[Question #3000] Window Periods - fup prev question

39 months ago
Hi Dr,

After my 6 weeks test from exposure, I started to feel intense joint pain in my left wrist, and mild joint pains in other joints. Felt this for 2 weeks, plus fatigue. Not sure if anxiety and stress could have caused those (maybe uncounscioulsny tensing my body?).
The question is related to hep b and c window period. Hep B tests also tests for antigen, but Hep C only for antibody.  In my previous question you was confident that 6 weeks tests would rule those out as well, but I see on several sources that those have larger and variable window periods (eg from 4 weeks to 6 months).
Appreciate your comments on my concerns.
39 months ago
Just to clarify, exposure was unprotected oral, followed by protected vaginal and anal intercourse with CSW. The condom was put after the oral, and her saliva was inside the condom when intercourse was performed.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome back to the Forum.  By chance, on this occasion I happened to pick up your question and will be providing answers.  In preparing to answer your current questions, I also reviewed your earlier interaction with Dr. Handsfield and agree 100% with all that he said. 

I'm sorry that you continue to worry about the exposure you described and I suspect that your guilt over this encounter is contributing to your concerns in several possible ways.  Related to this, I have several comments below, made in no particular order:
1.  The risks for STIs you describe are virtually non-existent.  Your vaginal and anal sex was condom protected and therefore, safe sex.  There has never been a case of HIV acquired from receipt of oral sex.  Similarly, although there are fewer studies, there are no data to suggest that either hepatitis B or C is transmitted through receipt of oral sex.
2.  Sexual transmission of hepatitis C through sexual routes other than anal sex is unheard of.
3.  I wonder if you have been seeking information on regarding these infections on the internet.  If so, this is a bad idea.  While it is a great means for communication, much of the information about medical problems there is taken out of context, mis-interpreted or just plain wrong. 
4.  Your tests at six weeks are virtually conclusive in your low risk situation.  If you had had a higher risk exposure such as a needle stick from a person known to be infected, then testing out as far as 3 months might be recommended but in your very low risk situation with negative six week tests, your risk for either hepatitis B or C is lower than 1 in tens of millions -i.e. negligible. 

Thus in summary, I am completely confident that you did not acquire hepatitis B or C from the exposure you describe.  Your joint pains are coincidental with your symptoms perhaps heightened by you continuing guilt and anxiety over your mis-step.  I hope that the information that I have provided, as well as my assurances, will help you to move forward.  EWH

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38 months ago
Hello Dr Hook, really appreciate your reply on that. 
For sure guilty plays a important role in this, but what drove me depressed was my wife symptoms. Also using statistics, I know that the odds of her developing zoster, by coincidence, 3 weeks after exposure are also extremely low/unlikely.  So you can understand my fear...
I was scheduled to test at 8 weeks, per local Dr recommendation, and now those are my recent results:
4 weeks - hiv ag/ab; hep b; hep c; syphilys - negative
6 weeks - hiv ag/ab; hiv 1 pcr; hep b; hep c; syphilys - negative
8 weeks - hiv ag/ab; hiv 1 pcr; hep b; hep ; syphilys - negative
I dont want to test anymore, as this is bringing enourmous anxiety, and I guess those tests, at this time, are conclusive enough.  I need to move on.
Once again appreciate your services , it is very good to count on expert knowledge.

Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Thanks for your follow-up.   Your follow up results conclusively show that you did not acquire HIV, hepatitis B or C, or syphilis from the exposure you described. Once again my advice is that it is now time to put your concerns aside and to move forward without further concern and certainly without any further testing. You are being too high and emotional price For your misstep.  I wish you the best.  EWH---
38 months ago
Dr, it is very hard to let it go, as every new thing became a scary thing. Yesterday I felt a swollen lymph node, located in the right side of the base of my neck. It does not pain, but I can clearly feel it (i can feel the same on mu left side). I felt it only if I raise my right amr above head (did it by mystake, as I went to bed with a larger pillow than usual). Do you think it can be related? Is ir possible that I had this already from the past, and it remained bigger?

38 months ago
A typo: I CANT feel the same on the left side of my nexk
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
This will be the final response to this thread, as per Forum guidelines.  I have little to add to my earlier comments.  Most people have lymph nodes which can be felt and they tend to vary in size.  This does not mean that they are abnormal or suggest HIV.  The more a person looks, the  more will be found.  This does not mean that they are abnormal.  I wish you the best in dealing with your anxiety which I sincerely believe is unwarranted.  Take care.  EWH---