Can I rely on fourth-generation HIV test result after six months of exposure?

Q. Can autoimmune disease interfere with the results of fourth-generation HIV test?

Answered by
Dr. Purushottam Sah
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 26, 2020 and last reviewed on: Nov 11, 2020

Hello doctor,

How accurate is HIV test after six months? What are the things that affect or delay the HIV test? I am taking Ashwaghanda, does it delay my test? When should I test if I have an autoimmune disease?

#

Hello,

Welcome to icliniq.com.

There is a window period of three months after an exposure in which the HIV antibody test may come negative, but six months is a good enough time for the test to become reliable. Ashwagandha does not affect the test. Even if you have autoimmune disease, it means you have antibodies to your own body tissues. But HIV is an external antigen and specific antibodies are formed for a specific antigen. So your autoantibodies will be different from HIV antibody. The test will detect HIV antibody only.

Thank you doctor,

I have done an HIV test on six months with HIV fourth-generation antigen/antibody. So would this p24 antigen be detectable in the high amount on the p24 portion of the fourth-generation test in rare cases of someone who never produces antibodies for HIV? Here is my HIV report.

#

Hello,

Welcome back to icliniq.com.

I have seen the report (attachment removed to protect patient identity).

Your report is negative for both antigen and antibody, so you are not infected. This test is very reliable if done after one month of exposure to possible HIV. You have done at six months so it is reliable. If you have an antigen, you will produce antibodies. If you do not produce antibodies and are infected, it is not possible, yet suppose it is, then you would be severely sick by this time.

Thank you doctor,

Do I need more tests? Have you seen or heard anyone who is negative on six months test and turn positive later on? Can I trust my test?

#

Hello,

Welcome back to icliniq.com.

You can trust your test. I have not seen anyone turning positive after being negative at six months. For disease purpose, you are negative if had no further exposure in between. It would be good to know what type of exposure you had and when and if there was any more exposure or the time of last exposure, or if you had multiple exposures?

Thank you doctor,

I had three encounters. One was on last year in November with a sexworker, but I used a condom. Second was on February with a random girl whose HIV status is not known, but I used a condom. Third exposure was also with a random girl whom I met on gym and it is was also on February, but this time I was without a condom. Then I tested on February end with fourth generation HIV test and it came out negative. I waited again and retested on May 26, after three months with HIV 1 and 2 with fourth generation, it is negative. Again I tested it on June 20 with the same fourth generation and again I did a test on July 20. It came out negative and latest test on August 04th with antigen/antibodies was non-reactive. I am just sacred do I need more tests? I heard that it would take six more months to be accurate, is that true?

#

Hello,

Welcome back to icliniq.com.

There is nothing to be scared of, just relax and chill. You are not infected, two tests are enough to confirm. It is six months since the last exposure, and fourth generation tests become positive by one month. After so many tests it is negative so you are negative just relax.

Thank you doctor,

After a few weeks, I heard that the P24 antigen would stop producing and decrease and it will not show in the test, and the antibodies produced are low and undetectable in the test. Is this possible? I heard that HIV is hard to get from females to males. Is that true? I am worried about it. Do you do HIV test? What kind of test you do? You have never seen patients turn positive later after three months of negative test, right?

#

Hello,

Welcome back to icliniq.com.

There are two tests antigen and antibody. Antigen enters the body with the virus, an antibody is formed in the body to fight the antigen. Hence antigen test becomes positive earlier than the antibody test. When the antibody starts to rise, it neutralize the antigen which gradually comes down. The advantage of fourth-generation test is that it detects both antigen and antibody. If one is low other is high. In either case, if you are infected, the test would be positive.

Even if the female is positive, you may not get infected. Male to female transmission is more because man deposits 2-5 ml of semen in the vagina. We do both antigen and antibody test. At three months, if someone is negative we repeat the antibody test only at six months but never seen anyone turning positive after being tested negative at three months.

Thank you doctor,

Is it possible that p24 antigen and antibodies both are undetected because of some weird things? So six months is final for all people I mean people who are suffering from cancer, immune deficiency people who are taking prep? Is six months final for all patients? I heard that HCV also delay on test? Why is that it is hard to get HIV from females to males? Can you look my CBC and look if I have any immune deficiency or any things that may delay? Please do I need more test or not this are my final question that most scared me is that I went to see prostitution but it was nine and half months, I use a condom and I cum inside but I was wearing it I pull out and throw away without looking maybe it was broken or torn.

#

Hello,

Welcome back to icliniq.com.

It is not possible for both to be undetectable if you are infected, of course it will be undetectable if you are not infected. Six months is final for all groups of people, those who are on immunosuppressive treatment may develop delayed antibody but their antigen test will not be affected. From females, you do not get much transfer of fluids. Your CBC (complete blood count) (attachment removed to protect patient identity) is normal. 9.5 months is a good enough time for the test to become positive if you are infected, so relax, take care.


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