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PLEASE ARE MY NEGATIVE RESULTS CONCLUSIVE EVEN WITH ORAL THRUSH

Question: 

I had an exposure 6 times on two consective days. Unprotected virginal sex. I took PEP for 28 days which i started within 72hours. I took HIV duo test at 14 weeks 1 day post PEP (18 weeks 2 days post exposure) which came out non reactive (0.02). I also took Hepatitis C rapid antibody test at 122 days post exposure and it was negative. The problem is that i have been having oral thrush for almost 3 months now. Can i rely on my results or should i wait for six months in case of delayed seroconversion? Is my hepatitis C result also conclusive? Am really scared please help. By the way the baseline HIV antibody test for both me and the lady i had sex with was negative but to rule out possibility of window period i took PEP.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the conclusiveness of a 4th Generation HIV Ag/Ab "duo" test taken 14 weeks after completing a full 28 day post-exposure prophylaxis (PEP) prescription (18 weeks following an unprotected vaginal sex exposure). From the information given, this scenario is determined to be High Risk (evidence of transmission through these activities and is the majority of cases of transmission).

The scenario mentioned above does meet the three components of the Transmission Equation. It is very responsible of you to seek out PEP after a high risk activity, such as unprotected sex, because starting PEP within 72 hours of a risky activity and taking it consistently for 28 days can reduce the likelihood of HIV transmission by more than 80% (1).

The HIV test results that you received can be considered completely conclusive as the test was conducted outside of the window period. Most HIV specialists agree that results from the 4th Generation HIV Ag/Ab "duo" test are conclusive six weeks post-exposure (or post-PEP in which the window period would restart) (2). Some physicians and guidelines recommend testing three months post-exposure (or post-PEP) for completely conclusive results, which you have done, thus you can be very confident that the results are accurate. In regards to the Hepatitis C antibody test, it takes the body six to nine weeks to develop enough antibodies to be detected by the test (3). Since you received the Hepatitis C test outside of the window period, you can also consider these results conclusive.

Oral thrush can be caused by numerous different factors (4). Just because you are experiencing oral thrush does not mean you have HIV, but it could be an indicator that something is going on in your body.

Recommendation: The results of your HIV test conducted outside of the window period are conclusive. Refer to a physician for other health related inquiries, such as your persistent oral thrush.

Regards,

AIDS Vancouver Helpline/Online, Marie