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4th Generation test at 6 weeks reliability

Question: 

Hi and thank you for the great service!!
I recently had a possible HIV exposure. While in Amsterdam I had vaginal intercourse with a window sex worker. A condom was used but I did not check its integrity by the end of the of the encounter which has significantly raised my anxiety level to the max. I had a fourth generation test done in amsterdam 4 weeks after the possible exposure and then again at 6 weeks, both came back negative! I also had an Insti rapid HIV test done at 45 days which also came back negative. My question is my situation looking ok? What are the odds of me getting a false negative out of these three tests? and finally do I need further testing?
(The nurses present at these tests all gave me different answers about the conclusiveness of these tests which is why I'm super confused)

Answer: 

Hello,

Thank you for your inquiry. From what we understand from the question you are asking about the conclusiveness of a 4th Generation EIA test taken at 6 weeks.

The 4th Generation EIA is considered to be highly accurate at 4 weeks, and conclusive at 6 weeks as this test looks for both antigens and antibodies. BC government guideline states the following: "Most patients can be tested at 4 weeks following exposure (>95% of infected individuals will have detectable antibodies at this time). If negative, repeat testing at 3 months is recommended (>99% of infected individuals will have a positive EIA at this time)." [1] Official HIV guidelines can recommend confirmatory testing at 12 weeks, but 6 weeks is considered by most to be conclusive. In your situation, if you are still concerned, you could speak to your physician about having a confirmatory test at 12 weeks to be absolutely certain.

Thank you, and have a good day!

AIDS Vancouver Helpline/Online, Sara

Reference:

  1. HIV Testing Guidelines for the Province of British Columbia [Internet]. Www2.gov.bc.ca. 2018 [cited 27 August 2018]. Available from: https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/hiv-testing-guidelines-bc.pdf