[Question #3923] Find myself back here

33 months ago

Hello Dr. Handsfield/Dr. Hook,

I find myself back here asking questions regarding an exposure which is now 8.5 months back. The biggest fear in regards to my exposure and subsequent testing has been two fold

.- Not fully remembering the exposure (do remember oral both ways)(i am a male and am hetrosexual)

- My girlfriend frequently feeling sick on and off a few weeks usually after intercourse with me

The anxiety i have been going through along with fear for now almost 2 years due to a first incident at the end of 2016 and then the latest on mentioned above in Oct. 2017 has become overwhelming. The ability to rationalize has been blurred and the obsession with sites like this along with health tap, healthboards, medhelp, freedomhealth, has become almost a daily thing. Searching this much, i understand i will indoubatebly find cases of late seroconversion, hiv positive but no antibodies and all the other stories under the moon.I find myself reading this forum and analyzing both of your writing styles, certain words like "be confident" "reliable" etc and then thinking of worse case scenarios vs. words like "conclusive" etc ===== THIS EQUALS A VERY SKEWED WAY OF THINKING and i am sure you will agree, its just been hard to let go.

Questions:1. Would having 4th gent tests (arm blood draws) at 26, 43, 71, 101 & 182 days (4,6,10,14 & 26 weeks) be ABSOLUTELY conclusive or is their any reason at all for me to continue to worry.... (Reading online and concerns of others puts me in confusion and continued worry)

2. If the above are fully conclusive and will not change then i understand i should believe that my girlfriend feeling ill from time to time has ABSOLUTELY nothing to do with my obvious worry or concern?

3. In what situation would you request someone test after 6 weeks if using a lab based test such as the 4th generation?

4. When you mention or say "Reliable" what do you mean? Are you simply saying "hey thats reliable but you could still test further" The term reliable to me when used in certain contexts can mean “hey trust it but I cant guarantee you anything” ????

5. Let’s presume someone had the highest risk for HIV acquisition, would 6 weeks with 4th gen lab based still be enough?

6. If someone made no antibodies for HIV would antigen still be presented in the tests?

7. Is it possible for 4th generation test to be false negative as many times as I have tested?

6. What are your suggestions on helping me get through this, I feel like I am a different person who always laughed and smiled and now just have heavy eyes and blurred vision along with a less cheerful attitude on life.------ its scary

As always your responses are greatly appreciated.

Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
 I am disappointed to see that you have felt the need to return to our forum. Seven months ago Dr. Handsfield indicated that future repetitive, anxiety-driven questions would be deleted without response. For some reason I have chosen not to immediately delete your response but to provide  brief answers. I do plan to close this thread quickly however.    Straight to your questions. 

1.   Your results are entirely conclusive and no further testing is required. Apparently you have been victimized through the Internet. Please understand that the Internet is a common source of misinformation by providing statements that are taken out of context, that are out of date, or are simply wrong incorrect statements.   The best possible advice that I can give you in this response is to stay off the Internet. 
2.   Correct. Your girlfriend's illnesses and episodic symptoms have nothing to do with the exposure that you worry about. 
3.   The only patients who I would suggest testing for after a negative result at six weeks or persons who had been exposed and taken postexposure prophylaxis. No one else! 
4.   You are being paranoid.  Reliable means that you should believe the result. Nothing more! 
5.  Yes.
6.  Yes.
7.  No
8.   My suggestions: you do not need further testing. Your guilt and anxiety over your dalliance are the problem and should be addressed with professional counseling. You do not need to further medical care and should not have further medical questions. 
32 months ago
Thank you Dr, i am doing my best to let the worry about HIV subside having tested out to 182 days and several times before that. 

It's just my girlfriend is constantly feeling sick with ear pain, sore throat, feeling feverish etc, this all just brings the worries back up for me. Recently now they are looking in her ear and mentioning something like trigeminal Neuralgia

I also took Hep B and C as well as Syphillis testing at 6 months (182 days) would that be enough testing as well?

I have had zero potential exposure after which was Oct 19 of 2017 and last testing was April 19 of 2018. For all STD's would this be sufficient including HIV.

I will not be asking further questions, thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Your obsessions and resulting anxiety have no rational basis.  I urge you to seek counselling/mental health assistance in moving forward..  that your GF has been ill does not mean that you gave her problems to her or that it is the result of your infidelity.  In answer to your follow-up questions:
1. This is also sufficient testing to confidently rule out hepatitis B&C, as well as syphilis
2.  Yes, this is sufficient to rule out all STIs tested for.

You are not infected.  EWH
32 months ago
Thank you, for future reference, can you tell me when it is enough testing for 
Hep B
Hep C
Herpes 1 and 2

There is so much variance on the internet and would like your professional opinion. I fully understand HIV now and that 6 weeks is the maximum time needed with a 4th gen test.

Thanks for your help and guidance on this.
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Repetitive.  Answers below.  Further questions on this subject sent to me will be deleted with no comments.

Hep B 3 months
Hep C 3 months
Syphillis  6 weeks
Gonnorhea  3-5 days
Clamydia  3-5 days
Herpes 1 and 2  3-4 months for Western Blot

These times are approximate and, for the most part, conservative.  I have no interest in what sort of other information you may have received on the internet.  Generalities may vary in specific cases.

End of thread.  Please, NO follow-ups. EWH