Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date. How accurate would a proviral PCR DNA be at detecting HIV-1 strains, around 10 days after exposure? I had the test done through Quest Diagnostics, and it came back undetected. Also, at day 2 I had a sore throat, and at day 6 a papular eruption on my trunk, which resolved in about 8-10 days and now only faint non- red remnants remain. Could this rash be due to unusually small amounts of virus, or could the virus just have been concentrated in some parts of my blood so that it only effected the chest? And my exposure was to a person of korean/chinese origin---it was possible condom slippage due to failing erection, and possible condom breakage that I did not check for --- so would the HIV-1 test be accurate in light of this?
Kindly let me know soon, I plan to get retested with a PCR RNA at 25 days, an ELISA/PCR DNA at 6 weeks and an ELISA at 12 weeks. Does that sound ok?
Trevor Hawkins, M. D.
Associate Clinical Professor, Dept. Family Practice, University New Mexico
Medical Director, Southwest CARE Center, Santa Fe, NM
And...
Mark H. Katz, M.D.
Regional HIV/AIDS Physician Coordinator
Kaiser Permanente of Southern California
HIV-DNA PCR is the most sensitive test there is for picking up HIV genetic material and, as you say, can detect it as low as 10 copies/ml.
While it is encouraging that it was negative at 10 days, it is not definitive. That would be at 28 days where it is as much as 96% sensitive.
I did try to find out for you the exact probability but it is a grey area and I cannot put a figure to it.
Get your PCR and Antibody test at 28 days and a repeat Antibody test at 3 months if it is negative for a final reassurance.
There is no such thing as unusually small amounts of virus causing fewer symptoms. If enough virus is present so as to cause infection, then any combination of symptoms may occur. The HIV test should be totally accurate and does not depend at all upon the scenario which led to the potential exposure. In your case, however, I would certainly say that the act your describe brings your risk fairly close to zero!
Good luck, and continue to practice safe sex. This is the best investment you can make in not acquiring HIV!
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