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Q. Do ELISA, CMIA, ECLIA, and RNA PCR need retesting for conclusive results?

Answered by
Dr. Sushil Kakkar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 06, 2017

Hello doctor,

I have had unprotected vaginal sex with an unknown girl for two minutes. I have taken the following tests: ECLIA third generation after 17 days of exposure, ECLIA third generation after 30 days of exposure, RNA by PCR after 31 days of exposure, TRI-DOT test after 50 days of exposure, and CMIA fourth generation after 59 days of exposure. All the tests have been negative. I have also taken the ECLIA third generation test on that girl after 35 days of exposure and it is negative. I would like to know if I am HIV free. Can I have a normallife?I am very much worried about HIV. Is the CMIA test conclusive after six weeks? Are the results conclusive? Should I need a retest after three months for conclusive results?

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#

Hello,

Welcome to icliniq.com.

  • A 12-week screening test for HIV (human immunodeficiency virus) antibodies is considered conclusive and a CMIA (chemiluminescent microparticle immunoassay) fourth generation test at 59 days of exposure with a window period of two to three weeks is very reliable but it is not considered conclusive.
  • Similarly, a third generation ELISA (enzyme-linked immunosorbent assay) at 30 days and RNA (ribonucleic acid) by PCR (polymerase chain reaction) for HIV with a window period of 9 to 13 days at 31 days are reliable and a negative result means that most likely you are HIV negative. Again these cannot be considered conclusive and should be followed up at 12 weeks for HIV antibodies by ELISA
  • To summarise, a third generation ELISA, an HIV antibody-based screening test, at 12 weeks post exposure is the most reliable and conclusive test.

Regards.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

If I go for an antibody test after three months and if it is negative then can I say that I am HIV negative? Am I free from HIV? I also read on the internet that for conformity one has to test after six months? Is this needed in my case?

#

Hello,

Welcome back to icliniq.com.

  • A negative ELISA (enzyme-linked immunosorbent assay) at three months is conclusive.
  • A six-month test is considered conclusive only in special circumstances if patients are on immunosuppressives like organ transplant patients or on oral steroids.
  • This is not the case in an otherwise healthy individual.

Regards.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

I read that CMIA (chemiluminescent microparticle immunoassay) test is conclusive after six weeks? I have read on the internet that one needs to be retested even if he gets a negative HIV test result after a potential HIV exposure. I have also read that if the healthcare provider uses an antigen or antibody test on blood, one needs to be tested again after 45 days. Does that mean that fourth generation test is conclusive after 45 days?

#

Hello,

Welcome back to icliniq.com.

  • Yes, certainly a fourth generation test result is considered more reliable after 45 days than performed immediately after the exposure.
  • Comparatively, a third generation HIV (human immunodeficiency virus) antibody test at 90 days is even more reliable and the result is considered conclusive.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

Are there chances that I get positive after three months even after being negative at 59 days of exposure? Have you come across cases where the results are negative at two months and suddenly get positive at the third month?

#

Hello,

Welcome back to icliniq.com.

  • It is very very unlikely. I have never seen someone turn positive so late.

Regards.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

Is the CMIA test conclusive after six weeks? I am worried if my test comes positive at the third month? I have taken the CMIA test at 59 days. Is that conclusive? For fourth generation test, the window period is two to three weeks. Does that mean that one has to test between two to three weeks? If someone tests after three weeks then that result is not reliable. Is it like that?

#

Hello,

Welcome back to icliniq.com.

  • Though at six weeks, a fourth generation test accurately depicts the HIV (human immunodeficiency virus) status in most cases, in high-risk exposure cases, it should always be followed by a 12-week HIV antibody screening test. That is the most conclusive. This is because the antibody response may be delayed in a small number of HIV infected individuals and the p24 antigen response may be weak or decline quickly before antibodies form.
  • A window period of a screening test is the time period from the day of infection until it first becomes detectable by that test. HIV cannot be detected immediately after infection. This time period between the onset of infection to when it can be first reliably detected (window period) varies from test to test. So, if the window period of a particular test is two to three weeks it means that this test is not reliable during the first two to three weeks after infection. Thereafter, it can reliably detect the infection.
  • The window period is two to three weeks for a fourth generation HIV combo test and longer up to 12 weeks for a third generation antibody test.
  • A 12-week test is the gold standard screening test and most accurate. Tests with shorter window period that is two to three weeks for a fourth generation and nine to 13 days for RNA (ribonucleic acid) by PCR (polymerase chain reaction) are reliable and they can be performed sooner. They should always be followed by a 12-week screening test for HIV antibodies.

Regards.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Thank you doctor,

I took her test after 35 days of exposure and her test was negative. Does that reduce my risk? I have had sex the first time and is there a chance that I would be infected with HIV?

#

Hello,

Welcome back to icliniq.com.

  • You cannot rely on others' test results.
  • What if she was in the window period? Her test would be negative even if she was HIV (human immunodeficiency virus) infected.
  • Your chances of getting the infection are minimal because all your HIV screening tests until now are negative.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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