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hiv ag/ab 4th generation w/rfl REPEATEDLY REACTIVE

Question: 

my HIV 1/2 ANTIGEN/ANTIBODY,FOURTH GENERATION W/RFL came back REPEATEDLY REACTIVE, I tested again and came back with the same result. I'm a 47yrs old man who hasn't had sex in quite a long time nor been exposed to any potential infected source. is this possible? what should I do? thanks

Answer: 

Thank you for contacting AIDS Vancouver. Many people are distressed when they have an HIV test come back reactive, and it sounds like you have questions about what your test results might mean. I hope the following information helps you understand your situation a bit better.

To begin with, if you have questions about your test results, you might want to partner with your doctor or another trained healthcare provider. I cannot interpret your test results for you, and I cannot diagnose you.

That said, here are some things to consider:

1) It may be possible that your test results are false positives. I cannot say how likely this scenario is, but typically (in BC at least) a confirmatory Western Blot test would be conducted if an HIV test came back reactive. The Western Blot test, which is the gold standard of confirmatory tests, is much less likely to return a false positive than screening tests (which are designed to err toward returning false positive results that lead to more testing rather than returning a false negative).

Additionally, repeatedly using the same kind of test may not be the best way to rule out a false positive result. If someone who does not have HIV gets a false positive result, retaking the same kind of test might allow whatever it was that threw off the first result to throw off the second result in the same way.

The best way to address this would be discussing this with your doctor and investigating whether additional testing is warranted.

2) The fact that you have not had "sex in quite a long time" nor had other exposures recently might or might not be relevant.

If you accurately understand the risk level of the activities you've engaged in, and if you have been tested appropriately, it might be relevant that you have not had any recent exposures because you cannot develop HIV spontaneously.

You can only acquire HIV if you engaged in an activity where there's an exchange of bodily fluids (blood, semen, pre-semen, rectal secretions, vaginal fluid or breast milk) that gives HIV within those fluids direct access to your bloodstream. Direct access to the bloodstream is key here, as HIV is a relatively weak virus that quickly stops being transmissible after exposure to an open air environment.

That said it may be that you were exposed to HIV without being aware that what you did put you at any risk of acquiring HIV. Here is a link to our Risk Assessment Chart, which you may want to look at to make sure you accurately understand the risk level of various activities you may have engaged in. More broadly, it's important to consider the risk based on the activity, not based on the person you engaged in that activity with. I'm not saying this is you, but far too many people think that they can only acquire HIV from certain types of people. This can lead them to engage in risky behavior with unfortunate results.

Additionally, it's possible to acquire HIV and not know that you have done so (indeed many people living with HIV do not know they have acquired the virus). So if you indeed are HIV positive, it may be that you acquired HIV awhile ago. This is especially true if you were not tested regularly, or you were tested too soon after an exposure to get a reliable result. Many HIV tests are not highly accurate until at least four weeks post-exposure. And following BC Centre for Disease Control protocols, we do not consider any HIV test to be conclusive unless it is taken 84 days or more post exposure. So if, for example, your last test before the ones that came back reactive were taken two weeks after that exposure, the test results may not have given you a reliable indication of your HIV status.

As with the previous issue, the best way to resolve this would be partnering with your doctor.

I know that my response does not provide any simple answers, but I hope that it helps you understand your situation a bit better and gives you a bit more context that might be helpful as you investigate this further.

Yours in health,

Matt, Helpline Volunteer

AIDS Vancouver Helpline/Online
helpline.aidsvancouver.org