Dr. Kiran Anaparthi
HIV/AIDS specialist
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Eleven weeks ago, I had protected intercourse with two female prostitutes. I do not doubt the condom, as I remember taking it off (we used two different condoms for oral and vaginal sex). Still, in the second encounter, I clearly remember the partner placing the condom on me, but I remember taking it off, which brought up a lot of anxiety. After this encounter, I had a rapid test at six weeks followed by a quick 4th generation test at eight weeks; I then did another rapid 4th generation test at ten weeks which came negative. Should I get tested again?
Kindly help.
Hello,
Welcome to icliniq.com.
Thank you for your query.
The combination of HIV 4th generation test is a test to detect acute HIV infection, and reduced time from 45 to 90 days to as early as 15 to 45 days, because it uses p24 antigen and it appears in the blood after ten days of exposure if you are infected. So, after these many negative tests with the 4th generation, you cannot be infected. So there is a need for further tests.
I hope this has helped you. Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
Would it be fine for me to ask a couple more questions I have had about HIV?
Hello,
Welcome to icliniq.com.
Sexual transmission has only 1 in 10000 acts. HIV is not an easy infection to spread. Yes, you may ask your questions.
Patient's Query
Hello doctor,
I have been told by many specialists how difficult HIV is to acquire. Why do some places consider HIV tests conclusive at six weeks and some consider them conclusive at twelve weeks?
Hello,
Welcome to icliniq.com.
Tests and procedures are the same but the procedures can differ.
Patient's Query
Hello doctor,
What does that mean? Can you please explain?
Hello,
Welcome back to icliniq.com.
Any infection is ruled out only by detection of antibodies in the body and they remain conclusive based in presence or absence of antibodies.
Patient's Query
Hello doctor,
I know, but how come some places consider the time to create enough antibodies to be different?
Hello,
Welcome back to icliniq.com.
If any laboratory declares you as negative before the stipulated period, take consideration of exposure (some persons may hide the actual truth). So, everyone advises repeating testing after 90 days to rule out serological antibodies. The period you are asking about is called the window period. It is the period between exposure and the detection of antibodies in the body.
Patient's Query
Hello doctor,
Here the window period is considered six weeks and not 12 weeks, which caused me some confusion.
Hello,
Welcome back to icliniq.com.
Virus strains are more, and every place has its own rules based on an adaption of the HIV program in that place.
Patient's Query
Hello doctor,
But how can my tests be conclusive if they were taken before the 90 days mark? Is it due to the 4th generation test?
Hello,
Welcome to icliniq.com.
In some places, it is hard to change the window period. It remains six months, later it became three months, and latest, they use 45 days.
Patient's Query
Hello doctor,
Thank you for your answer.
Hello,
Welcome back to icliniq.com.
Just remember, there are advances in the field, and maybe after a few years, they will use proviral DNA tests to detect HIV in less than ten days. So, as of now, 4th generation test is best and can see as early as 15 days, and you are free of infection. Test sensitivity and specificity are good, but acceptance is what changes the modalities and literature.
I hope this ahs helped you. Thank you.
Patient's Query
Hello doctor,
Thank you for the reassurance with a 10-week negative report.
Hello,
Welcome back to icliniq.com.
You are welcome.
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HIV/AIDS specialist
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