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Is A HIV PCR RNA Test Conclusive 3 Months After Exposure?
Question: Hi sir had exposure 3 months back it was protected ( but don't know the status of condom whether intact or broken ) , developed pain abdomen and diarrhea after 10 days of exposure but no fever cough , lymph nodes or rashes . with the use of antibiotics my diarrhea subsided in 10 days but i had persistent pain abdomen for about 1 and half month with occasional loose stools.
done HIV testing after 20 days of exposure-
HIV CLIA - NON REACTIVE.
HIV PCR RNA - Below 20 copies ( means undectable ?)
Westernblot assay - Negative ( not even single bands detected ) .
I have done repeat HIV tests at 11 weeks 1 day results -
HIV CLIA - NON RECTIVE ( Value < 0.09)
Repeat Westernblot - Negative ( No bands detected ).
My questions -
- Are these results conclusive of not being infected ?
- HIV PCR below 20 copies at 20 days post exposure means ? ( Is it as good as undetected ? what should be the levels in early stages to call it positive ?)
- My symptoms persisted for long time , are my symptoms looks like ARS ?
- Any other further tests needed or i can confirm its negative ?
done HIV testing after 20 days of exposure-
HIV CLIA - NON REACTIVE.
HIV PCR RNA - Below 20 copies ( means undectable ?)
Westernblot assay - Negative ( not even single bands detected ) .
I have done repeat HIV tests at 11 weeks 1 day results -
HIV CLIA - NON RECTIVE ( Value < 0.09)
Repeat Westernblot - Negative ( No bands detected ).
My questions -
- Are these results conclusive of not being infected ?
- HIV PCR below 20 copies at 20 days post exposure means ? ( Is it as good as undetected ? what should be the levels in early stages to call it positive ?)
- My symptoms persisted for long time , are my symptoms looks like ARS ?
- Any other further tests needed or i can confirm its negative ?
Brief Answer:
Symptoms were not specific to HIV. You are almost HIV free
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
You had protected exposure. When you had removed the condom you had noticed any tear meant that it was intact. Then why are you worrying about HIV.
Diarrhea and pain abdomen following an exposure after 10 days were unlikely to be due to HIV infection. A simple motion examination sometimes helps to fix the diagnosis and treatment.
HIV RNA PCR Test is a quantitative test, useful only to assess the prognosis of the disease during treatment. HIV DNA PCR OR P 24 Antigen test are diagnostic during window period for HIV infection (6-8 weeks after infection). All RNA PCR tests are able to detect the virus only at certain lower limit of copies not lower than that. Your test can not detect antigen less than 20 copies.
All antibody detecting test including Western blot can detect antibodies only after they appeared in the body following an infection with HIV (widow period normally 6-8 weeks may be extended up to 12 weeks).
As you had repeated HIV CLIA and Western Blot by 78 days after the exposure it almost sure that you are free from HIV infection.
Nothing to worry.
Dr S.Murugan
Symptoms were not specific to HIV. You are almost HIV free
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
You had protected exposure. When you had removed the condom you had noticed any tear meant that it was intact. Then why are you worrying about HIV.
Diarrhea and pain abdomen following an exposure after 10 days were unlikely to be due to HIV infection. A simple motion examination sometimes helps to fix the diagnosis and treatment.
HIV RNA PCR Test is a quantitative test, useful only to assess the prognosis of the disease during treatment. HIV DNA PCR OR P 24 Antigen test are diagnostic during window period for HIV infection (6-8 weeks after infection). All RNA PCR tests are able to detect the virus only at certain lower limit of copies not lower than that. Your test can not detect antigen less than 20 copies.
All antibody detecting test including Western blot can detect antibodies only after they appeared in the body following an infection with HIV (widow period normally 6-8 weeks may be extended up to 12 weeks).
As you had repeated HIV CLIA and Western Blot by 78 days after the exposure it almost sure that you are free from HIV infection.
Nothing to worry.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks sir for your assurance,
The condom i weared was of smaller size and also i did not check whether it was broken or not so worried about my symptoms.
ARS symptoms how long they last ? if pain abdomen and diarrhea can it last for 1 to 2 month or even more ?
If PCR RNA levels are quantitative tests how much should be the levels after 20 days of possible infection ?
HIV CLIA and Western blot tests are 4th generation tests ? if not which are the 4th generation antibody detection tests ?
Do i need any further testing like after completion of 12 weeks ? or my above results are 100% conclusive at 11 wks ?
The condom i weared was of smaller size and also i did not check whether it was broken or not so worried about my symptoms.
ARS symptoms how long they last ? if pain abdomen and diarrhea can it last for 1 to 2 month or even more ?
If PCR RNA levels are quantitative tests how much should be the levels after 20 days of possible infection ?
HIV CLIA and Western blot tests are 4th generation tests ? if not which are the 4th generation antibody detection tests ?
Do i need any further testing like after completion of 12 weeks ? or my above results are 100% conclusive at 11 wks ?
Brief Answer:
HIV RNA PCR reflects millions of viral copies in presence of late infection
Detailed Answer:
Hi,
Welcome back.
When you had removed the condom, if it contained the semen then it was intact throughout the act.
ARS is not used nowadays. Noe the acute infection or Primary HIV infection symptoms usually not having manifested with diarrhea. Fever and throat infection are common symptoms and last for around two weeks. Diarrhea usually a late manifestation in HIV disease, after 3-5 years of infection when the immunity starts going down to critical level.
