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Would TB treatment interfere with HIV test?

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Would TB treatment interfere with HIV test?

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 February 27, 2017
Reviewed AtJuly 5, 2023

Patient's Query

Hi doctor,

I had unprotected sex before 1.5 years. I was in deep mental stress after that with no proper food. After seven months, I got admitted to a hospital with skin rashes, headache and vomitings. Doctors tested and confirmed that I got meningitis TB (Tuberculosis) and given treatment for 10 days. I was asked to use Forecox tablets for nine months. Now, that is more than a year after my high-risk exposure; I was tested for HIV 1 and 2 under enhanced Chemiluminescence, which was non-reactive. Please tell me whether my HIV (Human Immunodeficiency Virus) results are conclusive despite all these parameters. Would my TB treatment and immune system alter the HIV results? Because my WBC count is low while testing HIV when compared to before. Please advice.

Hi, Welcome to icliniq.com.

Unprotected sexual exposure is a risk factor for multiple STDs (sexually transmitted disease), including HIV. However, the risk is quite low ranging from 0.02 to 0.04%. HIV (Human Immunodeficiency Virus) infection has a window period of one to three months during which the test results can be false negative. According to WHO (World Health Organization), all results are considered conclusive at 12 weeks after the last high-risk exposure. Tuberculosis and HIV are known to have a higher coincidence rate together. But, as your test results are negative and well beyond the window period, you can be assured that you have not acquired the infection. Kindly upload the report to check the method used and the laboratory to confirm the same.

Investigations to be done

1. HBsAg, (hepatitis B surface antigen) 2. Anti-HCV (hepatitis C virus) 3. VDRL (venereal disease research laboratory).

Regarding follow up

Revert with the reports to a HIV AIDS specialist online.---> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist

Patient's Query

Thank you doctor,

I have attached the laboratory reports. Please review and let me know the status. I have a doubt whether our medical history like Tuberculosis (TB) treatment or low immunity or any other case can alter the HIV (Human Immunodeficiency Virus) result. My HIV test was taken after a year including all parameters. Can it be considered conclusive? Please finalize my result status after viewing my results. Do I need to take any other test?

Hi, Welcome back to icliniq.com.

HIV (Human Immunodeficiency Virus)result remains uninfluenced with other infections such as TB(Tuberculosis). The method of testing that you have undergone is quite specific in HIV detection. Usually, TB tests are false negative when there is a co-infection with HIV and not the reverse. Your low white blood cell and neutrophil count are probably a consequence of TB infection as it is known cause neutropenia. Moreover, your test has been done nearly one year after your last high-risk exposure and after you have taken a right amount of anti-tuberculous drugs. Hence, there is no way these cofactors could influence your report. You can be sure that you have not acquired HIV and there is no need for any further testing. You can rest your fears and go ahead happily. However, do look into your low WBC (White Blood Cells) count as it may predispose you to other infections if it tends to drop further.

Investigations to be done

Repeat complete blood picture after a week to look for neutrophil count.

Patient's Query

Thank you doctor,

My last concern is as follows. Will the test detect HIV (Human Immunodeficiency Virus) even in case of a bad immune system?

Hi, Welcome back to icliniq.com.

A non-responsive immune system can affect the test result when the method employs detection of antiviral antibodies (HIV Ab). The methods using detection of viral components are not influenced by the body's immunity.

Patient's Query

Hi doctor,

I did not understand you. The test I have taken is fourth generation test. Does it get affected by the response of immune system? Is there any other cause that can change my result? Can the test be considered final after one year of last exposure?

Hi, Welcome back to icliniq.com.

The test that you have undergone employs western blot with a chemiluminescence method, which makes it very specific. It is a confirmative test and is not influenced by the body's immunity as it tries to detect viral particles. The result of it can be considered final and conclusive. There is no need for any further testing.

Patient's Query

Thank you, doctor,

Does my test detect both antibodies and viral particles?

Hi, Welcome back to icliniq.com.

No, the test detects only viral particles.

Patient's Query

Hi doctor,

Is there any chance that virus can be undetected from the collected blood sample? Do I need a test for antibodies detection? How is this test accurate when compared to antibody test?

Hi, Welcome back to icliniq.com.

Antibodies are produced only if the antigens are present in the blood. As there are no viral particles detected even after such a long time of exposure, it rules out the possibility of any antibody production. Western blot detects the viral proteins even to the slightest concentration. Hence, the test is usually considered as a confirmatory test.

Patient's Query

Hi doctor,

I read on the internet that viral particles are detectable only in the early days that is below three months. In that case, I have tested after more than a year. Will those viral particles still be detectable? What viral particles are tested in this test? Is there any viral particles that becomes undetctable?

Hi, Welcome back to icliniq.com.

It is the viral antigens that are tested in the western blot. It including GP (Glycoprotein)160 & p24. If infected, p24 antigen usually persists in blood and is the most specific measure to detect the viral load. A few of the envelope proteins may fall to undetectable levels with time, but p24 is always present.

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

Dr. Rakesh Kumar Bahunuthula
Dr. Rakesh Kumar Bahunuthula

Dermatology

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