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Is a 3rd generation HIV test done 4 months post exposure conclusive?

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Posted on Mon, 7 Mar 2016
Question: DEAR DOCTOR,
First of all I am really thankful to you for reading my questions. Basically I have too questions which are as follows:

Question No 1:
I am 25 years old male. I had a protected sex with a unknown prostitute in Dubai on March 13. After some time I experienced the following symptoms:

1) The very next day when I was taking bath, I scratch upper portion of my hand and I noticed very small red spots appeared.
2) Moderate Level flu after few days
2) After few weeks I experienced fever along with swollen lymph nodes behind my ear and groin area. (Please note that I never got these swollen lymph nodes in my previous life no matter how much the fever is and this is the first time I experienced these swollen lymph nodes)
3) Also got fungal infection between my two foot figures.
4) Unusual patches on my tongue. I have attached pictures for your convenience.

After exact 4 months I went for HIV testing and tested negative. HIV (AG/AB) test was done for me and I dont know whether it is a third generation test or a forth generation test. I have also attached test result report for your review. Here I also want to mention that although I used condom but there is some broken skin on my penis.

Nowadays all of the above mentioned symptoms disappeared expect for these listed below (after 9 months of the incident):
1) Unusual patches on my tongue.
2) Sometimes watery mouth.
3) Sometimes very slight itch feels on my tongue.
4) Frequency of stool increased and every time I passes stool, it is mostly watery form.
5) My weight has also increased too much after that sex incident -- may be it is because of reason that my frequency of masturbation has also increased.
6) I also feel numbness in my body parts when I sit still for some time.

Now I only want to ask that whether I have a risk of being HIV positive. Is there a need of further testing? Is HIV (AG/AB) test after 4 months conclusive, if YES, then why I am still experiencing symptoms and why swollen lymph nodes appeared along with fever after few weeks of sex?
Please answer and also explain why I experienced all mentioned symptoms if I have no HIV risk.

Question No 2:
I have sleep problems for almost 5 years. I consulted various psychiatrist. I was diagnosed with SCHZIOAFFECTIVE DISORDER and DEPRESSION. I took aripiprazole, Procyclidine (HCl) and prozac and my sleep was perfectly fine but after some years these medicines stopped working for me and I started taking sleeping pills but sleeping pills also some times work and some times. Here I want to mention that despite of the fact that I cant sleep properly at night I can sleep sometime during the day. One another psychiatrist diagnosed me with anxiety disorder but I think I have DELAYED SLEEP PHASE SYNDROME because I can sleep properly in morning and after but not at night. Now please tell me what is the exact problem with me?

Please answer both questions separately and also explain causes and solutions as I am quite worried. I will be really thankful. Thanks for your time.
doctor
Answered by Dr. S. Murugan (4 hours later)
Brief Answer:
Your test report 4 months after the exposure ruled out HIV infection.

Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
First of all, 2nd question asked by you is concerned with different speciality and you have to send the query to a psychiatrist and all the questions belongs to different specialities can not be answered by a single specialist.

I saw the copies your report and picture sent by you.
You had HIV Chemilumenescent immuno particle assay (CMIA) AG/AB test. It is a 3rd generation test. Highly reliable. You had this test 4 months after the high risk contact. The nonreactive report clearly ruled out both HIV 1 and 2. So all your symptoms are not at all related to HIV.
The symptoms explained by you are not specific to HIV. Fever, lymph node enlargement, fungal infection can occur to anybody as they are common problems. This could be more common after a close intimacy during sex relationship due to kissing or airborn infection or skin to skin contact.
Your tongue has geographical tongue which may preseny in some individuals without any problem. This has no clinical importance and can be ignored.
Your culture report reveals staphylococcal bacterial infection for which you have to take appropriate antibiotic in adequate dose for adequate duration.
Increase in weight establishes once again that there is no HIV infection.
If you have the problems persist, you have consult a specialist general medicine doctor or internal disease specialist.
Once again I assure you that you are free from HIV infection. Just forget the same and proceed with your day today activities.
Get well soon.
DR S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (3 hours later)
Dear Doctor,

I am really really thankful for your response. Now I am relaxed a little bit. Will be really thankful if you could also please address my following concerns:

1) If I have no risk of HIV then why only after that specific incident I got swollen lymph nodes and fever? I never got swollen lymph nodes in my life earlier.
2) Is HIV (AG/AB) 3rd generation test conclusive after 4 months of exposure. What is the window period for this (AG/AB) third generation test? I have read on some websites that 6 months test is also required to detect HIV. Is it required doctor as I have taken 3rd generation test and not 4th generation test.
3) I have also noticed that after that specific incident whenever I have any cut of my body it takes longer than usual to heal. In one cut after healing small black mark appeared. Why is this happening?
4) Is masturbation responsible for my weight increase? I read on one website that HIV is also linked with body fat and may increase or decrease it.

