[Question #2377] HIV further testing and Ureaplasma diagnosis

44 months ago
Hi Doctors, 

Thanks  for the great responses and work  all your advice has been right on. Following your correct advice of my previous question, I tested negative for both chlym/gonn but positive for UU bacteria. My OB suggests that I am a "carrier" due to the fact that the doxcy should have cleared this, but I believe both me and my regular partner must both have this bacteria and probably passed it back and forth to another as he did not take medication just myself. However, I read from your previous post - we probably should not be worried about anything? I should not try and treat this? Would this account for any abdominal pain my partner was feeling in my last post?

I would also like to hear your advice and opinion for follow-up HIV testing and any other STDs. For HIV, I took the rapid finger prick at planned parenthood which was at 17 days after the exposure I am concerned about. 

1) It was negative, how accurate is this test given the time period following the mentioned exposure? 
2) What kind of testing and when should I do my next testing to be conclusive that I have not contract HIV from this exposure? I am thinking about doing additional testing at the one-month mark. 

 I understand my risk is low and I am not apprehensive in anyway that I have anything so far, no symptoms but would like to know for peace of mind when I can rely on the test definitely and not have my regular partner at risk as we frequently have unprotected sex. 

3) What kind of further/other testing for STDs do you think would be conclusive at the one month mark following my exposure? 


Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Welcome back to the Forum.  I'll be commenting on your new questions here/

First a comment on the isolation of ureaplasma from your tests.  UU or Ureaplasma urealyticum is a normal bacterium that is present in most adults genital tracts and is not a cause of disease in normal human hosts (persons with rare, inherited immune deficiencies, which I can assure you that you do not have) can get sick with this organism but in healthy persons it is normal and not a cause for concern.  Your doctor is also right that we would expect it will be present in both you and your partner.  It does not need treatment and treatment may eliminate it briefly but then it tends to recur because it is part of your normal vaginal bacteria. 

with regard to your questions about HIV:
1) It was negative, how accurate is this test given the time period following the mentioned exposure? 
An HIV test taken at 17 days will miss a substantial number (10-20%) of recent HIV infections depending on the type of test performed.  The current recommended test is a test for HIV that tests for both HIV antigen and HIV antibodies- sometimes called a "4th generation" or "combo" test and is different from older types of tests that test only for HIV antibodies.  Your finger stick test could have been either type of test (antibodies only or a combination test).  Combination HIV antigen/antibody tests are close to definitive at 4 weeks after exposure, picking up all but a very small proportion (difficult to say just how small, probably less than 1-2%) of recent infections.  AT 6 weeks however, combination test results should be considered definitive. 

2) What kind of testing and when should I do my next testing to be conclusive that I have not contract HIV from this exposure? I am thinking about doing additional testing at the one-month mark. 
See above. 

3) What kind of further/other testing for STDs do you think would be conclusive at the one month mark following my exposure? 
You have taken antibiotics and been examined by your own physician with negative tests at that t ime.  I really see no medical reason for any further testing

I hope these comments are helpful.  EWH

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44 months ago
Thanks again for your help. I will get tested again at both the 4 (next week) and 6 weeks mark. Do I need to ask for this 4th generation combo test? Or is this a standard nowadays? I plan on going to this HIV testing clinic that is part of university research center. 

Based on what you know from my posts, does my risk of contracting HIV from single vaginal encounter fall at a high risk? Unknown partner status? In a foreign country such as China? Are HIV rates/infection statistically higher there? 

Not sure how much it matters, but he was an white,  heterosexual, ex-pat coming from a higher income class. 
 


Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
I would just suggest that you verify the type of test you are having when you get tested.  I would presume that most University testing centers will use combination tests.

I would estimate your risk having acquired HIV from the encounter you described is less than 1 in 100,000 and probably less than 1 in a million. I would not worry.

EWH
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43 months ago
Hi Dr. 

I received my DUO results back as negative after testing at 4.5 weeks. I was also tested using the Early NAT test as part of the university study, but it will take two weeks to get my results back if negative.  If these results combined with the 4-week duo come back negative, do you think this is conclusive enough as a negative HIV diagnosis? or would you recommend repeating the duo at 6 weeks mark ( when I would get the NAT results back)? 

Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
The DUO tests now detect nearly all recent infections at 4 weeks with only a small proportion (less than 1%) of new infections being missed by these tests at that time.  You should have great confidence that your NAAT test will also be negative and when it is, you can be entirely confident that you were not infected with HIV and move forward without further concern about that exposure.  I see no need for repeat testing when you get your negative NAAT result. 

I hope my comments have been helpful.  As this is my third reply, this thread will be closed later today.  Take care.  EWH
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