[Question #1406] Possible Std Infections

46 months ago
Hello Dr,

Please advise on the way forward and my risk status based on information below, HIV being the bigger concern,

Performed oral sex only on a woman(she has risky occupation, with out protection,dental dam) with unknown std/hiv status 33 days ago. I have had the following test's done,

1. Syphilis blood test 8 days after event-negative
2. Chlamydia trachomatis blood test 8 days after event-negative
3. Herpes virus type 1 & 2 dna urine test 8 days after event-negative
4. HIV 1&2 finger prick blood test in Dr's office 9 days after event-negative
5. HIV 1&2 finger prick blood test at clinic 14 days after event-negative
6. HIV 1&2 finger prick blood test at clinic 21 days after event-negative
7. HIV 1&2 finger prick blood test at clinic 28 days after event-negative
8. Cumulative PCR HIV blood test performed by lab 31 days after event-negative

Only abnormal out of the ordinary symptoms i have experienced was runny nose(possible hayfever) about 4 days after event but no fever or feeling ill, lasted for about  3 days and then 2 days ago when i had frequent urination with burning sensation, have been using anti-acid for past 2 days and it has stopped.

Thank you in advance!


Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago

Welcome to our Forum.  I'm pleased to address your questions.  Even before you were tested, there was little risk for infection.  Most people, even those who are considered "risky", do not have STIs, including HIV.  Further, most sexual encounters do not lead to infection and cunnilingus (oral sex on a woman) is the activity least likely to lead to infection.  Thus, even before you started to test and without the passage of time, I would have said your risk of acquiring any STI was less than 1%.  Now that you have been tested, you can be completely sure that you were not infected and do not need additional testing. 

Your tests for HIV are definitively negative. 

Your blood test for syphilis was taken too early to be definitive but if you had acquired syphilis you would have developed a sore on or inside of your mouth by now.  No further syphilis testing is needed.

Blood tests for chlamydia are unreliable for detection of recent infections however, I have never heard of a person acquiring chlamydia from cunnilingus.

Urine DNA tests for herpes are of little value in diagnosing this infection however if you have not developed lesions of herpes on or around your mouth, there is no reason for further worry.

The symptoms you report do not suggest STI of any sort.

My advice is to not worry further about this exposure.  I hope that with my assurances, you will be able to do that.  EWH

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46 months ago
Hello Dr.Hook,

Thank you for replying so fast and for your detailed response! It is highly appreciated. 

Best Regards,

G
45 months ago
Hello Dr,

Since we last corresponded I have had one more hiv 1 &2 finger prick test done this was 6 days ago ( it has been 5 weeks & 5 days after exposure) the test was negative.  But in saying that since yesterday i started experiencing a burning sensation on  both sides of my tongue (right at the back where tongue and throat meet) it looks like white sores and this morning a small white dot that also has a burning sensation on the inside of the lower lip. I do not feel ill otherwise, no fever etc. All I can say further is that i have been smoking allot more the past couple of weeks.

Please advise.

Regards,

G

Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

Albert Einstein once said that one definition of insanity is to keep doing the same thing again and again and to expect different results.  You have already proven you did not get HIV from the exposure that concerns you.  Further testing will not change this.  You did not get HIV!

The findings you describe are not due to HIV or any STI.  Your heavy smoking, undoubtedly enhanced by your guilt and anxiety may explain what you describe.  Tingling and burning of the sort you describe are not signs of HIV.  EWH

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45 months ago
Hello Dr,

Thank you for your response. In follow up to my original question a testosterone test was done yesterday and the results showed that my total level is within normal range but what i picked up on was that my shbg levels were "high", 63.4 nmol/L, free testosterone 208 pmol/L, total testosterone 15.8 nmol/L. Test was done at 15h30.

I have read up on this and what has stood out for me as possible causes was the following,

1. HIV- but we have covered that already...
2. Hepatitis (B) - this can according to information be transmitted via oral sex. 

No new symptoms since previous email and i am not a heavy drinker so liver problems have not been a problem in the past, i have not been tested for Hepatitis recently but have not been diagnosed with it either to date.

Please advise way forward?

Regards,

G
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

As you know, forum guidelines allow us to provide up to 3 replies to a client.  this is your 3rd reply to this thread and therefore later today the thread will be closed.

You need to stop worrying about HIV and hepatitis B.  Fluctuations in the levels of hormones such as testosterone are normal and not related to some sort of missed HIV or hepatitis infection. 

Hepatitis B is not acquired from receipt of oral sex.

Your concerns about hepatitis and HIV and not justified from the exposure you describe.  Thus, in closing I will repeat my original advice to you - "My advice is to not worry further about this exposure."  I hope you will be able to do this.

End of thread.  EWH

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