Patient's Query
Hello doctor,
After a high-risk exposure with a CSW involving unprotected oral sex and rubbing of genitals for a brief time without full penetration, but possible contact with genital fluid at vaginal opening, I did rapid HIV 1 and 2 tests with fingerprick blood at five months (2 numbers), Comb Aids test (serum) at six months, Meriscreen rapid test third generation (serum) at eight months of exposure at a testing center. All were negative. Do I need further testing, or am I conclusively negative?
Are the rapid kits reliable, like ELISA, after a window period? How soon can they detect the infection? Some studies show they are not reliable, like ELISA. Kindly guide.
Thank you
Hi,
Welcome to icliniq.com.
I read your query and can understand your concern.
You are right. Rapid tests are not as good as ELISA (enzyme-linked immunosorbent assay), which is used to rule out HIV (human immunodeficiency virus). But this is true only for six to eight weeks after your exposure.
With the help of rapid tests, we can rule out HIV after a maximum of three months of exposure. After three months of exposure, the antibody develops, and a rapid test is conclusive in ruling out HIV. Rapid card tests show good results, and do not worry about their result.
You have tested after three months and eight months of exposure. So, do not worry about HIV. You can consider yourself free from HIV.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I used the Comb AIDS test.
Please help.
Hi,
Welcome back to icliniq.com.
After three months of exposure, any test can be conclusive in ruling out HIV. A fourth-generation kit is used only when you want to rule out HIV early, like after six weeks of exposure. After three months, both tests, the third and fourth generation, are conclusive in ruling out HIV. So do not worry.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thanks for your reply.
I was told by the in charge in a private hospital that since I had a high-risk encounter, I have to keep doing testing every six months as the tests used were only rapid tests and they can detect infection only in established Hiv infection, i.e., patients having infection for years and not recent ones. 3 or 6-month guidelines are only for lab-based Ag-Ab tests, not Rapid tests. Since all testing centers use CombAids and Meriscreen only, how reliable are they? I can't find any testing center that does manual ELISA. Only blood banks do the 4th gen screening, it seems. Please advise, as the other countries are using a 4th-generation laboratory test and not a rapid test. What should I do?
Please help.
Hello,
Welcome back to icliniq.com.
I can understand your concern.
Following is my opinion on the question you asked.
Rapid card test detects HIV antibody, which usually develops after six weeks, and the maximum time required to develop antibody is three to six months. So rapid test is conclusive in ruling out HIV after three months. You had done testing after eight months of exposure. So, it is enough time to give a conclusive result. After three months, it does not matter that you are using which generation of HIV test. Fourth-generation tests detect the antigen as well, apart from the antibody. I think to give you 100% relief and to surely rule out HIV, you can investigate in a good laboratory nearby. Most of the laboratories nowadays do CMIA combo test for HIV, which is fourth-generation testing for HIV and equally effective as ELISA fourth-generation. So you can investigate with the CMIA combo HIV fourth-generation test, which is not too expensive as well.
I hope this helps you.
You can ask further until your doubt is solved.
Thank you.
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Answered byDr. Goswami Parth Rajendragiri
Medically reviewed byDr. Vinodhini J.
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