Are negative HIV tests post 5 months of exposure conclusive?

Question

Hi doctor,

I had multiple protected sexual encounters with a commercial sex worker last year. However, I remember that the four previous protected encounters were five to six months ago. I have used a condom every time in all the encounters, but in the last encounter five months ago, I kissed a sex worker.

After three weeks of the encounter, I had a sore throat and common cold and took tablet Paracetamol and tablet Azithromycin 500 mg for three days. As a result, I lost around 6 kg and gained back around 8.8 lbs. I am married and have a daughter of 8 months who is breastfeeding. After three months of testing negative, I had unprotected sex with my wife, and she had a mouth ulcer that is now gone. I continuously fear infecting my wife and daughter and if I have been infected.

I have taken the following tests, doctor. HIV combo ECLIA (Electro chemiluminescence Immunoassay) on 11, 27, 37, 45, 70, 82, and 91 days post last exposure. All the tests were negative. HIV combo p24 CMIA on 33 and 55, and 105 days post last exposure with the negative values of 0.05 and 0.08 and 0.05. HBsAg (hepatitis B surface antigen) and HCV (hepatitis C virus) antibody were negative after 86 days post-last exposure.

Can I conclude my HIV tests and be sure that I do not have HIV (human immunodeficiency virus)? Why do some articles suggest taking another test at six months? I have already taken 10 HIV combo tests after the second and third months of the last exposure. Do I need to repeat my HIV test as I cannot get a surety anywhere on articles on the internet? Are my test conclusive for HIV 2 as well?

Unfortunately, I am not getting information about HIV 2 on the internet. My last test was CMIA (chemiluminescent microparticle immuno assay) HIV 1 and 2 and p24 combo on the 105th day of previous exposure five months ago. I have been through a lot in these past four months. So please look into it and give your advice, doctor. Thank you.

Answer 1

Hi, Welcome to icliniq.com.

I can understand your concern. If there is no further exposure, a negative HIV (human immunodeficiency virus) antibody test will be considered conclusive 90 days after the last unprotected exposure. Those articles could mention patients receiving high-dose steroids or immunosuppressive therapy.

The recent 4th generation HIV rapid test kit can obtain high sensitivity and specificity. A three-month test is considered conclusive if tests are done from an accredited laboratory. There is no need to repeat the HIV test if there was no further exposure. A rapid HIV antibody test usually looks for antibodies to both HIV-1 and HIV-2.

For HIV-2, recommendations are to get a rapid HIV antibody test only. The oral ulcer mentioned could be due to herpes virus infection.

So you could get the following tests for confirmation:

Herpes 1 and 2.
Immunoglobulin M (IgM).
Immunoglobulin G (IgG).

Hope my answers have helped you. You can book an audio call for a detailed conversation.

Answer 2

Hello,

Welcome back to icliniq.com.

If the contact was with condoms each time, consistently and correctly, the risk of acquiring HIV is non-existent. Unprotected oral sex carries a low risk, but a negative HIV antibody test at 90 days is assuring. You can call for a detailed discussion. Thank you.

Answer 3

If there had been no further exposure, your test results for HIV will be considered conclusive. Symptoms could be due to any viral illness. Get covid RTPCR(Reverse Transcriptase Polymerase Chain Reaction). There are no specific symptoms diagnostic of HIV. You can go ahead with your normal life. No more test for HIV screening will be required, if there is no further exposure.