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Unprotected sex with HIV positive girl - follow up question
Jan 13, 2013

Hi doctor Wohl,

I wrote to you before, about this situation in October (under the topic "Unprotected sex with HIV positive girl") and would like to give you a follow up on my case as well as asking you some additional questions :)

Briefly summarizing, i had unprotected sex with an HIV positive girl during 3 days, and than some days latter i was put on a 3 drug PEP regimen for 28 days (2 days after my last exposure). I did several tests since I finished PEP (only antibody tests).

Right now it's been 20 weeks since last exposure and I tested negative yesterday on a rapid test. I also tested negative on a 4th generation combi assay (the name of the test is HIV-Combi PT manufactured by Roche) at the 16-week post-exposure mark.

My point is, I am still not convinced by these test results, even though in the HIV testing facility they told me those tests are conclusive. I feel these tests are still not 100% conclusive. The reason is the several reports of delayed seroconversion on health care workers i read about... As I am going out of my mind with all this situation, I was thinking about getting an HIV PCR test. My questions:

1. Considering that it's been almost 5 months after last exposure, do you think a PCR test will give me a reliable answer? I mean, how reliable are the results of such a test? 2. I have read that there are 2 types of HIV PCR tests: RNA and DNA. Which one do you recommend me to take considering my particular case? 3. Based on your experience, how reliable are the anti-body test results I had so far?

Thank you very much for your time!

Have a nice week.

Response from Dr. Wohl

We are no longer talking about delayed seroconversion when tests like p24 and HIV RNA are mentioned. These tests look for the actual virus. If PEP fails, the virus replicates and is found in the blood. You are months out from exposure and last dose of PEP. By now, if you had acquired HIV, the virus would be present and detectable.

You can certainly do an HIV RNA test (RNA is what you want). It will come back as "undetectable".

DW



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