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Is Negative HIV RNA PCR Test After One Month Of Possible Exposure Conclusive?

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Posted on Tue, 21 Apr 2015
Question: I took a complete std test on 2/27and then on 3/23. There was one risky encounter ( unprotected sex) during 1st week of feb and another protected sex on 3/4. My partner reported that she was positive for herpes on 2/26. Hence I took the on 2/27 all results were negative. Since I was unaware of the window period I had a protected encounter with girl on 3/4. I was freaking out as by body tingled but not in groin and on 3/22 I saw a blister on my innerthigh. I took the lab work and included hiv rna test got the result still all negative on 3/25.
However since i was overwhelmed with emotions I took 10 200mg of ibuprofen and tried to sleep. But I had sever stomach pain and payed a visit to ER there my blood work tells me low lymphocyte count and high neutrophils. Is it a possibility that hiv rna test was so soon??? Or low lymphocyte and high neutrophils was side effect of ibuprofen?? To add in ER I HAD A CAT SCAN and everything see normal. I have lost 5 pounds in 2 weeks this Monday it was 150 and today it's 152.4.

Want an opinion on entire situation. How sho I comprehend hiv rna results? Am I positive???
Hi, I received my new blood test report and neutrophils and lymphocytes are back to normal also I took an OraquickSexual test on 4/3 and it came out negative. But yesterday I did experience night sweats and I see very mild bums on my back when I compared it to hiv rash picture it does not seem like hiv rash. My major worry is weight loss on mar 7th I was 156 pounds and now I am 150.
doctor
Answered by Dr. Bharatesh Devendra Basti (45 minutes later)
Brief Answer:
Chances of HIV is almost nil.

Detailed Answer:
Hi XXXXXX
Thank you for query. I am Dr Bharatesh D Basti answering your query.
Welcome to health care magic.
I have gone through the details.

The chances of HIV transmission by unprotected intercourse is 1/200 to 1/1000.The risk of HIV transmission is low.
HIV RNA PCR is negative after more than 1 month. It is >99% sensitive after 10 days .So the chances of HIV is almost nil.I do not see possibility of HIV infection.

The symptoms of weight loss may be due to anxiety or stress.It has regained too.It is not specific to HIV.
The temporary change in lymphocytes and neutrophil count may be due to some minor infections. It is not specific to HIV.

The other Intercourses are protected so no risk.
If the partner is negative for HIV there is no risk .

You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Dermatologist and venerologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (27 minutes later)
Thanks for the reply.

1. What to know if there is any risk at all in a protected encounter?

2. The unprotected incident during 1st week of feb. She had another partner when she got tested she did an antibody test which came negative on 2/26. So I had only risky encounter with this lady during 1st week of feb and then protected encounter with another female on 3/4 whose hiv status I am unaware of. I took an hiv rna test on 3/23 and both antibody and rna test came non reactive. So can I rely on the results?

3. As I said before on 3/25 I went to the ER and got a blood test which showed wbc count of 21 with high neutrophils and low lymphocyte count.

4. On 3/30 I went to a primary care physician and told about my recent exposures. He ordered a blood test which came out fine on 4/3.
5. However yesterday night I experienced night sweat and some small rash on by back. But I don't have any fever running nose or swollen lymph node (checked by primary care physician).
But on the contrary I keep on loosing weight. Today 4/4 I am at 150 and am scared that I will lose further. Weight loss is unexplained.
6. I took an Ora quick test and it came back negative yesterday.
My primary concern is weight loss along with here and there rash on my back and with yesterday's night sweat making me nervous.

Can you help me out understand this? Is there a way I can send u picture of my rashes?
doctor
Answered by Dr. Bharatesh Devendra Basti (52 minutes later)
Brief Answer:
Unlikely due to HIV.

Detailed Answer:
Hi XXXXXXX
Thank you for follow up query.

Though antibodies test may not be reliable at 1 month, RNA PCR is reliable after 10 days exposure. So the test is sensitive for unprotected exposure .
She is negative too .The chances of transmission from her is nil.
Condoms do protect against HIV if used in a right manner and need not worry.
There is nothing like HIV specific rash .You can send the clear photos of lesion for clarification to YYYY@YYYY w.r.t Dr Bharatesh D Basti.

