I can't trust my test results? Anxiety...

[ki_79]

Hi,

please help me..

I had risky exposure about 11 months ago (I used condom, but not sure it was intact). I had many symptoms similar to HIV-infection and i became extremely worried, so I have some questions in my mind:

1. Since exposure i have tested negative by 4 gen. ELISA antibody-antigen (HIV-AgAb) at 3, 4, 6, 8 and 9 months. I have read it can take even years for antibodies to show up in some cases, althought almost everyone, including guidelines points out that 3 months is enough in normal case? Due to my symptoms i cannot trust antibody tests anyway.

2. At 8 month after exposure I also took  HIV-1 RNA NAAT-test (viral load, quantitative), which was done by  real-time TMA-method (possibly Aptima?). This test have  limit of detection of 30 copies/ml blood, and result was negative.
I would like to know is this test as reliable as RNA-PCR quantitative viral load tests, which can detect down to 20 copies/ml.? I guess these are both viral load tests, only using different methods (Real time-TMA vs. RNA-PCR)?. Is there any real differences between these tests?

 3. This is important! Also i want to know, is it possible to have undetectable, (in my case <30 copies) viral load 8 months after infection, or should viral load be higher if infection has occurred? Or is it possible viral load decreases naturally 8 months after infection so that these tests cannot detect measurable viral load at that point?


This time has been the worst time in my whole life, and i have extreme anxiety about this. I don't know if i can trust my test results. Should i continue testing?

And sorry for my bad english. I am from Europe.

[Jim Allen]

Hiya

It sounds like your overthinking this

Firstly it sounds like you had no exposure, you used a condom and if it breaks during intercourse than it shreds leaving no doubt. As long as that does not happen there is no point stressing about nothing.

Are you a long term IV drug user? Are you on PEP/PrEP or in Chemo Therapy?

If the answer to this is "No" than its simple you have conclusively tested negative and do not have HIV from this encounter.  Its 2019 not 1986, everyone with exception to the questions I asked above will produce antibodies before 6 weeks, an outlier takes 3 months and hence is called conclusive mark.  So you have tested conclusively negative and unless you are dead, you would have produced them long before this stage.

The Viral Load testing is irreverent, not recommend, not needed and a waste of time and money. So relax and move on with your life, you don't have HIV from the encounter 8 months ago.

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP as an additional layer of HIV protection going forward

Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs

Also note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

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[ki_79]

Thanks for your quick response!

"The Viral Load testing is irreverent, not recommend, not needed and a waste of time and money. So relax and move on with your life, you don't have HIV from the encounter 8 months ago."

I took this viral load test in hope to get my fear away. So i would like to have honest opinion about reliability of my viral load test at 8 month after exposure/possible infection?

Yes i know viral load tests are mainly used identifying acute infection (and not to confirm infection) soon after possible exposure..but does infected person usually have detectable viral load at 8 month??
So should i have measurable viral load at that point if infected.? Or are elite controllers the only ones with undetectable/low viral load at that point after infection?

[Jim Allen]

Hiya

Viral load test is not even recommend for early (acute) detection during screening situations like yours. Waste of cash and too many false results.

Now elite controllers would test positive on a antibodies test regardless of how low the VL is.

On a viral load test if the virus is suppressed well by the medication or EC it could come back “not detected” or “undetectable” as example depending on the terminology used on the lab report.

Again this is irrelevant though as you have a conculsive negative antibodies result following what was a no-risk situation to start with.

I wish you well however there is not much we can do for you further in this setting.

Jim

[ki_79]

On a viral load test if the virus is suppressed well by the medication or EC it could come back “not detected” or “undetectable” as example depending on the terminology used on the lab report.

Can i give any value to my <30 copies viral load test or should i rely on antibody tests only? Could one assume there should be measurable viral load 8 month after infection if not elite controller in question? I thought viral load test will take my fears away but now i'm not so sure about this. I Think i have to take antibody test at 1 year mark at least..

There,s very little discussion about

[Jim Allen]

I've already answered this.

You had no HIV risk, you also tested conclusively negative with the antibodies test although no testing was warranted and the VL focus, questions and VL testing is irrelevant and a waste of time and money.

If you can't move on with your life than speak to a therapist face to face to help you move on with your life

Jim