[Question #10395] Hiv

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23 months ago
Hello,
I had a vaginal intercourse with an African escort girl which lives already several years in Luxembourg. Condom was slipped and
We had an vaginal intercourse from around 4-5mminutes without condom. This was 32 days ago. I have really fear now. I have done a 4th generation test a day 
19, 23, 28 and 31 which come back all negativ. But now when I wake up at day 32 I noted that I have several small dots. 1 region mouth, 3 on left arm, 2 on abdomen and
1 on right leg. Could this be a Hiv rash? I checked on several pages from Germany and France and they said that there is only a accuracy of around 95 percent after 
Day 35 for a 4th generation test and 99 percent after 6 weeks. How are my odds in this course. Thks in advance
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Edward W. Hook M.D.
23 months ago
Welcome to our Forum and thanks for your questions.  I'll be glad to comment.

Congratulations on your commitment to condom protected sex- this will do much to protect you from HIV and other STIs although occasionally condoms do slip or break as you experienced.  The risk from this encounter was relatively low- most commercial sex workers do not have STIs and even when a partner does have untreated HIV, the risk of infection from a single episode of unprotected vaginal sex is less than 1 infection in more than 1000 exposures.  Further, we would say that current tests for HIV are more accurate than you have heard.  In our experience at 28 days, more than 99% of recent infections would be detected and at 6 weeks results are typically completely conclusive.  

Thus, it is very unlikely that the rash you noted represents recently acquired HIV.  In addition, when persons experience a rash due to recently acquired HIV, they typically also have high fever, a sore throat and generalized muscle or joint aches.  If you wish to determine whether your rash is due to HIV or not (I doubt that it is), you can test for HIV using a combination HIV antigen/antibody test of the sort you describe above.  If your rash is due to HIV, your test will be positive since when symptoms are due to HIV, tests are always positive.  (I realize that you were tested for HIV one day before you noticed you rash however there are no good scientific data on how often a test would be positive a day before the appearance of symptoms and while I suspect the test would be positive, I have no scientific data to base this statement on).

i hope this information is helpful.  If you wish to prove that your rash is not due to HIV, I suggest you test again for HIV.  EWH
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23 months ago
Hello, thks for the reply. 
So I will go tomorrow again to check my status. What I forgot to mention previous was that I had an Pcr test quantitative with min 20copy/ml at 11 days after exposure. I have no idea if this is important to mention.Plays this a role in accordance with the other tests I have already done? Thks

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Edward W. Hook M.D.
23 months ago
Thanks for the additional information.  It is often stated that persons with negative PRC results such as yours (the results of PCR tests are reported as being "less than" a specific number such as 20 copies/ml) at any time more than 11 days after an exposure will not go on to develop positive tests at a later date however the experience with such tests is substantially less than the experience with the combined antigen/antibody tests.  We have never seen nor heard of a person with a negative PCR test going on to develop a positive test at a later date.  Thus this result adds confidence that you are not infected.

I anticipate that your test tomorrow will be negative.  EWH
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23 months ago
Hello, so I have 3 replys I think I want to come back that my todays test was negativ. 2 more questions? Is it possible that this rash still shows up later in test?. In my case the test was 30 hours after the appearance of the rash? And my second question is how calm can I be with a test 4 generation after 33 days? has he a gudd accuracy?  Do I still need testing @ 6 weeks? Many thks Dr and many thks for your help. And sorry for my bad English
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Edward W. Hook M.D.
23 months ago
Thanks for additional information. Your results are now conclusive- you did not get HIV from the encounter you described.  There is no need for further testing.

Your test results prove that your rash was NOT due to HIV.  

I hope this information has been helpful.  This thread is now complete and will be closed shortly.  EWH
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23 months ago
Thks Dr Hook. So no need to to re test after 45 days? 
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Edward W. Hook M.D.
23 months ago
The official recommendation is that results are entirely conclusive any time more than 42-45 days after an exposure however, we have never seen or heard of a test which became positive following a negative test at 28 days or more.  There is a more than 99.9% chance that a final test would be negative and if I were you and I would not bother to test again.  Whether you choose to test however is, of course, up to you.  

This thread is no over.  EWH
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