[Question #2959] HIV exposure 24 days ago. Tested on 17th day.

39 months ago


24 days ago I had sex. Japanese guy (from Tokyo) I don't think he is an IV drug user, he's probably bisexual.


He had a SUSPICIOUS RASH on chest.


He used his fingers to stimulate inside my vagina, was REALLY rough. I felt something very irritated/raw. He previously opened a condom and left it out of its package for 10min or so.


He put THAT condom on and started the intercourse  (I couldn't see it was properly used, I am not sure, it looked BIG on him... Or had a hole or was broken) I asked him to stop and eventually did. 

It lasted 30sec-1min. No ejaculation. 


1 week after started feeling like my throat burns, like there is fire in it, comes and goes,  sometimes gets really bad at night.

 

Exactly on 14 day I felt like all my body and joints ached. Lasted 1.5 days. On17 day I noticed a swollen gland on my neck, I saw a family doctor and said it was a little bit swollen. He said it seemed something viraI, I freaked out. Said my throat wasn't to bad& prescribed amoxicillin "just in case" didn't get better.

A doctor and a nurse at the CDC said glands weren't swollen (but I feel something it wasn't there before!) &throat looked fine.

I got a NAAT POOLED PCR+DUO test@17 days post.exp and came back Negative.


I haven't had fever nor rash. But a burning itchy throat/esophagus,swollen tender glands(neck), muscle/joints ached for 1.5days.

And a yeast infection. 


Please, can you tell me how relievable my results are? 

What are my chances of testing positive@ 6weeks?


I'm really scared and anxious. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome back to the forum, but sorry to see you found it necessary. 

I reviewed your recent discussion with Dr. Hook and agree with all he said. I suggest you go back and re-read his reassuring replies. Mine are essentially the same. You had a low risk exposure in regard to HIV, with someone who probably doesn't have it. Most important, your negative DNA (NAAT) test plus antigen-antibody (duo) tests are nearly 100% conclusive. These tests overrule the exposure and any and all symptoms you have had. As already advised, the exposure was low risk; and your symptoms are not typical for a new HIV infection. But even if the exposure had been high risk, and even if your symptoms had been typical, the test results are much more reliable. In addition, if your symptoms were caused by HIV, your tests would have been positive. In other words, your test results are around 98-99% conclusive against HIV, and they are 100% proof your symptoms are caused by something other than HIV.

"...can you tell me how reliable my results are?"  Almost 100%.

"What are my chances of testing positive at 6 weeks?" Almost zero.

If your symptoms continue and you remain concerned, see your doctor. But HIV is not the cause.

I hope these comments have been helpful. Let me know if anything isn't clear.

HHH, MD
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39 months ago
Thank you for your answer Dr. Hunter, your words are always very reassuring . 

Now, if you don't mind... I have a few more questions for you. 

1. The PCR test was done in Canada, where I live. The person that potentially exposed me, he is Japanese. So I am worried that PCR test was not able to detect the virus because maybe they have different HIV subtypes in Asia?

2. Would you recommend me to keep testing? 
Do I really need to test at 3 months?

3. Do the rash on his chest and red face, would that be a sign that he's probably infected? (Dr. Hook mentioned that HIV is rare in japan, but how do I know he is not one of those 20,000?? He is bisexual...) 

4. Also, can you please give me some statistics, Dr. Hook mentioned my chances of being infected is 1/2000. But I would like to know what you personally think.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
1) There are no special strains or subtypes of HIV anywhere in the world that do not give positive results on one or more of the tests you had, including the PCR tests. And the tests also are the same in all countries, including Canada.

2) As discussed with Dr. Hook and confirmed above, for a conclusive antigen-antibody test, have another test 6 weeks after the event. It is no longer ever necessary to wait 3 months for conclusive testing. That's old advice left over from older antibody-only tests that have not been done routinely for over 10 years.

3) Such symptoms are not at all suggestive of HIV.

