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What do my lab test results indicate?

Answered by
Dr.
Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3129 Questions

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Posted on Sat, 4 Jun 2016 in Sexually Transmitted Diseases
Question: Dear Doctor

I recently had a potential exposure to HIV via brief unprotected anal sex with a sex worker that last 10 -15 seconds.

I saw a doctor within 24 hours and he did not recommend PEP, he said it was intended for this purpose and gave me antibiotics in case of infection from other STD's.
He said it if the person had HIV your chances are 1 / 1000 of being infected with HIV as the virus is fragile.
He said he would test me at 6 weeks, not to be anxious and in his opinion based the information I supplied he would tell me in 6 weeks everything was ok and to never make the same mistake again and have unprotected sex of any kind.

After 24 days the anxiety was getting to much and I had the following testes at a hospital.

HBSAG ( RAPID TEST ) negative.
HIV ! & !! ( RAPID TEST ) negative.
VDRL Non Reactive.

The doctor at the hospital based on my level of anxiety decided to take further blood samples and send to an outside laboratory for and XXXXXXX and Western Blot test as he sais these tests were 100% accurate.

The results were:
XXXXXXX Negative.
Western Blot:
HIV 1-gp -160 (ENV ) negative
HIV 1-g p-120 (ENV) negative.
HIV 1 - P - 66 (POL ) negative
HIV 1 - P - 55 (GAG) negative.
HIV 1 - P - 51 (POL ) negative.
HIV 1-gp-41 (ENV) negative.
HIV 1 - P - 39 (GAG) negative.
HIV 1 - P- 31 (POL ) negative.
HIV - 1 - p24 (GAG) negative.
HIV - P - 17 ( GAG ) negative
HIV - 11 negative.
Conclusion HIV 1 & 11 negative

The doctor told me to forget about the incident and get on with my life and don't put yourself in the position again.

After 30 days I developed a rash in my groin and went back to the first doctor who wanted to test at 6 weeks to look at the rash.

He stated it was nothing to do with HIV it was a fungal rash and gave me a cream which cleared it in 2 days.

He also decided to test for HIV because he said post 4 weeks from exposure with modern tests was good and it would put my mind at rest.

The test he ordered was an XXXXXXX however the report came back saying XXXXXXX using CMIA methodology which was again negative.

I returned to the doctor after 6 weeks and told him I had a slight virus:

minor muscle weakness / ache in the shoulder and back and generally feeling off colour.
no swollen lymph nodes.
no sore throat.
no rash.
no temperature.

He told me my condition could have been cause by a normal virus or from recently starting to use a statin for cholesterol control and had nothing to do with HIV.

He said we tested you for HIV and its conclusive that you don't have HIV, stop worrying you are ok.

My concern is I have read so much information on the internet, that is maybe old and not keeping up with modern practice, from people who are not registered medical doctors that I am confused

Two doctors have told me I am ok and to get on with my life are you of the same opinion ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 32 minutes later
Brief Answer:
Some information

Detailed Answer:
Hello and welcome,

The tests you have had done pick up 95% of HIV infections by 28 days. So you should feel quite relieved and I wouldn't worry. However, it is generally recommended as good practice to recheck at 3 months as anytime more than 3 months from possible exposure, the test is 99.97% accurate.

So:
1. Get rechecked 3 months (or more) from the date of possible exposure. And..
2. Consider this a matter of routine practice rather than that there is any significant risk that has not shown up. So no worries.

About the aching you described, this is quite common with statins. So no worries there either.

I hope this information helps. Please let me know if I can provide further information or clarification.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 30 minutes later
Dear Doctor


Dear doctor
The virus started 6 days after the cmia HIV test, if the virus was associated with HIV would the test have been positive not negative based on the test being for antigen and antibodies ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 37 minutes later
Brief Answer:
Yes, this would be likely.

Detailed Answer:
The CMIA or 4th Generation test looks for both antibodies and antigens. The antigen portion of the test is detectable immediately after infection (3-4 days after exposure) for the 1st 2-4 weeks. The antibody portion of the test is detectable after 3-4 weeks. Some HIV specialists consider the CMIA conclusive at 6 weeks (this is the usual standard in XXXXXXX I believe). In the US it is recommended to be tests at 3 months (90 days) for conclusive results.

So, given that your virus symptoms came on 4 weeks plus 6 more days, I think the CMIA test would have picked up on that. When people who are infected with HIV feel sick from it, the viral load (antigen) is elevated and the antibodies rise then too. So I don't think the possible virus you had was from HIV or it would have been detected.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 16 hours later
Today which is exactly 7 days since the minor back ache and pain presented itself I have a minor sore throat. The back pain ache and pain went away after 5 .
Today is 45 days since my potential exposure, should I get re-tested now or wait until 12?weeks based on the minor sore throat ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 2 hours later
Brief Answer:
I would wait.

Detailed Answer:
In the US, we retest at 3 months (90 days). The tests you had should be at least 95% accurate, and probably more since you were tested more than once. But to be absolutely conclusive, we test at 3 months.

Put the 3 month test date on your calendar, but then put it out of your mind, as you can be almost 100 percent sure that you are free of HIV. In XXXXXXX I believe, the 6 weeks confirmation is considered good enough.

I would not worry about every rash or sore throat that you get. These are very unlikely to be from HIV.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 36 hours later
Dear Doctor

Could you please confirm of clarify the following:

With the antigen detection at 2-4 weeks and the antibody detectable at 3 -4 weeks there is not time gap in the CMIA test when it does not detect either antigen and antibodies other than the first 2 weeks when the analyser cannot detect the P24 antigen.

I have assumed that Antigen production is not reliant on a person seroconverting and Antibody production is reliant on a person seroconverting.

Therefore if a person was not to seroconvert until 6 weeks, I have assumed the test would still detect the p24 antigen until such times as antibodies are produced at such levels that can be detected ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 8 hours later
Brief Answer:
Yes, this is correct.

Detailed Answer:
You are right. There is some variability of the window period where HIV is not detected, but by 6 weeks the results are pretty accurate with the 4th generation test.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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