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HIV counsellor who has lost his perspective - part 2!
Mar 29, 2005

I had a low risk sexual encounter 7.5 weeks ago - an escort licked the head of my penis once (see "HIV counsellor who has lost his perspective"). No risk, you told me, but fretted until I got tested today. HIV 1 and 2 antibody tests and p24 antigen negative.

Please clarify this for me. One of your colleagues says that there is an overlap between the disappearance of the p24 antigen and appearance of HIV antibodies. Assuming, then, that p24 antigen takes 2-4 weeks to become present, would this not imply that I do not need further testing? (ie as there is an overlap, at least one of these tests would have shown up positive had I been infected.)

Different answers abound on this site with regards to this issue. You told one person "must wait till 3 months for a definitive response", I would like to know whether my results should be reassuring given the overlap issue.

I would really like to understand if I have got the science right. Please don't tell me to "not fret about antigens and antibodies and get tested at 3 months"! I know this would be good advice but if the way I understand it is correct then I dont see why further testing would be necessary.

Thanks, donation on way if you respond!!

Response from Dr. Frascino

Hi,

The difficulty arises in that p24 antigen tests have a sensitivity of only 90%. That's not good enough for a "woo-hoo". Bottom line for you is "don't fret about antigens and antibodies and get tested at 3 months." Your 7.5-week negative test is encouraging but not definitive.

Good luck.

Dr. Bob



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