Quantitative RNA PCR will go up to reflect millions of copies of virus in presence of infection and in the absence of any treatment during the advanced stages.
4th generation test are COMBO/DUO test contains both P24 Antigen Ab 1/2 test.
An antibody based test (Elisa,Rapid or Western Blot) after 12 weeks would be more confirmatory to rule out both HIV 1 and 2 infection.
Dr S.Murugan
HIV RNA PCR reflects millions of viral copies in presence of late infection
Detailed Answer:
Hi,
Welcome back.
When you had removed the condom, if it contained the semen then it was intact throughout the act.
ARS is not used nowadays. Noe the acute infection or Primary HIV infection symptoms usually not having manifested with diarrhea. Fever and throat infection are common symptoms and last for around two weeks. Diarrhea usually a late manifestation in HIV disease, after 3-5 years of infection when the immunity starts going down to critical level.
Quantitative RNA PCR will go up to reflect millions of copies of virus in presence of infection and in the absence of any treatment during the advanced stages.
4th generation test are COMBO/DUO test contains both P24 Antigen Ab 1/2 test.
An antibody based test (Elisa,Rapid or Western Blot) after 12 weeks would be more confirmatory to rule out both HIV 1 and 2 infection.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Sir am going to complete 12 weeks of of window period in another 3 days, should i retest for HIV antibodies after that ?
what are the chances of turning out my 11 weeks negative reports to be positive within 1 week period ?
In some peoples window period will be up to 6 months is it true ?
presently am not having any symptoms since last 1 month except for some anxiety which is affecting my daily routine activities.
i read some of your answers to other people saying acute infection can present with diarrhea, fever and weight loss ?
My one more question - during breast feeding if women is infected with primary hiv infection what are the possibility of her child getting infection ? only with one breast feed she will transmit infection or it takes some time ?
what are the chances of turning out my 11 weeks negative reports to be positive within 1 week period ?
In some peoples window period will be up to 6 months is it true ?
presently am not having any symptoms since last 1 month except for some anxiety which is affecting my daily routine activities.
i read some of your answers to other people saying acute infection can present with diarrhea, fever and weight loss ?
My one more question - during breast feeding if women is infected with primary hiv infection what are the possibility of her child getting infection ? only with one breast feed she will transmit infection or it takes some time ?
Brief Answer:
A 12week HIV antibody test would clear all your doubts,so it is recommended
Detailed Answer:
Hi,
Welcome back.
The chances of the test after 12 weeks become reactive from a non reactive HIV test at 11 weeks is less than 1%.
As your test results after 11 weeks were negative. Then there is no question of acute infection for you. Those who are on steroids ,other immuno-suppressive drugs or ART would likely to have their window period can get extended beyond 12 weeks. Not with all.
Even after prolonged breast feeding by an infected mother, only 25-30% of the infant get infected through breast milk. Remaining 70-75% remain HIV free. So the chances of HIV transmission through a single feeding is almost remote possibility.
Dr S.Murugan
A 12week HIV antibody test would clear all your doubts,so it is recommended
Detailed Answer:
Hi,
Welcome back.
The chances of the test after 12 weeks become reactive from a non reactive HIV test at 11 weeks is less than 1%.
As your test results after 11 weeks were negative. Then there is no question of acute infection for you. Those who are on steroids ,other immuno-suppressive drugs or ART would likely to have their window period can get extended beyond 12 weeks. Not with all.
Even after prolonged breast feeding by an infected mother, only 25-30% of the infant get infected through breast milk. Remaining 70-75% remain HIV free. So the chances of HIV transmission through a single feeding is almost remote possibility.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir this is my last question after which am going to close my topic , thanks for your valuable information its really helped me lot.
my question is how many patients you have come across acute hiv infection presenting with pain abdomen and diarrhea persisting longer without any other complaints ?
If diarrhea is the presenting complaints how long it will last during primary infection ?
How many of them turned out to be negative by the end of window period ?
my question is how many patients you have come across acute hiv infection presenting with pain abdomen and diarrhea persisting longer without any other complaints ?
If diarrhea is the presenting complaints how long it will last during primary infection ?
How many of them turned out to be negative by the end of window period ?
Brief Answer:
No case remain HIV nonreactive beyond 12 weeks when there was an infection
Detailed Answer:
Hi,
Welcome once again.
To say frankly, I never had come across a single case of acute HIV infection in my experience of 25 years with HIV patients or I am yet to diagnose one such patient in my career. All my knowledge with acute HIV infection is only from HIV literature. This knowledge also told mostly FLU like symptoms and not diarrhea quite often.
Similarly I had come across not less than 4000 cases of HIV positives so far, but nobody became HIV reactive beyond 90 days when the individual had infection.
Dr S.Murugan
No case remain HIV nonreactive beyond 12 weeks when there was an infection
Detailed Answer:
Hi,
Welcome once again.
To say frankly, I never had come across a single case of acute HIV infection in my experience of 25 years with HIV patients or I am yet to diagnose one such patient in my career. All my knowledge with acute HIV infection is only from HIV literature. This knowledge also told mostly FLU like symptoms and not diarrhea quite often.
Similarly I had come across not less than 4000 cases of HIV positives so far, but nobody became HIV reactive beyond 90 days when the individual had infection.
Dr S.Murugan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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