HomeAnswersInternal Medicinefourth generation hiv testWill certain medicines interfere with HIV test results?

How accurate is the fourth-generation HIV test after six months of exposure?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At August 25, 2020
Reviewed AtJanuary 22, 2024

Patient's Query

Hello doctor,

Does Ashwagandha delay on HIV test? Does any medicine delay on HIV test? How accurate is the HIV test in six months with the fourth generation?

Hello,

Welcome to icliniq.com.

Usually, Ashwagandha shows some beneficial results like neuroprotective effect or boosting immunity in HIV (human immunodeficiency virus) positive patients on a part of the treatment plan.

But it is not going to delay any HIV test. Usually, after exposure to HIV 99% of patients will develop antibodies in 6-12 weeks. In immune-compromised patients, it may get delayed. Antigen may get positive on within three to four weeks.

After three months of exposure, HIV, RNA PCR, and western blot negetive means HIV is negative in that patient. So I tried to explain my level best still have queries, please feel free to ask.

Patient's Query

Thank you doctor,

How to know if immune-compromised person or not? If I am immune-compromised when should I test for HIV? I am really scared. I have tested five times within five and a half months after my last time? I think my body is not produced antibodies so maybe my result is negative in six months? I take Ashwagandha too.

Hello,

Welcome back to icliniq.com.

Please send a copy of your test reports. You are a young age male so less likely that you are immune compromised. Negative even after five and half months means you do not having HIV. So do not worry.

Cancer patients, patients on immune-suppressive drugs, old age patients, patients on chronic diseases, chronic kidney disease patients are called immune-compromised.

If RNA PCR for HIV negative means you do not have HIV antigen only. Leave about antibodies. If no infection (antigen) then no antibodies, so do not worry about that.

Patient's Query

Thank you doctor,

I did my thyroid panel and my TSH is 4.9. It was out of range may be Hashimoto autoimmune diseases it can delay? Here is my latest HIV after five months and 20 days. I had random sex twice with different partners, one with the condom but another without protection. What should I do? Please help.

Hello,

Welcome back to icliniq.com.

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

Both antigen and antibodies are negative. These reports are negative even after five months of post-exposure. It means you do not have HIV disease. So do not worry.

In autoimmune thyroiditis or other autoimmune conditions there are more chances of getting false positive results rather than false negative.

So, I can understand your problem, but I am here to support you that saying clearly you do not have HIV and you can live a normal life. From next time onward, do not forget to wear a barrier contraceptive (condom).

Patient's Query

Thank you doctor,

Are autoimmune and immune-compromised different things? Can you see my CBC report and why is my CBC report look different within two months? Do I have autoimmune diseases or not? Is fourth generation test accurate on fifth month? Do I need more tests or not? I heard that antigen will not show after 2-3 weeks. I heard it would disappear. Is that right?

Hello,

Welcome back to icliniq.com.

I have gone through all investigations all are normal only. Yes, immune compromised status is body not having sufficient white blood cells or antibodies to fight against the bacteria or virus.

Autoimmune disease means that our own antibodies and white blood cells attack our own tissue like thyroid tissue, joints, salivary gland, skin, etc. So you do not have autoimmune disease also. I have gone through all investigations.

Yes, CBP may vary from sample to sample but all are in normal range only. And yes, fourth generation test is 99% accurate after three to five months. Remaining 1% may be false positive.

No antigens will not disappear if the virus is present. But viral load may be decreased in early stages, but it is detectable.

I hope this helps.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Penchilaprasad Kandikattu
Dr. Penchilaprasad Kandikattu

Internal Medicine

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