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Q. I had negative rapid HIV tests on fifth, sixth and eighth month post exposure. Am I HIV negative?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 06, 2020 and last reviewed on: Aug 29, 2020

Hello doctor,

Post a high-risk exposure with a CSW involving unprotected oral sex and rubbing of genitals for a brief time without full penetration, but possible contact with genital fluid at vaginal opening, I did rapid HIV 1 and 2 tests with fingerprick blood at five months (2 numbers), Comb Aids test (serum) at six months, Meriscreen rapid test third generation (serum) at eight months of exposure at ICTC center. All were negative. Do I need further testing or am I conclusively negative?

Are the rapid kits used in India reliable like ELISA after a window period? How soon can they detect the infection as some studies show they are not reliable like ELISA.

Dr. Parth R Goswami

Hematology Pathology
#

Hi,

Welcome to icliniq.com.

I can understand your concern.

You are right. Rapid test is not as conclusive as ELISA (enzyme-linked immunosorbent assay) to rule out HIV (human immunodeficiency virus). But this is true only for six to eight weeks after exposure.

Rapid test can conclusively rule out HIV after maximum three months of exposure. After three month of exposure, antibody develops and so rapid test is conclusive in rule out HIV. Rapid card tests in India showing good results and do not worry about their result.

You have tested after three months and eight months of exposure. So do not worry about HIV. You can consider yourself free from HIV.

I hope this helps.


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Thank you doctor,

I used CombAids test.

Dr. Parth R Goswami

Hematology Pathology
#

Hi,

Welcome back to icliniq.com.

After three months of exposure, any test can be conclusive in ruling out HIV. Fourth-generation kit used only when you want to rule out HIV early like that of after six weeks of exposure. After three months, both tests third and fourth generation are conclusive in ruling out HIV. So do not worry.

I hope this helps.


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I was told by the ICTC incharge in private hospital that since I had a high risk encounter I have to keep doing testing every six months as the tests used were only rapid tests and they can detect infection only in established Hiv infection i.e. patients having infection for years and not recent ones. 3 or 6 months guidelines is only for lab based Ag-Ab tests not Rapid tests. Since in India all ICTC s are using CombAids and Meriscreen only how reliable are they?
I can't find any ICTC that does manual ELISA. Only blood banks do the 4th gen screening it seems. Please advise as even USA is using 4th gen lab test and not rapid test. What should I do?

Dr. Parth R Goswami

Hematology Pathology
# Hi,

Welcome back.
sorry for late reply.

I can understand your concern.

Following is my opinion for your asked question.

According to my knowledge dear, Rapid card test detect HIV antibody which usually developed after six week and maximum time require to develop antibody is 3-6 month.

So Rapid test is conclusive in rule out HIV after three month.

You had done testing after 8 month of exposure. So it is enough time to give conclusive result.
After three month it doesn't matter that you are using which generation HIV test.

Fourth generation test detect antigen as well apart from antibody.

I think to give you 100% relief and to surely rule out HIV, You can investigate in good laboratory nearby.

Most of laboratory nowadys doing CMIA combo test for HIV which is fourth generation testing for HIV and equally effective as ELISA fourth generation.

So you can investigate with CMIA combo HIV fourth generation test which is not too expensive as well.

Hope I have solved your doubt.

You can ask further until your doubt solved.

Regards

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