[Question #11074] When is Enough?

17 months ago

On Jan 22 I received brief oral sex from a Filipino gal. I also fingered her w/ a nail bed nick. We live in NJ. I do have hpv but no recent breakouts.

Several days after the I felt pressure in my testicle, My dr gave me antibiotics,

The girl agreed to be tested on Feb 6 w/ Alere rapid duo. It was negative. She had a multivitamin with 30 mcg of biotin 8 hours prior to the test. She says her last risk was in July.

Around 4 weeks after the risk my doc found a swollen lymph node in my armpit after I complained of armpit pain. He said the size (minor swell) was not relevant and not to worry. Since then I have been obsessing & pushing on all different areas of my body.

I have tested with rapid alere duos at 4, 5, 6, weeks. I also tested yesterday w? the Alere rapid duo (52 days). All these tests were negative.

Today I think I feel a lymph node in my arm crease (opposite side of elbow).

1. Did 30 mcg of biotin affect her test?

2. Is it normal if you search & prod for lymph nodes to feel them? I believe the answer is yes & that doesnt mean they are always swollen. Please advise.

3. Should I trust my results?

4. Has hiv 2 be ruled out?

5. Did I have a risk?

6. Would my tests rule out ARS for my lymph node issue that started several weeks ago ( and i noticed one today) ?

7. Can I sleep with my partner unprotected?

8. Can I stop testing?

17 months ago

9. Lastly is lymph node swelling as the only symptom typical of ars?

17 months ago

Hi Doctors-

I am sorry. I respectfully ask if my question was missed. Thanks for your time.

17 months ago

I just want to explain why I logged in with this account. I am locked out of my other account. I was not trying to be dishonest. I am hopeful I will receive an answer. I am an assault survivor and have limited funds.

Edward W. Hook M.D.

17 months ago

Please be patient, As you should know, we do not staff the site 24/7. It's only been 6 hours since you asked your initial question.

This is a redundant question which repeats many of the questions you have asked of us in the past. These answers are not going to change. Receipt of oral sex is low risk for acquistion of STIs and no risk for acquistion of HIV. There is no risk at all from masturbating a partner. The presence of a nick on your finger does not change this.

In response to your questions (again, if yu go back to your past questions, you will see that the answers have not changed:

1. Did 30 mcg of biotin affect her test?

No, this dose is far too low to have any effect on the accuracy of your tests.

2. Is it normal if you search & prod for lymph nodes to feel them? I believe the answer is yes & that doesnt mean they are always swollen. Please advise.

Most people have lymph nodes that can be felt y an experienced clinician. Lymph nodes are sometimes abnormal when they become swollen and tender. When lymph nodes are swollen this is a non-specific finding. I agree with your doctor's evaluation

3. Should I trust my results?

yes, yes, yes

4. Has hiv 2 be ruled out?

Yes

5. Did I have a risk?

6. Would my tests rule out ARS for my lymph node issue that started several weeks ago ( and i noticed one today) ?

Yes. If you had lymph node swelling, or any other symptom due to HIV, your test would be positive.

7. Can I sleep with my partner unprotected?

yes

8. Can I stop testing?

Yes please

9. Lastly is lymph node swelling as the only symptom typical of ars?

No, isolated lymph node swelling is not the ARS

You are worrying needlessly. You do not need more testing. I hope my responses will allow you to move forward. EWH

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17 months ago

Dr. Hook,

Thank you. I truly am at a loss what to do. Because of potential lymph node swelling I went and had the Alere rapid duo on Sunday. The result was negative. This was at 8 weeks post risk.

Yesterday I felt a bump on the back of my thigh. Since it felt like a lymph node I got worried again. This morning I had a rapid antibody only test (Insti). The result was negative(58 days post risk).

Questions:

1. Is 8 weeks after the event too late for ARS?

2. Did today’s antibody only test, less then 24 hrs after I felt a lymph node rule out ARS?

3. When can I put this episode and my anxiety behind me and move forward?

4. Did I rule out both hiv 1 and 2?

5. Should my test results be believed or my lingering symptoms?

6. When can I stop testing and resume relations with my partner?

7. In short what should I do?

Thanks

17 months ago

8. Lastly, how concerned should I be about the lymph node issues I mentioned?

Edward W. Hook M.D.

17 months ago

You continue to worry needlessly following your virtually no risk encounter. I don't understand why you cannot accept that you do not have HIV. This is a question which you can answer with the help of a trained counselor, not by repeatedly asking anxiety-driven questions which you have asked in your many previous questions. Brief answers to your follow-up questions:

1. Is 8 weeks after the event too late for ARS?

Yes

2. Did today’s antibody only test, less then 24 hrs after I felt a lymph node rule out ARS?

From above- "Yes. If you had lymph node swelling, or any other symptom due to HIV, your test would be positive."

3. When can I put this episode and my anxiety behind me and move forward

From above- "You are worrying needlessly. You do not need more testing." You should move forward.

4. Did I rule out both hiv 1 and 2?

From above- "Yes"

5. Should my test results be believed or my lingering symptoms?

Believe the tests

6. When can I stop testing and resume relations with my partner?

As said above to the question of can you have relations with your partner - "Yes please"

7. In short what should I do?

Move on- seek counseling. Believe your tests

8. Lastly, how concerned should I be about the lymph node issues I mentioned?

From my earlier responses above - "Most people have lymph nodes that can be felt y an experienced clinician. Lymph nodes are sometimes abnormal when they become swollen and tender. When lymph nodes are swollen this is a non-specific finding. I agree with your doctor's evaluation"

EWH

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16 months ago

Dr. Hook,

Thank you for your response.

Last week I had the following tests:

64 day rapid duo negative

66 day rapid duo negative

67 day rapid antibody (insti) negative

68 day rapid antibody (insti) negative

The last couple of days my arms have been sore. Today I tested negative at 71 days using an Alere rapid duo.

1. Did I rule out ARS with todays test?

2. Can ARS show up after 9 weeks?

3. Yesterday I ate two egg Benedict’s for Easter. The web says each yoke contains 10 mcg of biotin. So I guess approximately 20 mcg in total of biotin. I tested 21 hours after ingesting the eggs.

Would that amount of biotin affect today’s results hiv test results and would that amount mostly be gone from my system 21 hours after eating the eggs?

4. Has hiv 2 been ruled out? I thought you said 8 weeks.

5. When can I stop testing?

6. At what point do antibody tests become conclusive? I believe I read 8 weeks.

7. Can I sleep unprotected with my regular partner?

8. Do I need more hiv tests?

9. If I get more symptoms can I assume they are not hiv related?

Thanks

16 months ago

Dr. Hook

I noticed a typo in question 3. It should read:

Yesterday I ate two egg Benedict’s for Easter. The web says each yoke contains 10 mcg of biotin. So I guess approximately 20 mcg in total of biotin. I tested 21 hours after ingesting the eggs.

Would that amount of biotin affect today’s hiv test results and would that amount mostly be gone from my system 21 hours after eating the eggs?

16 months ago

Dr. Hook

I do have one final question. Is there a certain amount of biotin that is considered to much with regards to hiv tests?

I just want to get back to my life.

Thanks

Edward W. Hook M.D.

16 months ago

This will be the final response to your repetitive, anxiety-driven questions to a virtually no risk encounter. You should not return with further questions. If you do, your question may be closed without a response and without return of your posting fee. Please don't waste my time or yours.

1. Yes

2. No

3. No impact

4. Yes since your exposure was virtually no risk to start with

5. Now-

6. 8 week

7. Now

8. NO

9. Yes

The typo makes you different. This amount of biotin is insignificant

please do not return. EWH

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