I would like to ask if my radioactive iodine treatment of 125 millicuries for thyroid cancer treatment taken 6 years ago has any effect in the production of hiv antibodies (high risk exposure approx a year ago)? 

   

Is it possible that my body is unable to produce antibodies 6 years after this treatment?

  Thyroid cancer has returned a year ago with two small lymph nodes that don’t seem to grow in the operated area that can’t be removed right now due to their small size. My doctors however don’t worry and check them every six months. I don’t take  right now any cancer medicines for these lymph nodes. 

 I took a 4th generation test a week ago for an exposure 14 months ago and want to know if there is any chance that it could be a false negative due to my cancer treatment and any potential inability of mine to produce antibodies. 

To my knowledge, ionizing radiation has no effect on any standard lab tests and there certainly is no reason to suspect that the low radiation exposure from RAI would do so. Tere are no medications, drugs, medical conditions, or medical treatments that have any effect at all on the reliability or timing of any of the HIV blood tests (except for anti-HIV drugs themselves if used after exposure to prevent infection). So neither your RAI treatment nor your thyroid cancer change the reliability of your negative HIV tests. You can be 100% confident you don't have it. (As for "failing to produce antibodies"), that doesn't happen; and if it did, the AgAb (4th generation) HIV test would remain positive due to the antigen (Ag) portion of the test.

In short, don't worry at all about this. For sure you do not have HIV.

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

HHH, MD

I forgot to mention I had another negative 4th test at a lab (both drawn from vein) at 9 months along with my regular check up.

Can I rule out 100% hiv infection with these 2 tests despite my rai treatment 6 years ago? Have there ever been any cases of 2 tests missing an infection, the last one taken after a year of someone treated with RAI?

Sorry for the redundancy of my questions, you were quite clear at your answer above but I added extra info that might change your assessment. Thanks again !

Angular cheilitis by itself doesn't suggest HIV; it would never be the only symptom. You can be 100% certain it's not from HIV. The HIV blood tests overrule ALL other considerations:  no matter how typical the symptoms of ARS and no matter how high the risk after a particular exposure, the blood test results always tell the truth. Even the most typical symptoms of ARS or HIV occur far more often in people without HIV. You could have told me you have a life threatening opportunistic infection, or that you had mainlined HIV invected blood. Your test results PROVE you do not have HIV. There are no exceptions and never have been. 

In short, ignore any and all symptoms you have now or develop in the future. If you do not have another exposure that infects you, they will not suggest any possibility you have HIV. Unless and until you are reexposed, please stop testing. And stop worrying!

Yesterday I was so happy reading your reply, however unlucky as I am lately, as I  was walking with my flip flops and came across a used needle that was hidden next t some fallen leaves and tiny stones. I don’t think I stepped on it but later in the evening I noticed a tiny red area on my heel which is a bit cracked and thick lately due to the heat.I think I would have realised if i was indeed pricked right?

In the extraordinary scenario I was pricked by another needle there (which I didn’t notice to be fair) would I be in danger. ? Ps. In my country right now we have a heat wave.

Thank you so much again. You are alleviating my anxiety and pain. God bless you.

Your anxiety is the only problem here. Ignore any and all reports of HIV being transmitted other than by sex or shared needles and ignore theoretical risks like exposure to needles in the environment. In the 40 years of the worldwide HIV/AIDS epidemic and millions of infected persons, probably nobody has ever acquired the virus from exposure to a needle or other sharp instrument in the environment. Even if you were pricked, there would be little or no risk. (I hope this reply also helps alleviate your anxiety!)