[Question #2664] Test results

43 months ago
I had unprotected sex with a women. Later I found out through a friend she might be using heroin? I have had a really sore throat and sore lymph nodes 6 days after exposure. I had a negative hiv rna and a negative hiv 1 and 2 antigen and antibody at 28 days still two weeks later I can't get rid of my sore throat or pain in lymph nodes. How reliable is the 28 day test and should I get tested again at 45 days? Also ruled out all other Sti's with a full panel test although my lymphosites are slightly elevated. Herpes 1 came back positive but that could have been from a cold sore years ago? What is your advice?
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Welcome to our Forum.  I'll be glad to comment.  As explained below, you can be confident that you did not acquire HIV from the exposure you describe.  Before I do, a few background statements. 
1.  That your partner may have used heroin, does not mean she had HIV.  While IV drug users are at increased risk for HIV, most heroin users (over 90%) do not have HIV.
2.  Even if she did have HIV, most sexual encounters do not lead to infection.  Less than 1 in 1000 episodes of vaginal sex with infected partners lead to infection.

Thus, overall, you risk for infection was statistically rather low.  Your tests prove this.  Tests for HIV antigen and antibodies are not entirely definitive until 6 weeks (42 days) after exposure but there are only a very small, as yet undefined proportion of infections which are not positive in these tests by day 28.  In your case however, the addition of the HIV RNA test, when combined with your HIV antigen/antibody test prove you were not infected.  Virtually all persons with recently acquired HIV have positive RNA tests by day 14.  Thus, by considering both of your test results, you can be entirely confident that you did not get HIV from the exposure you mention.  there is no need for continuing concern or for further testing.

Your sore throat is likely due to some other, non-STI virus that may or may not be related to the sexual encounter you describe.  It is not due to HIV.  I hope you will be feeling better soon.  Take care.  EWH 
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43 months ago
I was texted for hiv 1 rna and hiv1 and 2 antigen antibody at 27 days 8 hours. Is there a possibility that I could have hiv 2? Still have all the symptoms sore throat PAINFUL sore lymph nodes joints and sore muscles 7 weeks from exposure? I can't sleep my armpits neck and groin are all painful I saw an ent he said my throat is red but can't explain it? Was the onset of the symptoms at 6 days to early?
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Thanks for the additional information  Your symptoms are consistent with a viral illness of which there are many.  Your tests however, PROVE that your symptoms are not due to HIV.  You may want to seek the input of your own personal physician or, if the symptoms are tolerable, try to wait them out.  This is not HIV however.  EWH
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43 months ago
Ok we checked a 20 panel STI all negative but herpes 1 what else should I be testing for? Lmyphsite and Monosites slitley evelvated. No mono or strep throat both ruled out? What should I be testing for?
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
As i said in my original reply- "Your sore throat is likely due to some other, non-STI virus that may or may not be related to the sexual encounter you describe."  This is most likely to be a non-STI, community acquired sore throat illness which could be caused by a huge number of viruses which are not typically tested for.  If mononucleosis has been ruled out, I would not recommend other testing.   It may not be in any way related to the exposure you described and it is time for you to put your concerns about STI aside.  Really!

This is my third reply to this thread. Thus, as per Forum guidelines the thread will be closed in a few hours.  While you may comment, there can be no further replies to this thread.  Take care and be assure that this will pass.  EWH
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43 months ago
Thank you!!!!