Is a 4th‑generation HIV combo test conclusive at nine weeks?

Question

Hello doctor,

I feel lost and afraid. Approximately nine years, six months, and one week ago, I had a small scratch from a disk that caused a little bleeding, which then stopped. Later that same day, I touched a clot from a CSW vaginal procedure with the same finger. The area was not bleeding at that time. The contact lasted about eight seconds. The woman then performed a handjob twice. I asked her to wash her hands before the second time. That was all.

I did a combo Antigen/Antibody HIV test approximately nine years and four months ago. The result came back after about thirty minutes as non-reactive. Since that time, I have had a lymph node in my neck, and I have lost 11 pounds in the last month.

I did a CBC blood test approximately eight years and three months ago, and everything was normal. My white blood cell count is 6,900. My ESR is elevated at 90, and my CRP is also elevated at 1.83. I may have ankylosing spondylitis.

Do you think my combo test performed after nine weeks is conclusive, given that I did not have intercourse? What might be the reason for elevated ESR and CRP?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

First of all, I want to thank you for providing such an elaborate history. It really helped me draw the right conclusion.

You should be proud that your combo HIV (human immunodeficiency virus) antigen/antibody test is nonreactive and that you know your HIV status. The combo HIV antigen/antibody test has very high sensitivity (96.1 percent) and very high specificity (98.9 percent), and numerous studies have shown 99 percent sensitivity and specificity with the fourth-generation test, which is the one you underwent. I suggest you repeat the test at a three-month interval.

There are numerous clinical scenarios in which ESR (erythrocyte sedimentation rate) and CRP (C‑reactive protein) can be elevated, and ankylosing spondylitis is one of them. If you engage in sex with an unknown partner, I suggest you use condoms correctly and consistently. Another suggestion is to avoid sex with partners of unknown HIV status and to remain faithful to your partner.

I also suggest you have your neck lymph node evaluated. A lymph node biopsy may help establish the diagnosis of any other clinical condition.

I hope this helps.

Kindly follow up if you have more doubts.

Thank you.