[Question #1662] Hiv subtypes and groups

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92 months ago
Hi Doctors.

I will start with my exposure.
Im a male had sex with a black African female in california CSW multiple times. One time the condom broke did not notice after ejaculating and pulling out. After 5 months I got a fever and sore throat. I wonder if it was ARS?

I tested no-reactive 3 months, 6months and 12 months after exposure. With HIV 4th gen Hiv 1/O/2 test. [Labcorp]

1. Do these 4th gen test cover All types of HIV,all groups and all subtypes?

2. Should I be concerned about any rear types since she was a Black African female CSW?

3. How late can ARS symptoms appear after exposure.

4. Can I finally move on with my normal life?

I would appreciate if you could give me a detail answer thank you Doctor.
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92 months ago
Just adding more info to original question

* The reason I continued to remain concern after the no-reactive tests is because I have reoccurring Boils aroud my body and folliculitis for the past 3 months

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Edward W. Hook M.D.
92 months ago
 Welcome to our forum. I will do my best to help you with the questions you have asked.  Perhaps I am reading too much into your questions but often when our clients asked questions about specific HIV genotypes it is a sign that they have been seeking information on the Internet. If this is the case for you I would urge you to stop. Information on the Internet is often incorrect,  taken out of context, or just plain wrong. 

 It's a generality I would come and get the exposure you describe is very low risk. You have that had only a single unprotected exposure when you're condom broke and most commercial sex workers do not have HIV. Even if your partner did have HIV, the chance of acquiring HIV from a single unprotected sexual encounter is less than one infection per  1000 exposures. 

Going on to your specific questions:

1.    Fourth generation HIV tests are highly accurate and provide entirely reliable results at any time more than four weeks after exposure. Concerns about possible missed infections due to different HIV genotypes are misplaced. 

2.    No, the fact that your partner was black or a commercial sex worker is not raise any particular concerns. 

3.  ARS  symptoms typically develop within 2 to 3 weeks of exposure. Occurrence of ARS symptoms after more than four weeks is extraordinarily rare, if it happens at all. 

4.   Given your exposure and your test results it is absolutely appropriate for you to move on and have no further concerns. There is no need for further testing. 

 Folliculitis send recurring skin lesions is not a sign of HIV. This is a common Dermatologic problem ounrelated to HIV. You should work with your doctor to address these concerns but not allow it to make you worry about HIV. 

 I hope these comments are helpful to you. Take care.   EWH
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