[Question #3096] Exposure, testing and symptoms-Hopeless

38 months ago
Dear Doctor

I am an Indian living in Japan. My exposure happened in August in India in a massage parlor. I was not involved in anal, vaginal or oral sex. Lady was lying naked on top of me for a very brief period of time, but no penetration happened as I was in disposal underwear. I did few activities:
1. Sucked the nipples of the lady briefly.
2. Rubbed her vagina with my finger and after 2-3 minutes , i masturbated myself using the same hand. She gave me hand job, but i believed she has not touched her vagina.
3. I cleaned my penis using a towel which could have some infected fluid from previous customer.

Testing part:
Alere HIV combo @16, 26 and 43 days, blood from arm, result after 20 minutes: All Negative
Laboratory based antigen/antibody (CLIA) at 57 days, antigen/antibody test at 69 days, HIV1/2 with P24 (CMIA) at 90 days and antigen/antibody  (CLEIA) at 106 days, blood from arm,  results after few  days : All Negative.

At 83 days, I developed some cough which resolved after few days.  With negative tests at 90 and 106 days, I was relieved. However, in last week, i.e. 16th week, some redness appeared at the roof of my mouth mainly at soft palate near the throat, a kind of mild inflammation and sores on front of tounge.  No fever, No rash and no pain in throat, infact I can eat well, but redness is still there and slight discomfort on roof of mouth all the day. I dont know how to check lymh nodes, still I found one around neck. Dont know, it was there or i created one by constant pressing and self-observations.

This episode has completely ripped off my personal and professional life. Almost hitting the point where I can loose my wife or job, or probably both. Just want to be 100 percent sure not 99 or 97 that I dont have HIV. Do I need some more advanced testing like NAT. Does my present symptoms seems like ARS and can it start at 16th week. Please suggest what to do? 

A.S.H.A means "Hope" in our language HIndi. Please give some HOPE.

Regards
Hopeless and worried..
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome to the Forum.  You have no reason to worry and continuing to test is a waste of time.  HIV is transmitted ONLY through unprotected, penetrative sexual contact or injection of infected material deep into tissue.  It is not transmitted by touching, through kissing, touching, sucking on another person's breasts, or on contaminated towels  It is not transmitted through material, even if that material gets wet.  Further, your test results are definitive and the fact that you were not infected was proven on your blood test taken at 57 days and confirmed by subsequent tests at 69, 90 and 106 days.  Your oral symptoms are not at all suggestive of the ARS which does not occur this long following exposure and is far more suggestive of the sort of occasional viral infection that most people get from time to time, 

These are all facts.  Further testing will not change this- you did not acquire HIV from the events you describe.  That you continue to worry suggests that you are quite anxious and guilty over these events.  My advice is not for more testing but to seek counseling with a trained counselor to get assistance in working through your guilt.  In addition, I would stay off the internet where you are far more likely to be misled than to find useful information.

I hope these comments are helpful.  You cant be 100% confident you did not get HIV from the events you describe above.  EWH
---
38 months ago
Thankyou doctor for your reply. I an trying to get professional help but language is a big barrier here..I wanted to use my two follow up questions  very carefully, however i am more worried by reading your last line that” You CAN NOT be 100 percent confident....do you really mean that or is it a typo?...

Regards
38 months ago
Thankyou doctor for your reply. I an trying to get professional help but language is a big barrier here..I wanted to use my two follow up questions  very carefully, however i am more worried by reading your last line that” You CAN NOT be 100 percent confident....do you really mean that or is it a typo?...

you wrote CAN NOT because no medical test is 100 percent accurate and there is always a possibility to miss an infection..
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
I apologize for the typographical error in the final sentence.  I had meant to say You can be 100% sure that you DID NOT get HIV from the events you describe.  I was typing fast and failed to catch the typographical error.

At the same time, the rapidity of your response serves to further confirm your anxiety and, I presume, guilt over the events.   Counseling, even if it is hard to find, is what is needed.,  EWH
---
38 months ago
Dear Dr. Hook

Thank you very much for your reply. I was relaxed after reading your response but today i freaked out again. As i told you that my exposure happened in India and i took all the tests in Japan except 90th day test which i took in India during re-visit for few days. My symptoms, redness at the roof of the mouth, at soft palate and mild sore throat, mouth sores started 22-23 days after 90th day test. This timing matches with ARS, No? No fever, No rash, 

Is it possible to get infected during the HIV testing process itself? I took test in one of the most reputed lab in India but it was a collection centre i.e. they took the blood and send to thier laboratory. The device was kind of a needle and then lady attached some tube at the back of the needle and took the blood. However, i didnt thought of checking the packing at that time and now, dont recall much things..

Before writing to this form, i took test again at  120 days from original exposure and 30th day from 90th day test. Result will be given on Thursday and i am very much tensed that it is likely to be positive..,

can i get infected through testing process itself? 
Will my result be negative again? 


Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
I'm sorry you felt the need to return to our site.  Your next test will be negative, as were your earlier tests.  The device used to obtain the specimen for testing is the same as is used world-wide and is in no way associated with risk for infection since, in addition to being packages a sterile, single use-non-reusable device, removes blood using a vacuum, leaving no chance of anything entering your body.  Thus, there is no risk from the testing procedure.

As for your symptoms, these are not at all suggestive of the ARS.  The ARS typically occurs within a few weeks (less than 30 days) of acquisition of infection and is unheard of more than 3 months following exposure.  Further fever is a crucial part of the ARS. No fever, no ARS.

Please control your anxieties and perhaps, guilt from the exposure you described.  You can be completely confident at this time you were not infected by the exposure you described and can be confident that any an all testing will show that you were not infected through the exposure you described.  There is no need for additional testing. 

This is the 3rd and, therefore, as per Forum guidelines, final reply which will be part of this thread.  I wish you the best.  Take care and please do not worry.  EWH . 
---
38 months ago
Dear Dr. Hook

First, Thankyou very much for your response and keeping my thread open. This is my last question and will be highly thankful if you consider this. Today, i recieved my results of antigen/antibody test, blood from arm taken at 123 days and as you predicted, its negative. The test was taken at Tokyo HIV testing centre and their window period is 60 days. 

I took this test after 7-8 days from onset if sumptoms. This test should have turned positive if symptoms were due to HIV or it requires longer period?

I know i may sound stupid but this test was taken at 33 day from blood drawn at 90 days (about which i am worried as i did not see the lady opening the new needle, but this lab is considered as best lab in India). If i consider this blood draw as exposure, then antigen/antibody test at 33 days should be highly accurate as i learned from your response to other questions. 

Although now from last couple of days i got some cold sores and pain in back and little disconfort in armpit, But i suspect that they are due to anxeity as i had similar symptoms last year when i developed cancer anxeity. Luckily everything was fine. 

Should i be worried for any exposure especially the blood draw one? 

May i resume my normal sexual life with partner?

Thankyou very much, i feel happy by writing all this to you

Happy nee year in advance and happy vacations

Regards


Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
1.  Your results are conclusive.  There is no need for further testing.
2.  Having your blood drawn is not a meaningful risk for HIV acquisition.  On one has ever been infected with HIV in the way you suggest.  Please do not worry about the possibility that you might have been infected when your blood was drawn. 
3.  The is no reason that you have described to not resume normal sexual relations with your regular sex partner.

This thread is now closed.  EWH
---
38 months ago
Thank you Dr. Hook

I am trying to move on. 

Thanks again, Happy vacations and Happy new year...

Regards