[Question #4294] I need your help doctor!

83 months ago

Hello doctor, I really need your help as soon as possible.I'm not in a good psychology.

First of all sorry for my English.I'll do my best.

I had sex with escort woman in Ukraine.I used condom but at the end of the sex,i saw a little bit blood on condom.That was her blood maybe she was on menstruation.I already had her blood on my genital area too,but there was no cut or something.After a short time,i heard that she was HIV POSITIVE.Then my anxious thoughts starts and i began to testing.By the way im a person who has just 1 kidney and i had asthma treatment with cortisone 8 years ago for a long time.I don't have any health problem right now.

39.day 4rd generation hiv duo ultra-negative

57.day 4rd generation hiv duo ultra-negative

84.day 3rd generation anti hiv-negative

90.day 4rd generation hiv combo-negative

108.day 4rd generation hiv combo-negative - cmv igG positive, igM negative , hepatitis b immune,syphilis negative

145.day 3rd generation anti hiv-negative

179.day 4rd generation hiv duo ultra-negative

237.day 4rd generation hiv combo- negative, hepatitis c negative

my hiv tests okay,all negative.I remember my symptoms (lymph enlargement with pain on neck,sores in mouth,thrush on tongue,headaches,often diarrhea)starts at almost 70.day after a encounter.My symptoms were sustain even after a 237th day too.Then i realized i haven't do my EBV test.I had this test after 244th day and i had igG 10.03 positive and igM 1.36 positive.So i thought by myself maybe my all symptoms due to this EBV thing.

1-Is this EBV igM positive result effect on HIV seroconversion ? I mean if i have HIV,is this EBV effect to obstruct to produce HIV antibody to detect on tests?Is it possible?

2-Are my asthma treatment with cortisone (8 years ago) and my 1 kidney,have any effect to obstruct to produce antibody for HIV?

4-Do I need any further test for HIV or anything else?

5-Can i continue to have sex with my wife without condom?

Looking forward to your response.Thank you.

H. Hunter Handsfield, MD

83 months ago

Welcome to the forum. Your English seems fine -- your questions and the overall situation are clear.

I understand how alarming it was to learn your partner had HIV, but it seems you understand your test results are reliable and you were not infected. That actually was nearly certain after your first blood test (39 days) and was 100% conclusive after the second test, at 57 days. The remaining tests were unnecessary, but they confirmed you were not infected. Your symptom started much too late to be due to HIV from that event, and you already had blood tests proving you did not have HIV. Your symptoms were not typical for EBV either. Your symptoms had nothing to do with the sexual exposure you have described. You also did not catch EBV during that event. Almost all humans are infected with EBV in childhood or in their teens; by age 20, almost everybody has positive blood tests. in theory, IgM antibody indicates early infection. However, IgM blood tests are notoriously inaccurate, and many people with longstanding infection have positive tests. Your weakly positive IgM result almost certainly does not indicate a recent infection.

To your questions:

1) There are NO medical conditions that have any effect on HIV blood test results, especially the newer antigen-antibody (4th generation) tests. Your EBV test results did not interfere with your HIV test results.

2) Even the most potent immunosuppressive drugs have NO effect on HIV testing. That was a rare issue with older blood tests, but never with the newer AgAb tests. And in any case, distant past cortisone treatment has no effect.

4) You do not need any more tests for HIV.

5) From an HIV standpoint, you can safely have unprotected sex with your wife. (You could have done that after your second negative blood test.) You don't mention other STDs, however. The odds you caught syphilis, gonorrhea, or chlamydia are very low, but if not tested, you might want to do so for extra reassurance.

So all is well, no worries! In reply to your opening comment "I'm not in a good psychology": Do not confuse your anxieties over a sexual decision you regret with infection risks from that event. They are not the same. Deal with the psychological issues as you need to (maybe discuss with your wife? professional counseling?), but you can forget about infections. Just go on with your life as normal!

I hope this information is helpful. Let me know if anything isn't clear. Best wishes--

HHH, MD

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83 months ago

Mr. Handsfield,first of thank you for your quick answer and im pleased to you to trying to make me feel relax about that HIV situation.I understood everything that you said i don't have HIV and i don't need any further tests about that.However I have more questions,i really didn't get it so right.You know I inform I got POSITIVE on EBV igG and igM antibody tests.I know that igG means i had it past in my life.It's clear.igM means i have it right now.So if i have EBV right now in my blood,how it's possible that i take from someone and still it sustains? I mean i had sex with this escort woman in Ukraine in JANUARY 2018 and i haven't have any kissing,or sexual touch after that exposure.Except my wife.I event don't share drinks with my bestfriends too.So is it really possible I got this EBV from this exposure at Ukraine in January and it still sustains in my blood? Because why,i did CBC two months ago (at june ) and i did 1 week ago with HIV test,everything was okay except my lymphocyte.It was above of borderline.So my doctor told me i could have some virus or bacteria in my blood even it would be a flue thats why lymphocytes rises easily but he said it's not because of HIV.So i understood now probably i was high because of EBV.

