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Is A HIV PCR RNA Test Conclusive 36 Days After Exposure?
Question: Respected Sir , I am 19years old male from XXXXXXX I was exposed to HIV 49 days back(Feb 7th).After 24hours I started PEP.Doctor gave me truvada. I was able to take only two pills (Feb 8th&9th) and discontinued due to side effects.After days post exposure PCR RNA and HIV duo test was negative.My cd4 count is only 780.On 28th day western blot test came out negative.Even p24 was negative.On 36th day PCR DNA test came out negative.Today on 49th day I am having oral ulcers ,joint pain and nausea.I am scared .Parents aren't cooperating for an HIV duo test for now .i have a doubt .
Doubts
1.As I took two pills of truvada will be there a delay for the virus to show up in blood ? If yes,did I get false negative on 36th day PCR DNA test ?
Thanking you with best regards .
Doubts
1.As I took two pills of truvada will be there a delay for the virus to show up in blood ? If yes,did I get false negative on 36th day PCR DNA test ?
Thanking you with best regards .
Brief Answer:
You are free from HIV1 infection and symptoms are unlikely to be due to HIV
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
You had mentioned that you had been exposed to HIV. Do you mean to say that lady has HIV infection already and her HIV status is known to you?
PEP is mainly intended for occupational hazards or exposures for the health care personnel during their working environment, not for post sexual exposures.
Moreover, nowadays as per recommendations, there is no role for two drug combination (as in truvada), it is recommended in the form of three drugs combination only. That too, you had dropped out without completing the course. So no use in talking about the same.
Regarding your test reports, Western blot by 28th day has of no value as it is an antibody detecting test which will be reliable only after the completion of window period. (12 weeks after the exposure). Non reactive DNA PCR and P24 antigen test are highly reliable, especially 4 weeks after the risky contact. Both negative tests ruled out the possibility of HIV infection with you as these p24 Antigen test and DNA PCR can detect only the HIV 1 infection and not HIV 2 infection. HIV 1 infection is the commonest type of infection throughout the world except in certain pockets of XXXXXXX up to the extent of 99.5%. The prevalence of HIV 2 in XXXXXXX is less than 0.5%. So not to worry.
2 tablets of Truvada was unlikely to have any influence over your results especially over Antigen detecting tests like DNA PCR and P24 Antigen test.
ART can delay the antibody formation but not much with just two tablets.
Joint pain and oral ulcers are fairly common symptoms for anybody and not necessarily to be due to HIV infection.
Dr S.Murugan
You are free from HIV1 infection and symptoms are unlikely to be due to HIV
Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
You had mentioned that you had been exposed to HIV. Do you mean to say that lady has HIV infection already and her HIV status is known to you?
PEP is mainly intended for occupational hazards or exposures for the health care personnel during their working environment, not for post sexual exposures.
Moreover, nowadays as per recommendations, there is no role for two drug combination (as in truvada), it is recommended in the form of three drugs combination only. That too, you had dropped out without completing the course. So no use in talking about the same.
Regarding your test reports, Western blot by 28th day has of no value as it is an antibody detecting test which will be reliable only after the completion of window period. (12 weeks after the exposure). Non reactive DNA PCR and P24 antigen test are highly reliable, especially 4 weeks after the risky contact. Both negative tests ruled out the possibility of HIV infection with you as these p24 Antigen test and DNA PCR can detect only the HIV 1 infection and not HIV 2 infection. HIV 1 infection is the commonest type of infection throughout the world except in certain pockets of XXXXXXX up to the extent of 99.5%. The prevalence of HIV 2 in XXXXXXX is less than 0.5%. So not to worry.
2 tablets of Truvada was unlikely to have any influence over your results especially over Antigen detecting tests like DNA PCR and P24 Antigen test.
ART can delay the antibody formation but not much with just two tablets.
Joint pain and oral ulcers are fairly common symptoms for anybody and not necessarily to be due to HIV infection.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much sir .
Sir on 28th day I did nly western blot .In that p24 and other antigen was mentioned and it was negative .on 15th day PCR RNA and duo test were negative.36th day PCR DNA is also negative .so HIV 1 is ruled out right ? Can I allay fears ?how accurate is PCR DNA after 36 days ? Sorry for irritating u ,this will be the last question from me
Thanking you with best regards :)
Sir on 28th day I did nly western blot .In that p24 and other antigen was mentioned and it was negative .on 15th day PCR RNA and duo test were negative.36th day PCR DNA is also negative .so HIV 1 is ruled out right ? Can I allay fears ?how accurate is PCR DNA after 36 days ? Sorry for irritating u ,this will be the last question from me
Thanking you with best regards :)
Brief Answer:
HIV 1 infection ruled out conclusively.
