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Is HIV antibody test conclusive at 53rd-day post-exposure?

Is HIV antibody test conclusive at 53rd-day post-exposure?

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 July 12, 2017
Reviewed AtJuly 7, 2023

Patient's Query

Hi doctor,

I got a complete panel and RNA PCR (Ribonucleic Acid Polymerase Chain Reaction) tests after 53 days of unprotected vaginal sex. The results were negative, except (Herpes Simplex Virus) HSV-1 was reactive. So, I went to meet my doctor with the reports, who told me to get an (Human Immunodeficiency Virus) HIV-1 and HIV-2 antibody fourth generation test. The results were negative again. But, I feel my body hot, burning, testicular pain, and I have red dots on my tongue. Are my results conclusive? Please answer my question. I am very anxious.

Hi, Welcome to icliniq.com.

The test kits used to diagnose HIV (human immunodeficiency virus) are highly sensitive and specific. It gives accurate results. You can surely rely on your 53-day result. The majority of people who are infected with HIV, develop HIV antibodies by 4 to 6 weeks of exposure. I suggest you get a confirmatory HIV antibody test at three months of last unprotected exposure. The symptoms could be due to various reasons. Was there any complaint when you were diagnosed with HSV-1 (herpes simplex virus)? Hope your query is answered, but if you have any other query, please do not hesitate to ask or call anytime. Best wishes.

Patient's Query

Hello doctor,

Thank you for replying. After 12 days, RNA PCR test was negative. Is HIV antibody test conclusive at 53 days post-exposure? My doctor says I do not need any more test, as long as no symptoms appear. This confuses me. Is there a chance that my test will change in the future?

Hi, Welcome back to icliniq.com.

HIV RNA PCR is a highly sensitive test, but you just took the test at borderline. HIV takes around 11 to 14 days to appear in the blood if infected. The good part is, your 53-day fourth generation HIV test is negative. A fourth generation test can detect both HIV antigen and antibodies if present in the body. As I mentioned, majority (95 %) people who had exposure to HIV, if the test is performed at four to six weeks duration, will give a positive result if infected. Almost all people who are infected with HIV, develop HIV antibodies by three months. The WHO (World Health Organization) guidelines say that a confirmatory test needs to be performed at three months of unprotected exposure. As far as the symptoms are concerned, the acute phase manifests in some of the individuals with flu-like symptoms. Also, I want to emphasize that there are no specific symptoms or signs, which can lead to the diagnosis of HIV. It is only through testing for it. Hope I was able to answer your questions but feel free to ask or call anytime for any further query. Best wishes.

Patient's Query

Hello doctor,

Thank you for replying. Did you ever see a person, who tested negative at eight weeks, turn positive later? I am also attaching my reports along with this query.

Hi, Welcome back to icliniq.com.

I have seen the reports (attachment removed to protect patient identity). In our clinics, most of the people come in the later stage of the infection with one or more presenting complaints. The actual duration of exposure and the diagnosis time is usually not very accurately revealed. However, the important point is that there are well-documented cases and also published in the medical literature for the cases, who have been diagnosed beyond eight weeks. But, such cases are now rare due to the availability of highly sensitive and specific diagnostic kits. But, the recommendations persists as already mentioned. I always advise my patients to get a three months test at least to be sure and be relieved of all stress. Hope your query is answered, but do not hesitate to ask or call anytime for any further information. Best wishes.

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

Dr. Ravinder K. Sachdeva
Dr. Ravinder K. Sachdeva

HIV/AIDS specialist

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