I had sex with a sex worker but I used condom. Some days later I noticed two little scrachtes at the base of my penis. I am concerned about the possibility of they were not covered by condom. So I tested PCR Quantitative For HIV 13 days later and it was ok. 43 days after this exposure I tested again (3rd generation HIV 1 & 2) and 59 days I tested again (4th generation test). They all were negative. But 5 days ago I had fever (38,5ºC) and yesterday again (39ºC). I have some problemes with Diarrheya too. These problemes began at 9 weeks after the risk situation and come again at 10 weeks after the risk situation. So I am afraid that it can be late seroconversion. What do you think? I'm scared.
The 4th generation test can find p24. But I tested 59 days after the risk situation. Is it reliable? Let's suppose I am positive, the test could find the p24 antigen if I had not developed yet the antibody for hiv?
Please, help me.
Hello and Thank You for Using the AIDS Vancouver Helpline as your source of HIV/AIDS related information.
First, it is great to hear that you used a condom during your encounter, as it is very rare to contract HIV from having protected sex. To transmit, the HIV virus needs direct access to the bloodstream through a mucus membrane, open cuts and sores (in theory though), the anus, the vagina or the urethra of the penis. Even if you did have scratches at the base of your penis that were not protected by the condom, it is important to note that the scratches would have to be actively bleeding to for you to be infected. However, this is theoretical because there has never been a reported case from a scenario such as that.
The window period for the 3rd generation test you took is 4 weeks-3months (95% of infections are detectable within 4-6 weeks), so the negative result you received at 43 days is a good indicator of your status.
In regards to the 4th generation test you took (which looks for both the antibodies and the p24 protein antigens), the window period is 4-12 weeks for the antibody portion of the test. Detection of the antigens (p24 protein) is only detectable immediately after infection and only for the first couple of weeks. The 4th generation test that you took at 59 days, that came back negative, is also a good indication of your status because as it was performed during the window period for the antibody portion of the test (as long as you have not had any risky exposures since then.)
Late seroconversion is very rare, but could happen. Therefore, for completely conclusive and definitive results, official HIV testing guidelines still recommend re-testing at 12 weeks (90 days) post exposure.
It is important to note that HIV symptoms mirror other viral infections, and can be due to a number of things. Therefore, testing is the only way you can know for sure if it is HIV, which you did!
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