[Question #4616] I had moved on...

26 months ago
I thought I could move on from this nightmare. Protected vaginal and received unprotected vaginal oral with Male of unknown status. Tested @2 weeks post for everything -all neg. I know it was too early for most, but gave a baseline, gon. And chl. Were a urine test and neg. 
Tested @7 weeks for syph, hiv, and hep c, all neg. Tested again at 14 weeks for peace of mind for syph and hiv, neg. Skipped the hep c based off the info I had read on here. Didnt get throat or rectum swabs since there was technically no contact. Only slight kissing I didnt perform oral on him. Had a sore throat about 1.5 months after figured it was allergies, again around 3 months after but also had cold. Did get treatment with amoxicillin for 10 days and augmentin for 10 days in the 2nd/3rd month post one right after the other. Now at almost 4.5 months post I got a rash on my arms was red, slightly itchy and went away when you touched it. Took benadryl for a couple days and it was gone.....THEN a couple days later I started having joint pain in my hands and feet with swelling, slight redness around joints and itching. Some pain in elbows and knees..... Is there any chance these symptoms are related to the encounter? Hep c? Did I miss Gon ???
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome (back?) to the forum. Your opening line suggests you might have previously posted a prior question about this exposure and testing, but I can't find anything under your username. I don't think that's crucial -- but if there were, please let me know your username and/or the thread number(s).

The tests you had are highly reliable, much more reliable than exposure history or symptoms. You could have had a very high risk exposure (you didn't, even if your partner was infected, on account of the condom use plus near zero risk from cunnilingus); and your symptoms could be typical for the STDs you're concerned about. Your symptoms really don't match any of them, but even if they did, the test results rule. Your 2 week chlamydia and gonorrhea tests were conclusive, as were the later blood tests. I agree there was no need for oral or rectal swab testing.

I'm not sure where and how you became concerned about sore throat as an STD symptom (oral gonorrhea and chlmydia rarely if ever cause symptoms at all). Maybe you read somewhere about disseminated gonococcal infection (gonorrhea in the bloodstream) causing arthritis and skin rash, but those symptoms are nothing like you describe. They also are not typical for hepatitis C -- and anyway, you tested negative for that as well.

I have the feeling you are quite concerned about a sexual decision you regret. Howver, you need to entirely eparate that in your thinking from your various symptoms. For sure they are entirely unrelated. That said, your symptoms could be significant:  the combination of itchy rash (hives?) and joint pain (arthritis) could indicate any number of medical conditions, some of them serious. If they continue, I would encourage you to seek medical care for diagnosis.  But for sure no concern about any STD.

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

HHH, MD

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26 months ago
I went to the dr. Complete blood tests, noticed ALT was elevated 57, everything else was within very normal ranges. If this is Hep C was my 7 week test just not conclusive and would having Hep C invalidate my hiv test? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Your AST is only a little high. A large number of liver problems can cause elevated AST. Hepatitis C virus (HCV) is one of them, but not in your case if your HCV test was negative (7 weeks is plenty of time, you're beyond the testing window). Anyway, it's not a risk from the exposure you have described. HCV infection shouldn't be thought of as an STD. The only proved scenario in which sexual transmission is in men who have traumatic sexual practices involving the rectum with other men. The heterosexual partners of persons with HCV have no higher risk or frequency of infection than anyone else. One recent research study cites a transmission risk of HCV from vaginal sex, if one partner is infected, at 1 in 190,000. That's equivalent to having unprotected sex with infected partnerrs for over 500 years before transmission might be likely. In other words, zero for all practical purposes.

There are no medical conditions, including HCV infection, that interfere with HIV testing. Even if you had HCV, it would not affect your HIV test result. The same is true of all other causes of liver disease.

You should follow up with a doctor about your AST test result. Most likely her first move will to repeat your liver function tests. An AST of 47 is barely elevated, and a repeat test might be normal. 
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26 months ago
It was alt that was elevated at 57
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Sorry for the misreading. But even better. Normal range for ALT is 7-56, so 57 is even closer to normal than my mistaken AST figures. So close that if you were my physician, I would consider it normal (assuming other liver function tests all are normal) and not retest you. But if you remain concerned, discuss with your doctor. In any case, this makes no difference in the important parts of your question and my replies.

That completes the two follow-up comments and replies included with each question and so concludes this thread. I hope the discussion has been helpful and helps you move on without worry. Best wishes.
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