[Question #1330] Test Results

46 months ago
Hi Doctors,
I would keep it simple and short, so here is the list of events since the last 81 days to be precise with -

Days after the exposure, NEGATIVE -

1) 33 Days: FINGER PRICK RAPID ALERE Determine Combo

2) 60 Days: In-House Oraquick Mouth Swab

3) 74 Days: Sneezing, runny nose followed by sore throat, ear pressure, phlegm and yellow thick discharge from nose. This freaked me out and I thought this could be ARS. Its been almost a week since this started and I am still not feeling well.

4) 75 Days: In-House Oraquick Mouth Swab

5) 78 Days: FINGER PRICK RAPID ALERE Determine Combo

6) 79 Days: Clearview RAPID Finger Prick

7) Today, 81 Days: In-House Oraquick Mouth Swab

Questions -
1) I have read your responses on medhelp and also on this forum, and you have always said that regardless of the exposure or the symptoms, negative tests over rule everything. So am I in the clear?

2) Could it be ARS? My 74 days symptoms.

3) If it were really ARS, which one of the tests done afterwards would have been positive for sure? I am worried that my ongoing symptoms could be something serious and I may still turn positive any day after the 81 days test.

4) Do I still need the 84 day test?

Due to some prior incidents in my life, I have become suspicious of medical science. I don't discredit it, but it takes me a while to believe the results. I really want to move on with my life by leaving this incident behind!!!

Regards,


 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question, and for reviewing other pertinent forum information.

I'm happy to report that the previous information you found has not changed. You don't say what your exposure was, which always is helpful in interpreting HIV test results. But the bottom line is that almost certainly you were not infected. Before answering your specific questions, I'll comment on your symptoms:  ARS can cause sore throat, but usually with symptoms you don't report, like skin rash, enlarged lymph nodes, and fever. Equally important, ARS typically does NOT cause typical upper respiratory symptoms liek yours, i.e. no runny nose, nasal congestion, phlegm, or ear pressure. Finally, the timing was wrong:  ARS symptoms start 10-20 days after exposure; 74 days is far too late. You caught a cold, that's all.

As for your testing, all blood tests, both rapid and lab based, are conclusive by 6-8 weeks after exposure. The oral fluids test can take up to 3 months (it's the only standard HIV test that still takes that long, but even this is rare; most are positive by 6-8 weeks). Now to your questions:

1) Yes, you are in the clear. Your understanding from our comments elsewhere on this forum and on MedHelp is correct. 

2) You do not have ARS. As discussed above, the symptoms and timing are wrong.

3) The HIV antibody tests generally are positive at the time ARS symptoms start, and for sure would be positive a week later (day 74 to 81).

4) Your tests for sure are conclusive; indeed, you were rather seriously overtested. However, some experts would say that if you had an especially high risk exposure -- e.g. something like receptive anal sex or sharing drug injection equipment with a known infected person -- you might consider a final HIV antibody test (any kind of test would be fine) at 90 days (3 months). But personally I would not recommend it. 

I hope these comments have helped. Best wishes and stay safe--  HHH, MD

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46 months ago
Hi Dr HHH,
You wrote - 'almost certainly you were not infected...'. The word almost caught my attention :)))
Anyhow, I met a woman at a bar, went back home, tried PROTECTED insertive oral for may be 5 seconds and then I stopped as I realized it was not the right thing. We then DEEP kissed for may be about 2 mins, tongues involved, and then said goodnight to each other. Nothing else happened.

I missed one more thing - I also have a cough that started few days after the onset of runny nose and sneezing symptoms. Sore throat also started at the same time.

Do I still need the 90 day test? If yes, would Oraquick be ok?

Regards,

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
That was a zero risk exposure. There are no proved cases of HIV transmission oral to penis (even without a condom) or by kissing. Sneezing and cough also are not ARS symptoms.

You don't need another test and certainly I would not do it if somehow I were in your situation. But of course I wouldn't have been tested in the first place. If you feel you must do it, Oraquick would be fine.

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46 months ago
Thanks Doctor. No one ever told me that I dont need testing for this exposure! All the clinics that I went to told me that if the gums were bleeding, lips were cracked, dental work etc etc, then it could happen!! That freaked me out. But then I wondered if it had been so common then there would have been no kissing scenes in the movies :-)) People wouldnt be kissing on dates! 

Now my concern is that if I go on a date again, and we end up kissing, I might have to ask her to open her mouth with my flashlight on! 

Last question, and it would help me in future too - for an event that is not high risk (as you mentioned), is there a difference between 84 days vs 90 days? I am flying out on the 84th day, and I am not sure if I would have the facility to do the 90th day. I understand that you said it was zero risk exposure, but for the peace of mind, I would like to do one last conclusive test.

Regards,


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
I suppose in theory the presence of mouth wounds could increase the risk if that person had HIV. However, in the billions of oral sex events that must have occurred iHIV infected person, millions must have occurred in the presence of mouth sores, chapped lips, etc -- yet still no known transmission events. I for sure urge you to not inspect your dates' mouths (or genital areas) before having sex with them -- that would be really weird and I can't imagine a more distasteful way to start a date. Just use condoms for vaginal or anal sex and don't worry further.

My advice for the future is also to completely disregard 3 months as a window period. Have a duo (4th generation) blood test, which is now the gold standard and is conclusive any time 4 weeks or more after exposure. But if you want to stick with self testing with the oral fluids test, 3 months is still correct.

That completes the two follow-up included with each question, so this thread will be closed. I hope the conversation has been helpful.

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