.T