Detailed Answer:
Hi,
Welcome back.
What was mentioned in the western blot is antibody against various antigens present over the HIV virus including P24 antigen. But it would not detect the antigen , only the antibodies. So it will be reliable only after the completion of window period.
HIV DNA PCR is reliable up to 99% done 3-4 weeks after the exposure. So your negative DNA PCR 36 days 95 weeks) after the risky act was highly reliable. HIV 1 was ruled out beyond any doubt and you can relax.
Any HIV antibody test (Rapid, ELISA,3rd and 4th generation tests, Western blot) can rule out both HIV 1 and 2 by 12 weeks following the exposure and it will be very much conclusive.
Dr S.Murugan
HIV 1 infection ruled out conclusively.
Detailed Answer:
Hi,
Welcome back.
What was mentioned in the western blot is antibody against various antigens present over the HIV virus including P24 antigen. But it would not detect the antigen , only the antibodies. So it will be reliable only after the completion of window period.
HIV DNA PCR is reliable up to 99% done 3-4 weeks after the exposure. So your negative DNA PCR 36 days 95 weeks) after the risky act was highly reliable. HIV 1 was ruled out beyond any doubt and you can relax.
Any HIV antibody test (Rapid, ELISA,3rd and 4th generation tests, Western blot) can rule out both HIV 1 and 2 by 12 weeks following the exposure and it will be very much conclusive.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much sir ... I am 99% confident about my status that m negative . Sir ,My cd4 count is 780 only . Does it mean that my body will take more than 12weeks time to form antibodies ?Or should I consider 12weeks to be 100% conclusive?
Brief Answer:
CD4 count will not interfere with outcome of HIV test result.
Detailed Answer:
Hi,
Welcome back.
CD4 count 780 is normal for some individuals. This will not interfere with your HIV results. CD4 has nothing to do with antibody formation which is taken care by the B lymphocytes in our body. Outcome of the HIV test which is going to be done 12 weeks after the exposure will not get affected and it will be conclusive for HIV 2 also.
Dr S.Murugan
CD4 count will not interfere with outcome of HIV test result.
Detailed Answer:
Hi,
Welcome back.
CD4 count 780 is normal for some individuals. This will not interfere with your HIV results. CD4 has nothing to do with antibody formation which is taken care by the B lymphocytes in our body. Outcome of the HIV test which is going to be done 12 weeks after the exposure will not get affected and it will be conclusive for HIV 2 also.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks so much for the info sir . I am planning to go for an antibody test after 9 weeks . Will be there false negatives due to those two pills of truvada ? U told that it may delay antibody formation.So how accurate is 9 weeks antibody for me ? What are the chances of getting positive result at 12weeks ?
I am getting all these doubts only due to that two pills of truvada :( only that's the prob
I am getting all these doubts only due to that two pills of truvada :( only that's the prob
Brief Answer:
Reliability of the HIV Antibody test more after 12 weeks after exposure.
Detailed Answer:
Hi,
Welcome back.
Window period for any HIV antibody test is around 6-8 weeks, in some individuals it may extend up to 12 weeks after the exposure.
If you had taken up the test by 9 weeks, then there is a chance for the test to have a delayed sero conversion. So your test can not be taken as conclusive. Moreover you had taken Truvada for 2 days. So I will not consider the HIV antibody test 9 weeks after the risky contact as an absolute one. So better have it after 12 weeks, so that reliability of the test will be more.
Dr S.Murugan
Reliability of the HIV Antibody test more after 12 weeks after exposure.
Detailed Answer:
Hi,
Welcome back.
Window period for any HIV antibody test is around 6-8 weeks, in some individuals it may extend up to 12 weeks after the exposure.
If you had taken up the test by 9 weeks, then there is a chance for the test to have a delayed sero conversion. So your test can not be taken as conclusive. Moreover you had taken Truvada for 2 days. So I will not consider the HIV antibody test 9 weeks after the risky contact as an absolute one. So better have it after 12 weeks, so that reliability of the test will be more.
Dr S.Murugan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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