The weight loss is not specific and need not be due to HIV.
If still anxious you can go for HIV 1&2 RNA PCR now.

You can get back for any clarification.
Thank you
Dr Bharatesh D Basti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (26 minutes later)
Hi I have sent the rash pictures in the mail provided. One question if this is decor conversion then will testing tools like Ora quick pick it up?
doctor
Answered by Dr. Bharatesh Devendra Basti (24 minutes later)
Brief Answer:
Rash not due to HIV.

Detailed Answer:
Hi
Thank you for follow up query.
I have gone through the photos.

The rash may be due to folliculitis .I would have advised to apply topical antibiotic cream like fucidin or mupirocin.
These are not due to HIV.

You can go for HIV 1&2 RNA PCR at this stage to relieve your anxiety. The weight loss may be due to anxiety or stress or not taking balanced diet.
Ora quick test detects antibodies .These can detect as early as 2-6 weeks exposure. But are not conclusive even at 3 months exposure.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (8 minutes later)
Thanks doctor!!!

I am planning to monitor my weight get into a balanced diet and since I have already taken the required test I would hold on my anxiety for couple of weeks and do a test in 1st week of May.
If my weight does not improve in coming weeks till may I would go visit my primary care physician.

One more thing, I think I might have hpv or pearly penile papules if I send a picture can u identify it and if that can be the cause of weight loss.
doctor
Answered by Dr. Bharatesh Devendra Basti (27 minutes later)
Brief Answer:
Send clear photos for clarification.

Detailed Answer:
Hi XXXXXXX
Thank you for follow up query.

Yes relieve your anxiety and stress.
Do yoga, meditation, exercises.
Get involved in activities you like/hobbies.
Take protein rich balanced diet.
You can send the clear photos of lesion(wart or PPP).I will try to help you.These do not cause weight loss.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (6 minutes later)
Hi doctor

I have send the picture kindly let me know if it is hpv or PPP also let me know how to treat it.
doctor
Answered by Dr. Bharatesh Devendra Basti (44 minutes later)
Brief Answer:
Pearly penile papules.

Detailed Answer:
Hi
Thank you for follow up query.
I have gone through the photos.
It appears to be due to pearly penile papules.
It is benign and harmless. There is no need to treat it unless for cosmetic purpose.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (2 hours later)
Hi doctor,

What is the sensitivity and specificity of hiv rna test after 18 day of exposure.
doctor
Answered by Dr. Bharatesh Devendra Basti (5 hours later)
Brief Answer:
99%.

Detailed Answer:
Hi
Thank you for follow up query.
The sensitivity and specificity of HIV RNA PCR test is around 99% post 10 days exposure.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (26 minutes later)
Thanks!!!
I opened up to my roommates about the incident and I am feeling light about it.

One last thing if condoms are used properly there is no risk of transmission of hiv?

Thanks for the clarifications.
doctor
Answered by Dr. Bharatesh Devendra Basti (23 minutes later)
Brief Answer:
Yes.Nil chances if used in right manner.

Detailed Answer:
Hi
Thank you for follow up query.
Yes if condoms are used in a right manner, the chances of transmission of HIV is nil.
You can get back for any clarification else please close the discussion and rate.
Thank you
Dr Bharatesh D Basti
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Bharatesh Devendra Basti

Dermatologist

Practicing since :1998

Answered : 1764 Questions

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Is Negative HIV RNA PCR Test After One Month Of Possible Exposure Conclusive?

Brief Answer: Chances of HIV is almost nil. Detailed Answer: Hi XXXXXX Thank you for query. I am Dr Bharatesh D Basti answering your query. Welcome to health care magic. I have gone through the details. The chances of HIV transmission by unprotected intercourse is 1/200 to 1/1000.The risk of HIV transmission is low. HIV RNA PCR is negative after more than 1 month. It is >99% sensitive after 10 days .So the chances of HIV is almost nil.I do not see possibility of HIV infection. The symptoms of weight loss may be due to anxiety or stress.It has regained too.It is not specific to HIV. The temporary change in lymphocytes and neutrophil count may be due to some minor infections. It is not specific to HIV. The other Intercourses are protected so no risk. If the partner is negative for HIV there is no risk . You can get back for any clarification. Thank you Dr Bharatesh D Basti Dermatologist and venerologist