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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: HIV and AIDS
Satisfied Customers: 18673
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Im very anxious and looking for guaranteed and honest

Customer Question

Hello
Im very anxious and looking for guaranteed and honest answers. What if a healthy person who was exposed to 6 months after exposure took both antibody and viral load test, and the antibody come out false negative. Ive heard that if the antibody comes out negative then there would be 100% guarantee that there is a high enough viral load for it to show up positive at 6 months. Is that true? Is not can you call me the reasons why and if so can u tell me thhose reasons too. Sincerely ***** *****
Submitted: 1 year ago.
Category: HIV and AIDS
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

Did you have blood drawn for a fourth generation antibody test?

Or was this a finger prick or mouth swab test?

Customer: replied 1 year ago.
Im acutally only at 7 weeks but concern about 6 months and all myntesting are through blood work
Customer: replied 1 year ago.
Blood drawn
Customer: replied 1 year ago.
But my main concern is the questions i just asked
Customer: replied 1 year ago.
If at 6 months after exposure and taking both of the test as a healthy person only on anxiety medicine and anti depressents. When at 6 months when taking both blood drawn for antibody and viral load. Ive here if the antibody trst if false negative will there always be enough viral load in the blood to be detected by 6 months?
Customer: replied 1 year ago.
Because ive heard defected b cells wont produce antibody so there is always a 100 percent guarenteed high enough viral load for the virus to show up on the viral load test. Is that true?
Expert:  Dr. D. Love replied 1 year ago.

If you are getting blood drawn, then there is no reason to be concerned about false negatives, unless you have an immune deficiency. The current generation of antibody test is designed to have virtually no false negatives once the person is past the window period. The current generation of lab-based antibody test is so accurate that it is now only recommended to perform testing up until 12 weeks or 3 months after exposure. There was a time that it was recommended that testing also be repeated at 6 months, but there has now been sufficient experience over years to show that testing at 12 weeks/3 months is sufficient. There has not been a seroconversion past 3 months since the current generation of test has been used, so there has not been a single case in which the test at 12 weeks/3 months has been a false negative.

The alternate methods of testing, such as finger pricks or mouth swabs, are not as accurate, and these methods may have false negative testing. But if the lab based test is performed after 12 weeks, there has not been a case of a false negative. Since no case of a late false negative has occurred, there has not been any situation that matches the question you are asking.

There is a special case that involves people that have an immune deficiency in which they do not make antibodies, which is rare, but can occur. Since these people do not make antibodies, they also will not make antibodies against HIV, and the antibody test would be negative. Actually, since there are no antibodies, this would not be considered a false negative, because the test results are accurate. It is only false in that it does not indicate whether the infection is present. This special case is not a concern for most people, because someone that has an immune system and does not make antibodies is already prone to numerous infections before they may be exposed to HIV. So, people that present for testing would already know that they have such an immune deficiency. However, in this special situation, yes, the method for detection of an HIV infection would rely on the viral load test. In this setting, then yes, the viral load test would be sufficient to be detected, even at 3 months, but would still be able to be detected at 6 months.

There are rare cases of HIV infection that are long-term non-progressors, and these people may not progress for years. The viral load test may miss these people, but these people have intact immune systems, and someone that is not able to make antibodies has not been reported to be a long-term non-progressor.

However, if you have never had an issue with frequent infections because of an immune deficiency, then there is no reason for you to be concerned about a false negative fourth generation test done after 12 weeks.

If I can provide any additional information, please let me know.

Expert:  Dr. D. Love replied 1 year ago.

Please let me know if I can provide any further assistance.

Customer: replied 1 year ago.
Even at 6 months getting blood drawn everyone even the ones with health issues that antibody show up late, 100 percent of ppl that is hiv + will show up no matter what right?
Expert:  Dr. D. Love replied 1 year ago.

Except for the one health issue that I noted above, yes.

If you have never had recurrent infections because of an immune deficiency in which your body has difficulty making antibodies, then the HIV will show up on a lab based antibody test.

Customer: replied 1 year ago.
theres never been a case that a viral wont be high enough at 6 months without treatment? If so when is it that viral load is high and can it decrease on its own without medication so it wouldnt be detected at 6 months?
Expert:  Dr. D. Love replied 1 year ago.

There are the rare cases of long-term non-progressors that I noted above.

Customer: replied 1 year ago.
if i dont have any health issues and both came out negative at 6 months there would be no way of showing at 7. And what is the latest time for a person who is hiv+ to show up on antibody or viral load?
Expert:  Dr. D. Love replied 1 year ago.

Correct.

Using the current recommended testing schedule, the latest that a person is detected to have HIV is 12 weeks. However, this is more a function of the recommended testing schedule. For example, there has not been a study on a sufficient number of people using the current generation of tests to differentiate the level of accuracy at 10 weeks and 12 weeks. Since the current recommended testing schedule is to test at 4 weeks and 12 weeks, we can say that testing at 4 weeks well detect about 95% of people that will become infected. And we know that there has not been a seroconversion past 12 weeks, so the test at 12 weeks is 100%. But the exact percentage for every week between these two points in time cannot be said.

Customer: replied 1 year ago.
If i took a 4gen antibody test along with a viral load test at 7 weeks and both are neg. is there a chance of it being false negative? How long would it take a high enough viral
Load to show up on a viral load test without any taking medication for it for health issues.
Customer: replied 1 year ago.
If both test are negative would that mean that i am 100% hiv free?
Expert:  Dr. D. Love replied 1 year ago.

The fourth generation test is not considered to be 100% until 12 weeks. The viral load test would typically be positive at 7 weeks except in the long-term non-progressors noted above. So, this testing at 7 weeks would not mean that you are 100% HIV free, but it would be well above 99% certain.

Customer: replied 1 year ago.
What do you mean typically positive at 7 weeks except in long time non progressor?
Customer: replied 1 year ago.
For the viral
Load test. So at 7 weeks it wouldnt be 100 percent for viral
Load. Even if u take a 4gen antibody test with it?
Expert:  Dr. D. Love replied 1 year ago.

It means that the viral load is positive in typical infections, but in the rare cases of long-term non-progressors, the test may not be positive, as I noted above.

No, it would not be considered to be 100%, even with a fourth generation test done at the same time. As I said above, our knowledge is limited by the current testing recommendations. But it is only the lab-based antibody testing at 12 weeks that is considered to be 100%.