[Question #1890] Am I infected ? tests reliable ? could duo test be false neg>hiv 2 ? am i crazy?

43 months ago
Dear Dr Hunter,
On 6-feb-17 sex with a CSW of unknown hiv status in Lahore,PK,first time sex outside of marriage,regretting.Her vagina was dry,kept fingering inside & clitoris but after a while stupidly used my saliva as lube.Later she stopped me & told to use oil!Then I used same wet hands to put on de condom.I couldn't see in de dark room if she was menstruating,wt if I had put de same vaginal secretions/blood on my penis under de condom. Could my attempts at making her wet expose virus to my gums which bleed when I brush.

19-Feb took a QUANTITATIVE PCR RNA HIV test,showed "NOT DETECTED"

Later my wife developed a heavy sore throat/flu may be because we had slept together after exposure.Depression came back strong coupled with diarrhea,chest pains,body aches & rare night sweats.Couldn't tell if it was ARS or stress.

10-Mar I took a HIV AG/AB I&II BLOOD test in de lab,was NEGATIVE.

Few days later my wife complained of a burning sensation on her chest & back which lasted for 3 days.

Since 21-Mar developed severe loss of appetite,night sweats,felt kinda cold,really sick & lethargic.Week ago had a severe burning sensation on my left hand dat went on & off accompanied by a small area of discolored skin like a rash,now de burning is rare and random.

22-Mar had HIV AG/AB I&II & Hep-B blood tests,NEGATIVE.

Today symptoms continue.This worries me since my body's first reaction to a viral infection like from last year's sinusitis is usually loss of appetite,feeling cold/tired.
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago

Welcome to the Forum.  As you probably know, clients on this site are not permitted to request who responds to their questions.  All questions regarding herpes go to Ms. Warren and Dr. Handsfield and I split all other questions.  As it happened, today I happened to pick up your question.  As an FYI, having worked closely for more than 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary.  I will be addressing this question.

Congratulations on your decision to use condoms for this exposure.  It made the events you describe no risk for HIV.  First, most CSWs in Pakistan do not have HIV. Second, even if your partner did, transfer of HIV containing blood or secretions from person to person on the hands (even transfer to the mouth) does not put you at risk for HIV.  HIV has never been acquired in this way,  Finally, you have now tested three times for HIV at times when if you were infected the tests would be positive and had negative results.  These test results prove that you did not acquire HIV from the exposure you have described. 

You can be confident that you did not acquire HIV from the exposure that you describe. Both your symptoms and those of your wife are the result of something other than HIV.

I hope these comments are helpful to you.  EWH


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43 months ago
Thank you Dr Hook,you have indeed calmed my nerves.

forgot to tell: I couldn't keep the intercourse going on maybe bcoz of dry vagina,consequently csw took off my condom,put oil & masturbated me with her hand.

1)Does the above add any risk at all?

2)if I had come to you earlier after incident would you have recommended me to get tested?

3)Are my wife & my symptoms indicative of any other STD?

4)Do I actually need any further testing?

5)Two days Before the last combo test I started taking terbinafine an anti fungal tablet bcoz I was getting the feeling that I might be getting another attack of fungal sinusitis.Can this med interfere with the results of tests in any way?

6)sometimes I have recurring attacks of fungus on the body like angular Cheilitis or on penis(bcoz of vitamin b deficiency,mainly when I am eating certain types of food though no fungus right now) does it mean I am immunocompromised & my body can take longer to produce antibodies for hiv?

7)I keep reading stories about people with late seroconversion,do my duo tests rule them out?

8a)My wife & I are trying to have kids & were planning to go for ivf-icsi,the fear of giving my wife & newly born hiv has had me horrified,it has adversely affected our sex life.
8b)I've been offered a wonderful job opportunity in UAE but I've been hesitant bcoz I've heard that authorities there embarrassingly deport people with HIV.

8)Can I safely go ahead with my life,the fertility treatment/job opportunity in uae & put this entire episode behind me?
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Brief answers:
1.  No risk means no risk.
2.  No, I do not recommend testing following no risk events.
3.  No, there is no reason to worry about other STIs related to the event you described.
4.  No.
5. Tebinafine would not interfere with test results
6.  This does not suggest you are immunocompromised
7.  Late seroconversion if an internet myth.  Believe your tests
8.  I indicated that the event was no risk and that your tests PROVE that you did not get HIV from it. There is no reason to change your plans or efforts to have children because of the events you described.  EWH
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42 months ago
I did not want to post this and waste my last response credit but the panic is setting in.. 

After your last posts I had accepted my fate that I did not contract HIV from the exposure and I was moving on until today, what changed today? 

My wife out of the blue informed me that she was not getting her periods(we have been intimate), this never happens since the 4 years we have been married I know because we have been trying to have kids..... We went for a pregnancy blood test at the lab and it came out negative. 
I'm not 

I'm horrified at the prospect of having given my lovely wife HIV. I've absolutely nobody to talk with about this. Pakistan has almost no counseling services, I fear that talking about it with anyone here would bring about terrible reactions. 

I started reading more stuff on the Internet today and found that the PCR RNA test I took earlier was the low grade kind with lesser sensitivity i.e. upto 69.9 IU/ml from geneexpert cepheid and it is not reliable like the one approved in USA. This got me thinking about the level of authenticity of labs in Pakistan, since there is no government authority that regulates their quality. 

I know doctor the tests are in my favor but the more I want to move on something abruptly halts me. I don't know if my wife's completely unexpected delayed period is a symptom? & if the labs in Pakistan are of equivalent standards to USA, making the duo and rna tests reliable? 

I would really appreciate your input on the matter. 

I really didn't want to waste this thread by posting this, rather I wanted it to be kept open so I could post results from the final test later on.. 
42 months ago
Additionally, I forgot to mention I'm diabetic, does that change anything
42 months ago
Yesterday (7 weeks and 2 days after possible exposure)  out of panic and severe anxiety, I went for another hiv 1&2 ab/ag test, the result was Negative but what has got me worried are the s/co values because they are rapidly rising, for the first test on 10th of Mar it was 0.05, 
on the 22nd it was 0.07, 
on the 29th it is 0.09

Although the reference range mentioned is:
< 1 Negative
1 - 4 Borderline
> 4 Positive

Could this be worrying or is this of absolutely no importance? 

I also wanted to tell you that the randomly occurring hot burning sensation on top of my left hand is still present. It comes and goes, this sensation is mainly felt just below the middle and index finger. Sadly, random pains throughout the body continue including joint and muscle pains. 

I don't know when will all this stop. 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
That your wife's period is late does not indicate or suggest HIV in any way.  HIV does not effect a woman's period and you have already proven that you do not have HIV, not only with the PCR test but now with two 4th generation tests at times when your results are definitive.  You need to believe the tests and look for some other explanation for your wife's delayed period. 

Fluctuation in the baseline of your laboratory tests is to be expected and does not raise concerns - not concerns that you are infected, nor concerns that the test is not working properly.

Similarly the random sensations you are experiencing in your hand and elsewhere are not suggestive or a known sign of HIV.

My sense is that you ae quite guilty feeling and anxious about your CSW contact and this is causing you to worry that anything that doesn't seem quite right to you might be due to HIV.  This is simply not possible given the nature of your contact and is proven by your multiple negative tests.  You need to get over your guilt and move forward - you were not unlucky in your sexual encounter outside of your marriage.  You should accept this and move forward from here.

This is my third reply to your questions.  Therefore, as per Forum guidelines, this thread will be closed later today.  I wish you the best. Take care.   EWH...
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