I am also sending you some new reports related to HAEMATOLOGY and MICROBIOLOGY taken on a same date when HIV test was taken. I will be really thankful if you could please review them and let me know for any thing which needs my attention. I will be really thankful if you please address all 4 of my above mentioned concerns.

Thanks once again doctor. May God bless you.
doctor
Answered by Dr. S. Murugan (49 minutes later)
Brief Answer:
Window period for HIV is 6-8 weeks, may be delayed up to 12 weeks.

Detailed Answer:
Hi,
Welcome back.

1. Swollen lymph nodes in previous incidents would not have been so obvious and you were not aware as now and would have missed to notice.
2. Winow period is almost same for all generation test. May be slight difference in days. Window period is only for the antibody part of the test, not to the antigen part of the test. Window period for HIV is 6-8 weeks, may be delayed up to 12 weeks. It may take more time to manifest if the individual is on immunosuppressive drugs or ART. Otherwise it will not go beyond 12 weeks in normal individuals. Not to bother about other information.
3. Wound healing may vary in person and at situations depending upon the secondary infection and extent of the wound and depends upon the host response. It has nothing to do with HIV.
4. Masturbation has nothing to with increase in weight. It depends upon your diet and activities.
DR S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (9 minutes later)
I will be really thankful if you could please review my other reports related to HEAMATOLOGY and MICROBIOLOGY and please let me know for anything which requires my attention.

Thank you.
doctor
Answered by Dr. S. Murugan (9 minutes later)
Brief Answer:
Hematology values are normal.Microbiolgical abnormailty taken care by physi

Detailed Answer:
Hi,
Welcome back.
Your hematology reports are well within normal limits.
Microbiological report shows bacterial growth. Responding to many antibiotics. Your physician will decide the course of management according to the clinical situation.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (12 minutes later)
Thanks alot doctor. You relaxed me alot. As you are also a doctor can you also please guide me a little regarding my second question. I will be really really thankful plz plz plz.
doctor
Answered by Dr. S. Murugan (2 hours later)
Brief Answer:
Consult a psychiatrist in this regards.

Detailed Answer:
Hi,
Welcome once again.

I am also a doctor, but consultant and specialized in HIV Medicine, Sexual Medicine and STD. My experience in psychiatry is almost nil except related to the above field. So kindly seek the help of a psychiatric expert.
I wish you a speedy recovery.
Dr S.Murgan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan (2 days later)
Dear doctor,

I have one more question for you. Just one more problem which I want to ask you about. Since you are also an STD doctor therefore I consider it appropriate to ask it from you. My problem is that whenever I see a slight sexy material I experience precum problem. Some precum always come out of my penis even when I only see a very slight sexy material even when I had no intention of masturbating or something else.

Please answer as I am quite worried.
doctor
Answered by Dr. S. Murugan (4 hours later)
Brief Answer:
Precum is good sign and helps in safe traspoert of sperms.

Detailed Answer:
Hi,
Welcome back.
Precum is gift by nature to us. It cleans and clears all unwanted dirt in urethral passage (deposited during repeated urnation), and makes the pH safe for the sperms to be transported safely to the female counterpart during the process of sex. So nothing to worry. Whenever you get excited precum will appear and it is good sign.
Dr S XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2985 Questions

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Is a 3rd generation HIV test done 4 months post exposure conclusive?

Brief Answer: Your test report 4 months after the exposure ruled out HIV infection. Detailed Answer: Hi, Welcome to HCM. Thanks for posting your query. First of all, 2nd question asked by you is concerned with different speciality and you have to send the query to a psychiatrist and all the questions belongs to different specialities can not be answered by a single specialist. I saw the copies your report and picture sent by you. You had HIV Chemilumenescent immuno particle assay (CMIA) AG/AB test. It is a 3rd generation test. Highly reliable. You had this test 4 months after the high risk contact. The nonreactive report clearly ruled out both HIV 1 and 2. So all your symptoms are not at all related to HIV. The symptoms explained by you are not specific to HIV. Fever, lymph node enlargement, fungal infection can occur to anybody as they are common problems. This could be more common after a close intimacy during sex relationship due to kissing or airborn infection or skin to skin contact. Your tongue has geographical tongue which may preseny in some individuals without any problem. This has no clinical importance and can be ignored. Your culture report reveals staphylococcal bacterial infection for which you have to take appropriate antibiotic in adequate dose for adequate duration. Increase in weight establishes once again that there is no HIV infection. If you have the problems persist, you have consult a specialist general medicine doctor or internal disease specialist. Once again I assure you that you are free from HIV infection. Just forget the same and proceed with your day today activities. Get well soon. DR S.Murugan