[Question #4257] ANAL Sex with HIV acute infection

31 months ago
Dear users
I had unprotected insertive anal sex with a woman from Nigeria. We met at a large conference for work in switzerland. She called a few weeks later to inform me that she had tested positive for hiv-2  and that I should get tested positive . She did not know at that time that she was hiv positive. She said she is waiting for her confirmation test . Her  number has been switched off ever since that day and I don’t know how to contact her. SHe has left the company where she was working and iv been unable to contact her since then. 
As you can imagine iv been a nervous wreck since then as she was probably in her acute infection stage . I have taken 4th generation tests on the following days 
Day 60, 90, 120 and 126 post exposure .
This means my last test was at 18 weeks post exposure. 
I had an oral herpes breakout at 10 weeks after exposure but iv had this before.
at 10 weeks after exposure i had a breakout of angular chelitis for which i was given cortizone treatment for two weeks. 
One local doctor said that 3 months is the guideline but i should wait 6 months or 24 weeks for a final check due to my medication. Another one said that 3 months is enough.
1, Do you think that an 18 week negative test can be considered 100 pc proof despite my cortizone treatment. 
2. In the last decade have there been any cases of delaved seroconversion after 18 weeks. 
3. Is there any way that i could still be positive despite taking 4th generation tests
4. Do you think i need a pcr / dna test ?




31 months ago
sorry oral herpes breakout at 4 weeks post exposure and angular chelitis at 10 weeks 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to the Forum. I'll be glad to comment, while HIV-2 rates are somewhat higher in Nigeria than many other parts of the world, the infection is still relatively rare even there.  Because the infection is so uncommon the data are somewhat less precise for HIV-2 infections than for HIV-1.  What is agreed upon however is that HIV-2 is substantially less infectious than HIV-1 (which is transmitted about once in every 1000 episodes of vaginal or insertive rectal intercourse).  There is also general agreement that currently available tests would detect HIV-2 within 12 weeks of exposure so your tests at 90, 120 and 126 days after exposure should be considered conclusive and that you did not acquire infection from the exposure you describe.,  Thus, in answer to your specific questions:

1, Do you think that an 18 week negative test can be considered 100 pc proof despite my cortizone treatment. 
Yes, believe your test results.

2. In the last decade have there been any cases of delaved seroconversion after 18 weeks. 
No.

3. Is there any way that i could still be positive despite taking 4th generation tests
No

4. Do you think i need a pcr / dna test ?
No.

I hope my responses are helpful to you. EWH
---
31 months ago
1. Is delayed seroconversion just a myth then ?
2. Doctors said that the test is 99.99 percent accurate at 3 months . Why do they say that ? when does it become 100 pc ? 
3. If there have been no cases of delayed seroconversion why do some guidelines still say 6 months . thats crazy 

Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
!.  Yes, delayed seroconversion i a myth.  There are data to suggest that for HIV-2 seroconversion may take a bit longer than the 6 weeks it takes to provide a conclusive diagnosis of HIV-1 but tests do provide reliable answers regarding HIV-2 within 12 weeks of exposure.

2.  I think they are being overly cautious.  The fact is with humans and medical science strange things happen. Thus just as your results are more than 99.9% conclusive for HIV-2 for tests at more than 12 weeks following exposure, it is also more than 99.9% assured that you are not going to be struck by lightening today. 

3.  See no. 2 above. 

I hope this information is helpful.  EWH,
---
30 months ago
Dear Doctor 

Im feeling terrified today . Iv developed a mouth ulcer and iv read that mouth ulcers are a sign of HIV 

You mentioned that it is 99.99 percent sure that i dont have HIV.  Iv had 13 tests since my exposure on the following weeks . 3,4,6,8,9,10,11,12,16,17,18,21 

They have all been fourth generation tests and the last one was taken at week 21 post exposure. 2 days after my last test i developed the mouth ulcer .

1. Could the mouth ulcer be a sign of HIV ? I read it is a possibility and that it could be caused due to delayed seroconversion at week 22. 
2. When should i keep testing till to be 100 pc sure and not 99.99 pc sure ?
3. Im also in an area where dengue fever is rampant. My sister just got dengue . Im worried i might get dengue / malaria . Does dengue fever interfere with test results and give false positives . i read that acute dengue fever leads to false positives .
If i get fever, should i do an hiv test again ? 

im so scared 

Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
I'm sorry I missed your follow-up question earlier.  I will answer it now and suggest that you contact our administrator and request a refund of your fee.  There is no need for you to pay for. 2nd question.  On to your questions:

1.  Mouth ulcers are not a sign of recently acquired HIX and, as I mentioned earlier, the concept of delayed seroconversion is an internet based myth.  It does not exist.
2.  Your test results from repeated testing PROVE that you did not get HIV.  Accept the results.  There is no need for additional testing.
3.  Your results are negative, thus the idea of false positives should not trouble you.  There are no data to suggest that Dengue is associated with false positive (or false negative) test results.  Once again, believe your test results.

With or without fever, there is no need for further testing related to the encounter you describe.  No further testing is needed.  I hope this reply is helpful and will allow you to move forward without concern.  EWH
---