[Question #11906] Follow up questions
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11 months ago
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Hi doctors, thanks for answering my last question, but I have some follow up questions.I know you said that it is impossible for me to transmit HIV to my partner when I had sex with her during my PEP treatment last year. However, I forgot to mention that starting a month after we had sex, she developed oral thrush on her tongue. It went away after she took an antifungal pill. However, this past year it has been coming back and going way recurrently without treatment, only on her tongue. She’s has not had any discomfort or has not been otherwise sick. Also she has never taken antibiotics, does not smoke, does not have diabetes, does not use cortosteroid inhalers either. Everything I read said that oral thrush is a result of HIV.
1. Since I had unprotected sex with her on day 21 of my PEP, was that enough PEP to ensure that there was no HIV in my system?
2. Is her recurrent thrush alone (which started one month after we had sex) suggestive of HIV? It has been recurring for about 10 months now. She also suffers from severe anemia, exczema, HS, and IBS. I read that severe iron anemia and low b12 can cause a weakened immune system and lead to oral thrush. Is this true?
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Edward W. Hook M.D.
11 months ago
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Welcome back to the Forum although I'm sorry you felt the need. I read your interactions from yesterday with Dr. Handsfield when he said your mind is working overtime and that there was simply no way you could have HIV - something that you proved with a negative HIV PCR test. I also agree with his sense that you are "working overtime" to "create impossible scenarios". Asking these sorts of question is not going to help the guilt that it appears you have.
It is also apparent that you have been on the internet looking for information. This is a bad idea. The described association of oral thrush with HIV is a great example of this- most people who have thrush do NOT have HIV and when thrush occurs in persons with HIV it occurs among persons who have been infected for years and have advanced HIV
In response to your questions:
1. Yes
2. See my comments about oral thrush. If she is being treated for her other problems, the treatment may increase her risk for thrush. Low iron and a weakened immune system, as indicated by her eczema and anemia can contribute to risk for thrush.
Please do n't worry. EWH
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11 months ago
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Thank you doctor. I will try my best to put this all behind me and not be paranoid. I will also stay off of google because it’s fueling my anxiety. A few clarifying questions
1. I took the PCR test day 10 of taking PEP, and had sex with my partner day 22 of PEP. I then took another PCR test a month after completing PEP. Is this strong evidence that I never had HIV? Should I have taken the PCR test closer to the day that I had sex with my partner?
2. I did also take a 4th generation test on day 14 of PEP, which was negative.
3. The only medicine that she takes is cortosteroid cream for her eczema. Can this, along with her severe iron deficiency anemia weaken her immune system, leading to oral thrush?
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Edward W. Hook M.D.
11 months ago
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1. It's not "strong evidence", it's PROOF!!! that you don't have HIV and cannot have infected your partner
2. The PCR is better evidence
3. You may never know why she is predisposed to thrush. You can be sure however that you have not given her HIV. You reallyneed to move on. EWH
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11 months ago
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Thanks doctor I am finally starting to understand. So to sum up everything you and the other doctor said:
1. It is impossible for me to have transmitted HIV to my partner while having sex during my PEP treatment, and still myself test negative over a year later?
2. While taking PEP, There is no HIV circulating in the body, which means that I can’t give HIV to someone else?
3. If I was indeed exposed to HIV, the PEP short circuited it HIV before it replicated and infected me?
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Edward W. Hook M.D.
11 months ago
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Final Responses:
1. Correct
2. Correct
3. Correct
This completes this thread. There should be no need to return to the forum with further questions about this exposure or pep. Should you return with further repetitive, anxiety, driven questions, the thread may be closed without a response and without return of your posting fee. EWH.
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