4) IF your partner had HIV, and IF you had unprotected vaginal sex, the risk you would have caught it would be around 1 in 1,000. You used a condom, which reduces HIV risk by at let 99%, and the other exposures described (fingering etc) were risk free. If we assume 1 chance in 100 your partner had HIV (it could be that high because he is bisexual), then even before you were tested, the chance you caught HIV would be 0.01 x 0.001 x 0.01 = 0.0000001, i.e. 1 chance in 10 million. Furhter, the combination of the tests you have had is at least 99% accurate. That means the current odds you have HIV are 100 times lower than 1 10 million, i.e. 1 chance in a billion. In other words, zero for all practical purposes.

You probably should still go ahead with the 6 week Ag-Ab test as suggested above. But you definitely can stay relaxed in the meantime:  unless you have been reexposed yet again, there is no chance it will be positive.
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39 months ago
Thank you so much for your answer Dr. Handsfield, your answer is very reassuring and extremely professional. You are an amazing physician.  

However, I still feel really concerned... 
The last few days, at night I have been having very hot when I am sleeping, which causes me to sweat. 
It is not like the bed is soaked nor my clothes, but it is something  I've never felt before... this started about two days ago. 
also, the enlarged lymph node on my neck it's very palpable, I can feel the bump right there... and it was confirmed for a nurse yesterday;
also, my lack of energy it's unbelievable. 

I took a rapid test on day 30th day post possible exposure (insti test finger print) it came back negative, this test looks just for the antibodies, 

The nurse again, ordered a DUO test & NAAT POOLED TEST. 
The Dr. In charge authorized it.

Which makes me really concerned, he quialified the encounter as a medium risk: cause it was not consensual + his profile (bi sexual man). 

I am really confused Dr. Hunter, and this is killing me... 

I am scared that now I am testing negative but maybe it will turn positive in the next weeks, my immune system has never been the greatest ever, since I was a kid I always got all the bacteria viruses etc, so so easily... I am afraid maybe my body is taking so long in producing the antibodies... 

Is this possible? 
Is an antibody test permormed on day 30th post exposure reassuring at all? 
Can stress cause enlarged lymph nodes? 
(I've read so but I wonder how stress can enlarge the nodes since stress is psychological and lymph nodes react to viruses or bacterias)

please, help me 
And again... thank you so so much for your time and sharing your knowledge and experience with all these people going crazy. 




39 months ago
Oh, I mentioned a condom was used but I am not sure how properly used it was. Since he opened it put it on. And I couldn't see anything cause I was laying on my tummy.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
I'm afraid you have missed the main point of both Dr. Hook's comments and my replies above. The current HIV tests, including the ones you had, are among the most accurate diagnostic tests ever developed, for any medical condition. When done sufficiently long after the last possible exposure, the results are 100% reliable and always outweigh exposure history, symptoms, or anything else you can think of. Given the test results so far, I am confident the additional tests at 30 days also will be negative. When they are, no matter how high the risk of HIV might have been at the time of exposure (it was not very high, despite your doctor's comment about it) and no matter how typical your symptoms might have been for HIV (they are not typical at all), they will PROVE you do not have HIV, and this will not change no matter what may come to mind about other symptoms, lab results, advice from your doctor, or more details about your exposure. So there is no point in asking about any of this again!

I'll leave this thread open for you to post the results of these final tests, but will have no other comments or results until then.

Really, mellow out. You are letting your right brain (emotions) rule, even though all indications are that you are a rational, objective (left brain) sort of person. Rely on the latter part of your psyche and ignore the latter. You don't have HIV.

Sorry if this sounds blunt, but I think you can handle it. Call it tough love.

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39 months ago
Thank you so much for leaving my question open.. and for the tough love (really appreciated it).... and of course for all your patience and your amazing answers. 

You're such an admirable doctor!!! I am literally your fan.  

Well, today I got my results from the NAAT pooled test, and DUO test 30 days after exposure. 
And of course, as you predicted so... they come back negative. 
It seems like my swollen lymph node is hiding now... or maybe gone???.... 

The nurse didn't want me to come back at 6 weeks, she said I am negative and I have nothing to worry about.

am I 100% negative and can I sleep in peace again?

THANK YOU SOOOO MUCH!!!!! 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Congratulations -- indeed you are "100% negative and can...sleep in peace again".

Thanks for your kind words about our services. I'm glad to have helped. Best wishes to you.

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