Anonymous
On November 5th, I went to a nightclub and I kissed a prostitute many times (french kiss). I didnt realize that she had blood in her mouth. After that day, I noticed that I had wounds in my mouth and one week after I had flu symptom.
26 days (3.7 weeks) after that event I took ELISA 4th generation (antigen/antibody) and the result was negative.
48 days (6.9 weeks) after that event I took HIV RNA test (NAAT) and the result was negative.
63 days (9 weeks) after that event I took ELISA 4th generation (antigen/antibody) and the result was negative again.
My understanding is that P24 antigen is no longer detectable after 6 weeks (42 days) so that means that the ELISA 4th generation (antigen/antibody) I took will only use to detect antibodies. But I my HIV RNA (NAAT) was negative that means that I dont have HIV? or I have to wait 12 weeks to be sure about my condition? 2 QUESTION: do I have to wait 12 weeks or 3 months to be sure about my results?

Thank you in advance.
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Anonymous
Hi there, thanks for contacting us with your HIV related questions/concerns. We're happy to help!

I understand that a lot of the information around testing guidelines can be confusing and vague, so hopefully this will help to clarify some things for you.

First of all, your exposure would be, at most, a Low Risk situation. "Taking blood into the mouth" is considered a low risk exposure, which means that there have been a few reports of infection attributed to these activities, but usually under certain identifiable conditions. In your case, a condition would be if you had dental surgery done that left major wounds in your mouth. These would provide direct access to the bloodstream that is not normally present in the mouth. Typically though, for wounds to provide this, they must be severe, such as ones gushing blood or requiring medical attention such as stitches. A factor that reduces the risk in this case, however, is that saliva contains an enzyme that helps to break down viruses and therefore provides protection.

Your understanding about p24 antigen is correct: it is detectable only from immediately after exposure, to a few weeks after exposure. The antibodies are detectable anywhere from 21-25 days onwards.

The great news is that you've had several consecutive negative tests. All negative tests are great, especially considering that most HIV tests are ~95% accurate within 4-6 weeks. Here in Canada, all HIV tests are considered to be conclusive at 12 weeks (84 days) post exposure. That means that if you want officially conclusive results in Canada, you would require one more test at 12 weeks. That being said, your results are unlikely to change past this point. Further, most HIV specialists consider the 4th generation test now to be conclusive at just 6 weeks, and if you go by those guidelines (that some countries have adopted) then your 9 week 4th generation test would be conclusive!

Ultimately it is up to you whether or not you want to do another test at 12 weeks or not. In Canada, that will make it officially conclusive, and if you're worried and it would help to ease your mind this may be a good option for you, but since your risk level was only low to begin with and you've had several negative tests up to 9 weeks, this may not be necessary.

I hope this helped to provide you with useful information! Please visit http://www.avert.org/hiv-testing for more reliable HIV testing information.

Sincerely,

Christina


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