Question that might help many
Sep 30, 2008
Hi Dr. Bob,
First off I want to thank you for helping others, when people tend to be very confused and scared. Also I want to let you know I will be donating soon.
My question is, Is it possible for a person who is hiv infected with many symptoms, test negative on a anitbody test at the 3 month mark. Due to the fact that antibodies are not present ( or not sufficient enough ) to show up on the antibody test. Therefore, they are feeling sick because there are no antibodies ( or not enough ) fighting the virus. Assuming the person is a healthy one who hasn't had any chemotherapy or organ transplant. Let us know. I'm sure there are many wondering this but don't know how to ask the question.
Also, would you be so kind to share your thoughts on my situation. I am a male who had protected sex with a sex worker on 7-28-08 ( vaginal only ). After I ejaculated, I continued intercourse for about 1 min. When I pulled out, I realized the condom was not on my penis But rather it was in her vagina. When she pulled it out, she showed me that I indeed ejaculated in the condom. So my guess is, some how my penis must of slipped out ( of the condom ) during that 1 min that I continued intercouse before I pulled out. I have had no symptoms, other than mild sore lymph glands around my neck ( under jaw ) at about the 2-3 week mark after sexual encounter. Which lasted for about a week. I also have mild night sweats around the upper cheast and neck area on and off ( till this day ). This might be due to some anxiety I have had. The symptoms don't concern me much because, 1) Symptoms don't really mean much, 2) Many people were getting colds and fevers at my work place right about that time. I have had a dna pcr test at 21 days which was negative ( undetected ). And two antigen\antibody tests at 4 wks and 8 wks. Both were also negative. I tested negative for hepatitis A,B,C, and negative for syphilis at 8 wks also. From what I know, the risk was pretty low. But, there was still a risk. I still plan on getting tested again at the 3 month mark. Is it true that a negative antigen\antibody test at 8 wks is 95% correct, and that the average person is positve if infected by 25 days ( tested with a antibody test ) Please let me know what your thoughs are on my situation. I know there is alot to read, but your input is very important to me. Thanks Dr. Bob!
Response from Dr. Frascino
Actually, I've addressed this "question that might help many" many times before! (Check the archives!) "Symptoms" are unreliable in determining who is and is not HIV infected. A negative HIV-antibody test at the three-month mark is considered to be definitive and conclusive, unless there are extenuating circumstances, such as the ones you reference in your post.
Regarding your situation, there may have been brief unprotected insertive penile-vaginal sex when your condom slipped off for "about 1 minute." This would put you at some degree of risk for STDs, including HIV. Your undetectable DNA PCR at 21 days plus your negative HIV-antibody/antigen tests at four and eight weeks are extremely encouraging. I'm very confident your definitive three-month test will remain negative.
I cannot confirm the 95% accuracy figure for an eight-week test. Even if it were correct, would you be satisfied with a 5% inaccuracy rate? I certainly wouldn't. It is true that the majority of HIV-positive folks would have detectable levels of anti-HIV antibody and p24 antigen in the blood by four-six weeks from the date of primary infection. However, a "majority," again, is not nearly good enough when dealing with an illness like HIV. Consequently, the three-month window rule remains intact, at least for the time being.
Thanks for your interest in making a tax-deductible gift to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return, I'll send my good-luck karma that your three-month HIV test remains negative. I'm confident it indeed will!
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