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Q. How accurate is the 4th generation HIV antibody test 30 days after exposure?

Answered by
Dr. Basti Bharatesh Devendra
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Dec 01, 2021 and last reviewed on: Sep 27, 2022

Hello doctor,

I had a possible HIV exposure risk about a month and a half ago. Although the individual said, they recently tested negative three weeks before and were on PREP. I did not know them that well. I am circumcised, and I was the insertive partner and had unprotected sex. Out of precaution, I got on PEP 36 hours later, a 28-day cycle. They said I was at low risk. I got a fourth-generation combo test two days after finishing my cycle of PEP, so 30 days after the exposure, it came back negative. So my doubt is, how accurate would you say this result is? Would the PEP impact the window period? I am extremely anxious and depressed, and I am thinking about retesting again in two days (48 days after potential exposure).

Kindly help me.

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#

Hi,

Welcome to icliniq.com.

Thank you for the query.

It is good that it is negative after one month of PEP (post-exposure prophylaxis). The chances of HIV tests coming positive later are very low. But it is better to go for an HIV (human immunodeficiency disease) antibodies test after three months of exposure. No need for HIV tests now as it is likely to come negative.

I hope this helps you out.

Hi doctor,

Thank you for your reply.

I would prefer not to wait three months for a definitive result if that is possible. Also, in your experience, has anyone who has taken PEP later tested positive after testing negative initially? Assuming they did not have any future exposures and adhered to the protocols correctly.

Kindly answer.

#

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query.

Suppose PEP is initiated as early as possible and the medications have been taken according to recommendations. In that case, very few positive cases were reported after PEP, especially in those with inappropriate or delayed PEP. In your scenario, your partners have also been initiated on PREP. So it is an added advantage too. The fact that the HIV test reports were negative after one month of PEP is a good sign. You need to undergo these tests after three months to have conclusive results. The chances of HIV tests becoming positive later are less to almost nil. But you need to wait.

I hope this has helped you out.

Hello doctor,

Thank you for your reply.

I started about 36 hours after exposure, and I took every dose on time. I am taking Truvada and Isentress. What do you mean by inappropriate or delayed? I grilled them about it, but in hindsight, I should have never trusted a stranger. I have attached a picture of my hand. I have been getting rashes like this when I was on the PEP. They appear like bumps with raised lines. Have you seen anything like this before? It comes and goes in various places on my body. I stopped my Lamotrigine and Bupropron a couple of days ago to see if that could be the cause. I am scared to death.

Please help me.

#

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query.

Some do not complete the PEP course or start late after 72 hours or 60 hours. In your scenario, it is 36 hours. They are on PREP (pre-exposure prophylaxis) and may be HIV-negative too. Your post-one-month test is negative. So relax. The rash may be due to an allergy, urticaria, or drug interaction. These are dermographism (the raised lines) and you need to follow up with your dermatologist if it persists. It can occur due to allergies but is not related to HIV. So relax and forget the episode for now. Get involved in activities of your interest. Do yoga, meditation, and exercise regularly. Kindly undergo HIV tests after three months.

I hope this has helped you.

Take care.

Hi doctor,

Thank you for your suggestions.

I took a fourth-generation combo test three months post-PEP, approximately 100 days. Would it be over four months now post-exposure? Are you sure this is conclusive and will not turn positive later? I am extremely anxious about it.

Please guide me.

#

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query.

If the fourth generation HIV antibody test is negative after 100 days of exposure, it is conclusive, provided there is no risk of further exposure. You can relax. In my opinion, there is no need for further HIV tests.

I hope this helps you out.

Hi doctor,

Thank you for your reply.

That is great news. And yes, it has been 128 days post-exposure and 100 days post-PEP with a fourth-generation test. I have not had any exposure this time. And there are no symptoms now. The dermatographism I spoke to you about has been resolved.

Thank you.

#

Hi,

Welcome back to icliniq.com.

Thank you for the follow-up query.

Yes, then it is conclusive. You can relax and lead a normal life.

I wish you safe and good health.

Take care.


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