[Question #12058] syphillis test conclusive?

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10 months ago
Hi there, 
simple question. I had a RPR done for syphilis at 4 weeks post exposure and then 10 weeks post exposure. both negative. could this be considered conclusive or is additional testing needed? 
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10 months ago
first rpr at 4 weeks says RPR, Rfx Qn RPR/Confirm TP, second RPR says syphilis  RPR with reflex. does that make a difference? or are they the same 
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H. Hunter Handsfield, MD
10 months ago
Welcome back. I'm sorry you've felt the need for spreading your questions about these sexual exposures over several questions; we would have been happy to address them in a single thread! Looking over your three previous ones, I agree with all you have heard from Dr. Hook and Ms. Warren.

Your RPR results are conclusive; for sure you do not have syphilis. The two labs use different terminologies, but they describe exactly the same tests. Four weeks was a bit too soon but would have detected most infections. Your 10 week result is conclusive, however.

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

HHH, MD
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10 months ago
apologies for spreading them out! this is due to me not realizing the correct test timing on things until after the fact. and also having anxiety about whether results are conclusive or not as i’ve been having symptoms still! i realize this my my problem though, so thank you for your replies! 
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10 months ago
just trying to figure out what’s going on, anyway hiv - conclusive, hpv likely, hsv1 yes unsure if oral or vaginal. hsv2 unsure and syphillis negative. 
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H. Hunter Handsfield, MD
10 months ago
I understand your concerns -- and no need for apologies. The only harm was to your pocketbook -- but ASHA appreciates the donations!

It is clear that nothing is "going on":  clearly you have no STD or any other infection from the sexual exposures you have described. Had you asked ahead of time, all three of us would have advised against testing for HSV, including HSV2. The chance of HSV2 in your situation isn't zero, but in absence of typical herpes symptoms, the chance of it is extremely low -- under one chance in several thousand, I would estimate. 
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10 months ago
agreed it seems at this point nothing can be pinpointed as to an std. my symptoms were green vaginal discharge, oral thrush, (still very mild) some muscle aches and a sense of malaise that lasted a week or so.  along with some digestion issues that are still occurring. had diarrhea etc. i can see at this point there is nothing (std) wise to attribute them to. and regarding the hsv i actually didn’t ask for that to be tested! they included it in the panel (s) when i got tested. i appreciate your replies! yes not the best for my pocketbook but glad to have donated haha. 
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H. Hunter Handsfield, MD
10 months ago
OK. You have one more follow-up comment coming. Let me know if I can help further.---
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10 months ago
not necessarily unless you feel like there’s anything else you can add. thanks for the help!
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10 months ago
do you think it may have just been a bacterial infection? (green discharge) (oral thrush) etc. if this is past the follow up, no worries!
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H. Hunter Handsfield, MD
10 months ago
I wasn't aware of vaginal discharge, which I don't see mentioned in scanning your previous threads. It's often hard to know the cause, but it could have been an STD issue. Presumably you were tested for gonorrhea and chlamydia somewhere along the line, right? With negative results I assume. What about trichomonas? Is the discharge continuing? 

As for thrush, was that vaginal or oral? A professional diagnosis? Just symptoms (like white coated tongue) isn't the same thing and doesn't necessarily mean thrush (yeast infection). If vaginal, it is irrelevant: vaginal yeast infections are not sexually transmitted or acquired. In any case, it's actually not a common symptom of early HIV infection -- and as Dr. Hook said, your HIV test overrules all else and shows you don't have it.
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10 months ago
i hadnt discussed that this was a symptom i experienced post exposure in previous threads - no more green discharge was treated for it and it went away. tested for all 3 and all 3 were negative. and yes i was told it was oral thrush, i had been put on medicated mouthwash twice, as it persisted after the first time and is still slightly persisting after second treatment. i’m aware it’s conclusive, regardless of any symptoms or how high the risk at 42 days. 
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H. Hunter Handsfield, MD
10 months ago
OK, thanks. That concludes this thread. Best wishes and stay safe.---