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test result, how conclusive?
May 12, 2010

Hello Dr. Bob,

I hope you are doing well.

I don't know if oyu can retrieve my original post with just my e-mail address, but in case not, in brief, my situation was sexual vaginal intercourse with a female of unknown status in the US, my condom broke and I was exposed for about 1 minute. within 2 days (after a flight home and then 2 days later another flight halfway around the world) I developed various symptoms that all came on at different intervals and lasted about 5 weeks. My most concerning symptoms (nausia, loss of apetite, night sweats) came on when I started taking azithromycin for 5 days, but lasted about 3 weeks after completing the dose. The only symptom I did not experience was a fever.

Did a blood test 2 weeks and 3 weeks post exposure (both were negative) and last week I did an Elisa test at my 6 week mark, got the result back today, negative.

1) I know 3 months is definitive, but how conclusive is my 6 week Elisa result? What is the likelihood of my 6 week negative changing to a positive at 12 weeks?

2) If any of the symptoms I experienced from week 1 to week 5 were in anyway related to HIV ARS, then would my 6 week test have shown 100% positive?

3) Can ARS symptoms begin beyond 4 weeks post infection, and can they last for more than 3 or 4 weeks?

4) It's my understanding that if an individual experiences ARS symptoms from an infection then within days of experiencing the symptoms a test would show up positive 100% of the time, however if there is no ARS, then the absolute longest period until antibodies are present/detected is 3 months.

Now, if an individual becomes infected, and let's assume this individual was not going to experience any ARS symptoms, however 1 week after becoming infected this individual happens to catch a flu or cold bug, would the virus's presence in the body have an effect on the cold or flu (making the symptoms worse or last longer) even though antibodies would still not be detected at that point?

Thank you again for everything, I am making a $100 donation to your organization tomorrow morning.

Response from Dr. Frascino

Hi,

Welcome back to the forum.

1. The vast majority of HIV-infected folks will have detectable levels of anti-HIV antibody in their blood within four to six weeks following HIV primary infection. However, due to variability of the body's immune response from person to person, some folks may take a bit longer to develop detectable levels of these antibodies. Consequently the current published guidelines continue to recommend testing at three months minimum for a conclusive result.

2. No, not necessarily.

3. There is considerable variation in HIV ARS symptoms from person to person. They generally manifest themselves at two to three weeks and persist for several weeks.

4. No, these two separate and distinct viral infections would not affect symptom severity or duration.

Thank you for your generous donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. In return I'm sending you my good-luck/good-health karma that you are now and will always be HIV free.

Good luck.

Dr. Bob



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