« Go Back

Exposure

Question: 

Hello.
On June 8th 2013 I had unprotected anal insertive sex with a guy (I was topping) who on September 17th found out he was HIV+. He is still awaiting Western Blot confirmation.
I did not know of his condition and neither did he until September, apparently. It was foolish of me to engage in such act, I know.
In July I developed a pseudomononucleotic syndrome which, after tests, revealed to be an actual mononucleosis relapse. Elisa 4th gen (HIV1/2 AB, p24AG) was negative on July 25th 2013. Other values for Epstein-Barr were positive.
When he told me of the news I repeated the test one day after. Elisa 4th generation again, negative. This was September 18th, more than 100 days apart from the possible exposure.
My doctor and the lab told me I was lucky and did not get exposed. However, they also suggested I do a PCR qualitative assay for RNA to rest totally assured before repeating the test in 3 months and consider this chapter closed. I have done that but the wait is killing me. I know the blood samples are pooled and tested together, and then tested individually should the whole batch come out positive...
I want to know: on what grounds precisely are 4th generation Elisa tests considered to be totally effective after three months? Is it because of the combined AB and Antigen qualities? Could there be a slight change I seroconvert after the three months (100 days, actually)? If I am not mistaken, that is why 4G Elisa looks for p24 -- because that antigen is present before seroconversion and for a brief period after antibodies are created.
Please let me know. Thank you for your service to the community (I am neither Canadian nor live in Canada). It is extremely laudable. 

Answer: 

Hello, the 4th Generation HIV test is the newest HIV test available today and the accuracy of this test at 3 months is 99.9%. There is no need for any further testing as long as you have no other risk exposure.
While having unprotected vaginal or anal sex with a person living with HIV is a high risk for exposure, the information you have provided proves that you were not exposed to the HIV virus.
At 100 days, post risk exposure, all people who have been passed the HIV virus will have developed HIV antibodies that fight the virus. Some HIV specialist will consider this 4th Genaration test to be conclusive at just 6 weeks however the International Guidelines still indicate an HIV test is not conclusive until 12 weeks or 84 days, post risk exposure.
The guideline of HIV testing at 6 months is now outdated and from the information you have provided, you are absolutely in no need of any further testing. We do recommend that you consult with the doctor who is testing you and ask why any further testing is required.
Going forward please do your best to support your friend and continue to become educated in risk associated with sexual activity. Every person is responsible for their own sexual health and safety. Finally, please have your friend give us a call if he is in any need of support or a referral to care.
Your other health issues, including mono are in no way a relation to HIV and we encourage you to follow all directives from your physician in regard to treatment and care.
David
AIDS Vancouver Helpline
E-mail: helpline@aidsvancouver.org
Phone (Mon-Fri 9am-4pm): (604) 696-4666
Web: www.aidsvancouver.org/helpline