HomeAnswersHIV/AIDS specialisthiv risk factorsThe fourth generation combo test is negative. Am I risk-free from HIV?

The fourth generation combo test is negative. Am I risk-free 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

iCliniq medical review team

Published At April 2, 2018
Reviewed AtJuly 18, 2023

Patient's Query

Hello doctor,

I had protected vaginal sex and unprotected oral sex with CSW (Community sex worker) and for peace of mind, I tested with HIV fourth generation duo combo (Ag/Ab) test and RT PCR (Reverse Transcriptase Polymerase Chain Reaction) viral load test at 23 days from exposure. The fourth generation combo test came negative and RT-PCR viral load came below the detectable limit. Can my test be conclusive? Am I risk-free from HIV (Human Immunodeficiency Virus)?

Answered by Dr. Sushil Kakkar

Hi, Welcome to icliniq.com.

Protected sex is safe as far as risk of HIV (Human Immunodeficiency Virus) is concerned. Insertive or sex has a negligible risk of transmission of HIV. As far as testing is concerned, only a four-week fourth generation HIV screening test is considered reliable. Though even that has to be followed up by a 12-week screening test for a conclusive result. RNA (Ribonucleic acid) PCR (polymerase chain reaction) is a very sensitive test early on after possible infection. A negative test at 23 days is fairly conclusive. A fourth-generation HIV screening test has a window period ranging from 18 to 45 days. Whereas RNA PCR has a short window period of 9 to 13 days. Therefore both the tests taken together reliably excludes the risk of HIV.

Patient's Query

Hello doctor,

Along with fourth generation combo at 23 days, I also tested RT-PCR viral load.

Answered by Dr. Sushil Kakkar

Hi,

Welcome back to icliniq.com.

Yes, I noted that. Your tests are conclusive and reliable. You do not have HIV.

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

Dr. Sushil Kakkar
Dr. Sushil Kakkar

Dermatology

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