Anonymous
Hi
had an unprotected sexual contact back in 2018 and completed PEP treatment. I’ve done several 4th gen and PCR tests afterward on a monthly basis, all came negative.

But it seems the immune system is moderately damaged cd4: 38 (range 35-55) and cd4/cd8: 1.3 (range 1-3)

concerns:
1-I’ve read on product manuals of Roche and Abbot 4the gen kits that they are designed to detect antibodies to certain subtypes of HIV-1 group M and O.
according to this, other subtypes (HIV group N, CRFs and URFs) can be easily missed.
Taking PEP may cause HIV genetic mutation so same concern may apply to RNA PCR tests.
2-I’ve been told that in some rare cases HIV proviral DNA may become dormant and hide in resting cd4.
Is my negative status considered conclusive anyway??
thank you
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helpline-volunteer

Hello,


Thank you for your inquiry. From what we gather from the question, you were asking about the accuracy of the HIV tests you accessed after engaging in unprotected insertive sex followed by full course of PEP. From the information given, this scenario is determined to be High Risk (there is evidence of transmission through these activities and are the majority of cases of transmission).

The scenario mentioned above does meet the three components of the transmission equation. It was very responsible of you to access PEP and HIV testing after engaging in a risky activity such as unprotected insertive sex. Helpline Transmission Equation .jpgYour concern about the test potentially missing the other strains of HIV is not a large issue because the other strains are extremely uncommon and have rarely been identified (1). Further, the genetic mutations you mentioned as a result of PEP treatment would only affect the type of treatment used in the future if you were to acquire HIV. The possible mutations would not make the HIV virus undetectable via 4th generation tests or by RNA PCR.

Recommendation: Refer to a health care provider for HIV testing. If you have accessed HIV testing outside of the window period (12 weeks for HIV antibody tests) then you can be reassured by your negative results.

Regards,

AIDS Vancouver Helpline/Online, Marie
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