Q. I test negative for HIV but I present with its symptoms. Is delayed seroconversion the cause?

Answered by
Dr. Rakesh Kumar Bahunuthula
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 19, 2021

Hello doctor,

Three months back, I had an exposure with a girl whose HIV (human immunodeficiency syndrome) status is unknown. During the intercourse, my condom is halfway slipped, and I stopped doing it when I masturbate. I felt pain and had a slight injury under my foreskin. What are the chances of HIV transmission? Nine weeks later of the initial exposure, I felt full-body pains and feverish. I had medicine, and the next day I started feeling better, but two days later, I see swollen lymph nodes in the groin, neck, and armpit area then I realized these are the signs of HIV, and I did get tested after ten weeks with 4th generation combo, and the result was negative. I again did a confirmation test after 12 weeks and 13 weeks (94 days) both came negative but still have swollen lymph nodes all over the body. Can symptoms persist despite HIV negative results? Are these tests conclusive? Should I have to retest after six months or get a viral load test to rule out HIV? Is it true that some people take more than three months to develop HIV antibodies? If so, am I a delayed seroconversion person? If swollen lymph nodes present at nine weeks, the body has produced enough antibodies by 13 weeks and should get pickup by blood test? What are the chances of my negative test at three months turns positive later? Did you have seen any case like this? My WBC (white blood cell) count got decreased from 7.1 to 5.3 within a month. Is that a sign of HIV? Why I still have swollen lymph nodes all over my body? Is it because of HIV or other infections? Please let me know, doctor. And I was under prolonged stress and anxiety for two months.



Welcome to

The window period is 12 weeks after the exposure, and any test done beyond this is considered definitive. The 4th generation HIV test detects both p24 antigen and antibodies as well. Hence the test does not rely only on antibody production and is more accurate even at 4-6 weeks after the exposure. Your test result of being negative can be taken as conclusive provided there has been no further exposure in the period said so. The only cases which turn positive after 12 weeks are those who continue to have exposure. It also appears that you are very anxious, although it is understandable. But in such a mental state, every bodily symptom will appear due to HIV. This is HIV phobia which is very commonly noticed in patients. You do not need to have any further tests, and swollen lymph nodes are not due to HIV.

Thank you doctor,

I am only worried about my swollen lymph nodes day by day, and I see them in different places, and I never experienced it before. If it is in one place, I can understand it may be due to other infections, but it has been present across multiple places for almost a month. Does the decline of WBC count indicate anything serious?



Welcome back to

WBC (white blood cell) count has a range of usually 4000-11000 per microliter (can vary according to lab). There can be a day to day variations in the count, and as long as it is within the range of normal limits, it is not considered abnormal. You can choose to ignore the fluctuations in the numbers as it is well within the range.Regarding lymph nodes, size matters, and anything greater than 2 cm in diameter is only considered significant. Moreover, what you perceive as a lymph node may not actually be one as you might not have the right medical background to palpate them. But as your test is negative even beyond 12 weeks and expecting no further exposure in that period, definitely your symptoms are not due to HIV.

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