1-How it's possible if I have EBV igG positive antibodies and i have igM antibodies now at the same time if I got sick EBV at the past for example at the chilhood?

2-Do you think i take that EBV from last exposure that i have in Ukraine in January? Because i didn't have any exposure after that even i didn't have any kissing with someone else except my wife.

3- What kind of diseases effect on HIV seroconversion? For example cancer or something like that?

4-If my lymph nodes got big because of HIV or EBV,does it feel painful?Because i have 2-3 nodes on my neck and they are painful especially touching with hands.

Mr. Handsfield,I really appreciate to you and to Mr.Hook about that services and that patience you show to people like us.You are really big hero,hope everything will fine in your life.God bless you and your family.Same for Mr.Hook too.Big thanks doctor!

H. Hunter Handsfield, MD

83 months ago

These questions make me wonder whether you understand my replies above. Consider re-reading them carefully, perhaps with assistance of someone with excellent English language skills; or maybe try Google Translate.

I saw and understood your original question and was aware that you had a positive EBV test. So do all adults: EVERYBODY has positive blood test results for EBV.

1,2) These test results are normal for all people who catch EBV in childhood. The IgG blood test is positive for life. IgM usually is not, but often gives false positive results, which almost certainly explains your blood test results. There is no evidence you have an active EBV infection. Having EBV is normal and expected for everybody. You did not catch it during your recent sexual exposure and it is not the cause of any of your symptoms.

3) This is the same question you asked above (Question 1). Re-read my reply above.

4) There are many causes of enlarged lymph nodes and most are not serious. HIV and EBV are uncommon causes. If you believe you still have enlarged lymph nodes, see a doctor to determine the cause and possible treatment. However, if they are going away, you can just forget it and move on.

I will be happy to reply to one more follow-up comment. Please be careful to not ask the same questions again. The answers will not change!

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82 months ago

Hello Mr. Handsfield,hope everything is going well.I have one more question.I had a ache on my neck,armpit and back of ear.Especially right side of my neck and back of my ear.Both armpits were aching.Upon this,i had an ultrasound to check my lymph nodes.They are all reactive,right submandibular 17x7 mm, left submandibular 15x5 mm , right submental 12x7 mm , left submental 12x6 mm , right posterior cervical 7x3 mm , right axilla 23x10 mm , left axilla 19x9 mm . all of them are reactive.so my doctor told me axilla lymph nodes would be a dangerous because they're above of 2 mm.By the way they're aching almost 3 months (starts after 2 month of exposure) and still aching sometimes especially my armpit (axilla) lymph nodes.So i believe my test results about HIV but that aches of lymphs scares me.I don't know it's because of HIV or EBV but i haven't have them,before an exposure,I totally know that because i always control my body because of doing gym regularly.So after this exposure,my life exactly return like a hell.After all,Mr. Handsfield, here is my last questions and you can close this thread after them but please don't be angry to my if i will answer the same questions,but i don't think they're same.

-Does my lymph nodes are on a risky level ? Why they are aching? Especially right side of my neck and both armpits.

-Do you think EBV could make them bigger?

-Should i check my EBV igG and igM again soon? Do I need that?

-I still have a concern that my EBV igM 1.36 (low titres) could affect my HIV tests or HIV seroconversion.But i really believe you too.I'm not saying you're wrong just because of my aching lymphs and occasionally diarrhea.

-What do you recommend me about that issue Mr. Handsfield? It would be really much valuable for me and for my life..

Thanks for everything,God bless you and your family.

H. Hunter Handsfield, MD

82 months ago

The HIV blood tests are among the most accurate diagnostic tests that exist, for any medical condition. Your test results prove you did not catch HIV. If you have enlarged lymph nodes, they are caused by something else.

I suggest you ignore EBV. Even if you have it, so what? EBV is rarely serious and there is no treatment anyway. If that's the explanation for the lymph node problem, the nodes will return to normal size and all will be well.

If any of this remains uncertain, ask your doctor to refer you to an infectious diseases specialist. But in the meantime, there are NO worries about HIV: you don't have it. And NO worries about EBV, because it's not a serious problem and will go away.

That concludes this thread. Thanks for the thanks about our services.

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