[Question #1266] Follow up 2 - stds

47 months ago
Hi doctors,

Following up on questions 1251 and 1242. It's now been 9 days since the exposure. The days are not getting easier I will tell you that. Never putting myself through this again. I have a few follow up questions:

1. As mentioned, I took my chlamydia and gono test approx 80 hours post exposure, a little over 3 days. It showed negative. You had mentioned that this test would be reliable and I don't need to retest if these showed negative. Over the past few days I've noticed a couple of things - increased urge to go pee, some stinging sensations in my penis tip here and there, pain in the balls that comes and goes, urine sometimes has a weird smell to it (nothing I've smelt before, no diet change).  There has not been any discharge, redness, nor has it hurt to pee. I've been checking religiously. Is there a chance that the test missed an infection? I know the tests are sensitive these days (especially in NYC labs) but want to be sure I don't need to retest. Are these symptoms without discharge and pain during pee any indication or infection? Or is this purely being created mentally?

2. I've noticed I've had extreme fatigue the past couple of days and my muscles have started to ache. Is it too soon for ARS to start (6-8 days post exposure, 3-5 days after finishing my short pep stint). Could the 3 days of pep I did be causing these symptoms? 

3. I'm setting up two hiv tests - one 17 days post exposure (14 days post pep stint).  This will be a 4th gen and rna test. And one 28 days post exposure. This will just be the 4th gen test. I know you suggested just to wait for the 28 day test but I want to understand how accurate my 17 day test will be?  Am I looking at 80%, 90%, 50%? Unfortunely I don't have the patience to wait.


Thanks in advance for your advice. Talking to you guys is really what gets me through the days until I can do further testing.

Bob
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
*Sigh*

In one of your rearlier threads, I wrote "Please do not start a new thread; any additional advice here will be no different than you have had so far." That is the way it has been in two threads since that one, and also here. These questions have been answered in your other threads, directly or indirectly, and you know very well, or could have accurately predicted, exactly what our replies would be this time. You really need to get a grip here!

1) Your test was reliable and the result shows you dont have gonorrhea or chlamydia, no matter what symptoms you have now or might develop in the future. 2) "Fatigue" alone is not a symptom of HIV or any other STD. PEP is also not a likely cause. All your symptoms sound like the physical manifestations of anxiety and stress, that's all. 3) Your planned tests at 17 days (RNA plus 4th gen) will be 100% conclusive. So will any 4th gen test (alone) at 28 days after exposure. Three days PEP probably is too few to make any difference.

This forum is not a substitute for in-person care, and we are not your doctors. If you don't have a personal physician guiding your care, please find one and rely on that person, not this forum. We are not permitted to provide medical care and that is what you are asking you to do. I'll leave this thread open for you to tell us your test results, but we will provide no other advice of any kind, e.g. no further comments on any symptoms you may have or what they might mean.

HHH, MD

---
47 months ago
Hi doc,

Thanks for replying. I know I shouldn't keep posting and I will be sure to post my results of testing.

Question on testing:
Due to anxiety and current symptoms (sore throat), I was thinking about moving up the tests I was going to take 17 days post exposure (14 days post pep stint) to tomorrow, which would be 13 days post exposure (10 days post pep stint).  This would be the rna viral load test + 4th gen. I know you mentioned the 17 day test combinations would be 100% reliable, but are these 4 days going to make the tests any less reliable? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
There are no firm data on this, but my guess is that 4 days won't make any difference.

You get one more follow-up comment and reply, after which this thread will be closed. And as I said, any new questions after this will be deleted without reply. And there seems no point in posting any negative results:  I'll just agree "yup, that's negative" and it won't change my evaluation of the reliability of the result. So I suggest you not post anything more until you have your negative final result at 4 weeks.

---
47 months ago
Hi doc, 

Realize this is my last follow up, so here it goes.

I ended up taking an hiv rna test down to 20 copies 13 days post exposure (10 days post 3 day pep stint). It came back negative (not detected). He didn't end up running an 4th gen test in addition to the rna.

My questions are:
Is this test 100% conclusive even though I didn't run the 4th gen in addition to it? If not 100% conclusive, how accurate are we talking? 
Should I still get  retested with a duo test at 28 days? I'm feeling good right now, so would like to move on, but understand if I should get retested. 
I haven't any other symptoms, my chlamydia, ghonorea,  and syphillis tests have been negative. Think it's ok to be intimate with my girlfriend at this point?

Let me know. Thank you for all your help these past couple weeks. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
The RNA test is virtually 100% conclusive on its own, but most experts would have recommended an antibody test as well, either 3rd or 4th generation. But all things considered, it is impossible you have HIV and can safely resume sex with your partner. You had a very low risk exposure with no need even to be tested for HIV in the first place. Had somehow I been in your situaiton, I would never have stopped having unprotected sex with my wife. You certainly can resume sex with your partner at this time.

Thanks for the thanks. Best wishes and stay safe. But do not be tempted to start yet another thread about these issues. In that event, it definitely will be deleted without reply and without refund of the posting fee. It's time for you to move on. Good luck.


---