[Question #6378] Hiv

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68 months ago
Hello doctor,

I was having sex with a massage lady and when she went on top the condom broke but we kept going until I ejaculated. 

I kept stressing because of hiv. 
The story:
1)I took her to the doctor a week (7 days) after the incident and did a hiv combo p24 test for her and the results was non reactive but the value was 0.716 (which is high in my opinion) 
2) after I saw that high value I did a test for myself which was 0.34. Which was the highest I got. I normally get 0.15-0.25. So now I’m freaking out
3) I did hiv pcr quantitative for her and  I’m waiting for the results which will be coming out this Thursday. 

My question:
1)Should I be freaking out because of hiv? And because of the value of the test? Would the hiv quantitative be positive?
2) I am having weird sensations in my lymph nodes but nothing is swollen. 
3) random question: is hsv 2 (herpes) 
contagious when not active?
Thanks and best regards,

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Edward W. Hook M.D.
68 months ago

Welcome to the Forum.  I'll be glad to comment.  Let me start by saying that I anticipate that your partner's HIV PCR will be negative and I am confident that you did not acquire HIV from the event you described.  You are over interpreting the results of the 4th generation, combination HIV antibody/antigen tests.  Negative is unequivocally negative and fluctuation in the negative values is typical.  When one negative numerical value is higher than another the differences are irrelevant and there is no such thing as a "worrisome" or "high" negative value which should cause concern.   

1)Should I be freaking out because of hiv? And because of the value of the test? Would the hiv quantitative be positive?
You are worrying needlessly and mis-interpreting your negative test values.  See my comments above. 

2) I am having weird sensations in my lymph nodes but nothing is swollen. 
This suggests that you are looking too hard for symptoms. 

3) random question: is hsv 2 (herpes) 
contagious when not active?
Persons infected with herpes can "shed" the virus when lesions are not present although such circumstances are far less contagious than when lesions are present.  We estimate that the likelihood of infection when exposed to an infected sex partner who does not have lesions present is less than 1 in 10,000 exposures.  I would not worry and certainly would not waste time testing unless lesions appear in the 7-10 days following the event.

I hope this information will be reassuring to you.. EWH
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68 months ago
Thank you for your reply
I have a pimple-like behind my ear. I don’t know if it is a swollen lymph node or not.  I feel uncomfortableness under my jaw sometimes and behind my neck. 

Question
1) how can I be sure that I don’t have hiv? Do I need to wait for the pcr result or rest my mind?

2) how can I be sure I didn’t get hsv 2. She didn’t have any herpes signs. But her test results were positive for hsv2. 

Regards 

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68 months ago
Sorry forgot a question. 
Thank you for your reply
I have a pimple-like behind my ear. I don’t know if it is a swollen lymph node or not.  I feel uncomfortableness under my jaw sometimes and behind my neck. 

Question
1) how can I be sure that I don’t have hiv? Do I need to wait for the pcr result or rest my mind?
2) when is hiv  pcr quantitative accurate 99% accurate?
3)how can I be sure I didn’t get hsv 2. She didn’t have any herpes signs. But her test results were positive for hsv2. 

Regards
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Edward W. Hook M.D.
68 months ago

A swollen lymph node would not seem to be a pimple.  If you have a concern regarding this spot, I suggest you see a doctor.  If the spot you describe were due to HIV, your combination HIV antibody/antigen test would be positive.

Regarding your follow-up questions:

In preparing to answer your questions I note that you do not mention how long it has been since the event when the condom broke, nor how long after the event you had your PCR and 4th generation test performed.

1) how can I be sure that I don’t have hiv? Do I need to wait for the pcr result or rest my mind?
If your partner's test was negative 7 days after the exposure, you can be confident that you were not exposed to HIV.  I see no reason for you to worry.

2) when is hiv  pcr quantitative accurate 99% accurate?
HIV PCR is typically positive 11-12 days after acquisition of infection.

3)how can I be sure I didn’t get hsv 2. She didn’t have any herpes signs. But her test results were positive for hsv2.
Any single exposure is quite low risk for acquisition of herpes.  If you do not develop lesions within 10 days of your exposure, you can be confident that you did not acquire herpes.

EWH
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68 months ago
In reply to your question 
 In preparing to answer your questions I note that you do not mention how long it has been since the event when the condom broke, nor how long after the event you had your PCR and 4th generation test performed.”

The condom broke 7 days earlier to the hiv combo p24 antigen test. 
So when the condom broke I waited 7 days before taking the masseuse to get a blood test for hiv combo p24. 
1)The result was 0.716. Non reactive. 
2)On the same day I did for her the the pcr but it takes 5-8 days to receive the result. (Still in progress)
3) now it has been 12 days since the condom breakage. 

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Edward W. Hook M.D.
68 months ago
Thanks for the additional information.  Given that is was 7 days between the condom breakage and testing your partner, you can be confident that she was not infected.  I am confident that, based on the information you provided, you were not exposed to HIV.  EWH
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Edward W. Hook M.D.
68 months ago
This thread has received three responses.  As per Forum guidelines it will now be closed.  EWH
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