[Question #10206] Information

25 months ago

Hello,

I am from India. Please answer the following questions:

1) A person (male/female/others) can transmit HIV (Type 1 and/or 2) to others ONLY if he/she is infected with HIV (Type 1 and/or 2), correct?

2) If a person (male/female/others) never had HIV (Type 1 and/or 2), he/she could not have transmitted HIV (Type 1 and/or 2) to anyone. Is my understanding correct?

3) Once a person (male/female/others) gets infected with HIV (Type 1 and/or 2), he/she will test positive on 4th generation HIV (1/2) test (HIV Duo test or HIV Antigen-Antibody test) for his/her entire life, correct?

4) A person (male/female/others) can transmit Syphilis to others ONLY if he/she is infected with Syphilis, correct?

5) If a person (male/female/others) never had Syphilis, he/she could not have transmitted Syphilis to anyone. Is my understanding correct?

6) Once a person (male/female/others) gets infected with Syphilis, he/she will test positive on TPHA test for his/her entire life. There is ONLY one situation in which seroreversion of TPHA test (from positive to negative) happens - if syphilis is cured by antibiotics in primary stage (cured by antibiotics within 1-2 months from an exposure that lead to infection). Is my understanding correct?

Thanks.

H. Hunter Handsfield, MD

25 months ago

Welcome to the forum. I'm happy to address these questions. Thank you for your confidence in our services.

Thanks for your careful research. You clearly understand the truths you state about HIV infection and syphilis. To be explicit:

1) Yes. No virus or other infection can appear out of the blue, or is caused by sex itself. HIV only can be acquired by contact with a partner already infected. This applies equally to both HIV1 and HIV2.

2) This is the same question in different words. The answer is the same.

3) Correct. It takes at least 2 weeks, usually 3-4 weeks, and once in a while as long as 45 days (6 weeks) for the HIV AgAb ("4th generation") blood test to become positive. Once positive, the test remains positive for life.

4) Same answer as for HIV: syphilis only can be acquired by intimate contact with an infected person.

5) Once again, this is the same question as the one above, using different words. Correct.

6) The treponema pallidum hemagglutination assay (TPHA) is one of several blood tests that accurately detect current or past infection with syphilis. Others include FTA-ABS, TPPA, and a few more. Once positive, all such tests remain positive for life, with occasional rare exceptions for syphilis treated very early.

I hope these comments are helpful and reassuring. Let me know if anything isn't clear.

HHH, MD

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25 months ago

I have full trust in your expertise. I am from India. Please clarify:

1) Once a person is infected with HIV (Type 1 and/or 2), he/she will remain infected with HIV (Type 1 and/or 2) for his/her entire life, correct?

2) "A person never had Syphilis" and "A person was never infected with Syphilis" mean the same, correct?

3) A person got infected with Syphilis but his/her immune system cleared or cured or contained Syphilis. This person will test positive on TPHA test if TPHA test is done ANY TIME after 3 months from his/her sexual act that lead to infection, correct?

4) A person can transmit Hepatitis B / Hepatitis C to others ONLY if he/she is infected with Hepatitis B / Hepatitis C, correct?

H. Hunter Handsfield, MD

25 months ago

1) Correct.

2) Correct.

3) Correct, except TPHA normally is positive sooner than 3 months, usually by 6 weeks or thereabouts.

4) Correct.

Another clarification about TPHA, which might reflect how the test is used sometimes in India -- based on other questions we have had on the forum. I have the impression that TPHA is often done when screening persons for syphilis in India, in addition to RPR (or maybe sometimes in addition to an EIA tests). This is unnecessary, as agreed by most syphilis experts worldwide. In the US, only RPR or EIA is done as the first test for syphilis. If negative, usually no further testing is done. That negative result is considered conclusive: it means the person does not currently have active syphilis, either because of past treatment or that the immune system cleared the infection. In most of the world, TPHA or related tests are done only if the initial RPR or EIA is positive.

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24 months ago

Thanks for your kind help. This will be my last follow-up.

I am from India. Please clarify:

1) "A person never had HIV (Type 1 and/or 2)" and "A person was never infected with HIV (Type 1 and/or 2)" mean the same, correct?

2) A person (male/female/others) had multiple sexual acts over the years. If this person has a negative 4th generation HIV (1/2) test ANY TIME after 6 weeks from his/her last sexual act, it will mean that this person NEVER HAD HIV (Type 1 and/or 2). Is my understanding correct?

H. Hunter Handsfield, MD

24 months ago

1) Yes. "Never had" and "was never infected" are just different wording for the same thing.

2) Yes, your understanding is correct here as well.

That competes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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