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When is the Test conclusive? And how long is the window period ?

Oct 13, 2013

Dear Dr. Wohl, It is confusing about the length of window period? I have read that the test may detect as early as few weeks and some say it took even 3-4 years in the forum. And it scares the hell out of me too. After having sex with a prostitute out of curiosity with supposedly enough protection in Bangkok. After around a month of exposure when I was never worried about the infection and doing lots of physical exercise/adventure activities , I was sick for almost a month which was almost like all the symptoms thats given in internet like diarhoea, weight loss, fibromyalgia, rash, candidiasis in the penis, exhaustion, lymph node swollen, night sweats, mild fever etc and began testing on completion of 3 months and they were negative but it scares the hell out of me as it could be HIV-2 too also. I have tested negative to more than 5 months by combo test. And the undetectable PCR RNA test could be just for HIV-1. And my continuing symptoms/OIs in the form of fatigue, loss of muscles, pain in muscle/joints, rashes here and there scares me all the more. I even thought whether it is because of stress but I doubt it is ? I dont know whether 3 months test was conclusive. Or I should go for further PCR RNA, PCR DNA, Different forms of Antibody test. I want to move on with full confidence that it is not HIV and do some better things in life, get married etc.

Response from Dr. Wohl

The confusion comes from the change in the window period with the development of better antibody tests, the advent of newer tests for the virus itself, and nonsense people post on the internet.

The combo test can detect HIV-1 and HIV-2 antibodies and is considered conclusive by 12 weeks. Some feel reassured by testing again at 24 weeks and that is fine. The test also looks for part of the virus (p24) on HIV-1 and can detect that within 2 weeks of infection.

The HIV RNA PCR can detect virus even earlier.

So, in your case HIV-1 is ruled out. HIV-2 is a possibility but it is not common in Thailand and it would be weird to lead to symptomatic disease so quickly. You can repeat a combo test at 12 or 24 weeks and when that is negative consider yourself HIV-2 free.


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