HomeAnswersCommunity Medicinefourth generation hiv testHow accurate is the HIV combo test after 35 days?

My HIV combo test is negative after 14 and 35 days of unprotected oral sex. Am I safe from HIV?

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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. Chithranjali Ravichandran

Published At August 27, 2021
Reviewed AtJanuary 22, 2024

Patient's Query

Hello doctor,

I am a 35-year-old male. I had unprotected oral sex with a girl. Her HIV status is unknown. After oral sex, we had vaginal intercourse with a condom. After 14 days of that incident, I had a negative PCR test, and the HIV combo test is also negative. And after 35 days, I repeated the combo test, which was negative again. My query is, are my test reports are conclusive, or furthermore tests required? And am I safe? I have attached test reports here.

Please advise.

Hi,

Welcome to icliniq.com.

Thank you for the query.

The chances of transmission of HIV (human immunodeficiency virus) by single unprotected intercourse with an HIV-positive person are low. It is good that you had negative HIV and PCR after 14 days and negative HIV antibodies test after 30 days. The chances of HIV tests coming positive later are almost nil. But it is advisable to do an HIV antibodies test after three months to have conclusive results.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

Is the fourth generation combo test after 35 days not a conclusive result?

Thanks.

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query.

It is considered almost conclusive. The chances of HIV tests coming positive later is nil. It is better to go for an HIV antibodies test after three months of exposure to relieve anxiety.

Thanks.

Patient's Query

Thank you doctor,

My result of the combo test taken after 48 days of exposure is negative. But for the last two days, I observe slight swelling on the tip of my penis. It remains reddish. I have attached a picture. Please advise. I do not have any pain or itching.

Hi,

Welcome back to icliniq.com.

Your photo is not attached. It is good to hear that the test is negative. It is better to go for an HIV antibody test after three months of exposure to have conclusive results. It provides relief from anxiety.

Patient's Query

Thank you doctor,

I have tried to send it again. Kindly have a look. It has been 55 days. How long does it take to have symptoms after exposure?

Hi,

Welcome back to icliniq.com.

These symptoms are not related to HIV. it occurs due to irritation or friction or overcleaning. Do not overclean. Avoid friction or irritation. Wash with warm water twice daily. Do not use harsh soaps. Do not repeat the HIV test again until post 3 months exposure.

Patient's Query

Thank you doctor,

As per CDC guidelines, fourth-generation tests are conclusive after 45 days. Can I assume that I am safe? Can it get changed at any circumstance? Kindly reply. I am having little pain while swallowing. Is it a normal infection or a symptom of HIV?

Hi,

Welcome back to icliniq.com.

It is almost conclusive. The chances of HIV tests coming positive later are almost nil. But it would be better to go for an HIV antibody test after 3 months of exposure to get relieved of anxiety totally.

Patient's Query

Thank you doctor,

I got red patches on my tongue but it is not painful. Is it related to HIV? Normally when does these mouth sores appear? I am so scared. Please help me.

Hi,

Welcome back to icliniq.com.

These mouth sores occur due to stress or aphthous ulcers. Avoid stress. These are not related to HIV. Take a balanced diet with multivitamins.

Patient's Query

Thank you doctor,

I forgot to ask one thing. I am having tonsillitis and a little sore throat from yesterday. This is my 65th day.

1. Is it related to HIV?

2. How long after exposure do these symptoms appear? Kindly reply.

Hi,

Welcome back to icliniq.com.

Thank you for the query. This may be due to respiratory contact with any person. You can take treatment for this from your treating doctor. It is non-specific and need not be due to HIV. There are no specific symptoms of HIV. HIV is diagnosed by tests. In your scenario, all HIV-related tests are negative so far, and likely to be negative too after three months.

Patient's Query

Thank you doctor,

Can my symptoms appear after nine weeks as well?

Hi,

Welcome back to icliniq.com.

Thank you for the query. There are no specific symptoms and time frames. Anyway, these are unlikely in your scenario with given test results and symptoms. Just relax. Forget the episode and wait for the final test.

Patient's Query

Thank you doctor,

I have a question. As I told you, my PCR test was taken at 14 days and the HIV combo test results taken at 48 and 61 days were negative. But I have asthma and took Prednisolone 5 mg one tablet daily. Can it affect my combo test result? As I saw in your reply, steroids can be the cause of the delay of antibodies. Kindly help me to come out of this fear.

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query. Yes, steroids can affect the antibodies production to some extent. But one thing good is your HIV PCR test, which is already negative. That is usually not affected by steroids. So your antibodies taken after three months will be almost conclusive. So nothing to worry about.

Patient's Query

Thank you doctor,

Sir, I have the below concern.

1. Should I stop taking Prednisolone until I do an antibody test, or can I continue it?

2. Should I go for a PCR test at this moment, or should I wait for the antibody test to be done at 90 days? Please reply.

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query. You need not stop Prednisolone without your treating doctor's advice and for this purpose. You can go for an HIV antibodies test after three months of exposure. It is good enough. Usually, antibodies are formed in two to six weeks. You are doing after three months. Moreover, it is a combo test that has antigen components too. You need not worry about this. Three months is enough with your previous test results too.

Patient's Query

Thank you doctor,

Hello doctor. My HIV antibody test came non-reactive at 92 days. But I have a mouth ulcer, which has been coming one after another for more than a month. Once the one heals and then the other one comes out. So please advise me whether my test result is conclusive now? Should I need to repeat it? Would you please suggest whether my tongue ulcer is related to infection? (photo attached).

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query. In my opinion, the HIV fourth generation antibodies test with negative results taken after three months can be considered almost conclusive along with your previous negative test results too. There is no need to do further HIV tests. The tongue ulcer symptoms may occur due to stress or drugs treatment, or deficiency. It is non-specific and not related to HIV.

Patient's Query

Thank you, doctor,

Thanks, doctor. So can I be assured that I am free from HIV? Can I have unprotected sex with my wife now? Please advise.

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query. You need not worry about HIV, provided there is no further risk of exposure, and you can have a normal relationship with your wife.

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

Dr. Basti Bharatesh Devendra
Dr. Basti Bharatesh Devendra

Dermatology

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