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NAT test at 4 months exposure negative result doctor advise for elisa test for further confirmation

Question: 

I have had unprotected exposure with hiv positive undetectable viral load on december 2014, last exposure on feb 13, 2015 NAT test on March 20, 2015 negative result. No signs and symptoms except for occasional flu which lasted only for 5 days...was my NAT test still not confirmed about my hiv status?

Answer: 

Hello and thanks for reaching out to the AIDS Vancouver Helpline.

It's great to hear that you're having such open conversations about HIV with your partner, and I'm so pleased that they have reached undetectable levels.

With regards to your recent testing, 95% of HIV infections are detectable from 4 weeks, and as such, the test that you had on March 20 would be a really good indicator of your status following your exposure in February. You mention "4 months exposure", and while a test at four months is generally considered conclusive, in your situation there was a second exposure prior to testing, and so we will consider the most recent exposure when we discuss testing timeframes.

If you did have a NAAT test, this is a very specific test which is not routinely carried out for regular exposures (they're more commonly used in blood or organ donors, or mother and baby testing). NAAT looks for specifics of the virus rather than just a presence of antibodies, and so a result from a NAAT test even at five weeks is a great indicator as to your HIV status.

Testing is generally considered conclusive at 12 weeks, except in some very specific circumstances. These are:
* Antiviral treatment for Hep C
* Treatment for cancer (Chemotherapy)
* PEP treatment for HIV
* Immunodeficiency diseases (which would have been diagnosed in infancy).

Perhaps your doctor is following protocol to ensure you can receive a conclusive result, or maybe one of these circumstances affects you. I suggest that you follow up with your doctor as to their recommendation for your personal situation and medical history.

You do not mention whether you are in a committed relationship with this partner. If you are, perhaps you might wish to look into the availability of PrEP, a pre-exposure prophylaxis which is often used by couples in sero-discordant relationships (ie, where one partner is living with HIV and the other is not). It can be quite expensive, however it can offer peace of mind should the undetectable status of your partner become at risk, from missed medication for example. Your doctor will be able to advise as to the availability in your area, and more information on PrEP can be found here: CATIE - Prevention technologies

We do recommend all sexually active persons include HIV and STI testing as part of their regular healthcare, so regardless of whether you decide to proceed with your 12 week test on this occasion, it is still worth planning your next routine check up. The ELISA test you mention has the same 95% rate of detection at 4-6 weeks post exposure, and is one of the most commonly available tests for HIV.

I hope that this answers your question.

Very best wishes

Wendy (Volunteer)

Thank you for contacting the AIDS Vancouver Helpline.
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