[Question #6462] Follow-up post of question #6157

13 months ago

Happy New Year, Doctor.

 

This is a follow-up post of Question #6157.

 

Basically, my first exposure, on August 14th, 2019, was due to haircut on. I took PEP for 30 days and did a PCR 26 days after the cessation of PEP. The PCR result came back as negative. Currently, I don’t worry too much about this incident.

The other exposure was due to a sex toy (fleshlight) that I purchased from online on October 9th. I feared that the sex toy might be previously used and went to local clinic for help. They told me the incident that I described was a zero-risk event and put me on PREP(Truvada) on the same day. Although Dr. Hook’s words put my mind at ease for quite a while, I still couldn’t get away with the thoughts that I might get infected if there was infected body fluid remained inside the fleshlight. It has also stopped me from pursuing new relationships. Therefore, I decided to complete the 30-day dose of Truvada and get tested again to convince myself. Details and information about both exposures can be found in Question #6157.

 

Here are my test results:

4th generation combo lab test – 28 days post 30-day Truvada: Non-Reactive

4th generation combo lab test – 35 days post 30-day Truvada: Non-Reactive

Alere Determine Ab/Ag POC rapid test – 46 days post 30-day Truvada: Negative

 

However, I experienced blurry vision, a terrible sore throat and a mild fever at about 5.5 weeks after the completion of Truvada, which was also 5 days after my second lab test. My throat swelled very badly that I was hardly able to drink or eat. It was recovered in approximately 3 days.

Then 2 days later, I did the Alere Ab/Ag POC rapid test (the one mentioned above). After I did the rapid test, I started to experience a bad running nose and sore throat again in the very next day. It was recovered in 4-5 days.

 

Here are my questions:

1.     Are my symptoms related to ARS?

2.     Are my testing results conclusive?

3.     Is there any need for me to take more tests at a later time? If yes, what’s the best time? (I saw different answers on this site regarding on when the results can be considered as conclusive in the setting of PEP being used. Since Truvada alone was used as PEP a few years ago, I was putting myself into the PEP category. Please let me know if I am wrong about doing this. I saw 6 weeks post PEP, 3 months and even 6 months post PEP.)

4.     Is the Alere Determine Ag/Ab rapid test as reliable as the lab test? Can I trust the test result?

 

Thank you so much for your time.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
Welcome back, but sorry you found it necessary. Also, it appears you have been using more than one account and/or username -- your last question with Dr. Hook refers to a previous question that doesn't show up with your current information. That's against forum policy and rules.

This and your previous message both indicate abnormal and frankly irrational fears of HIV from events or contamination that don't ever occur. For example, you other question shows obsession with survival of HIV in the environment. That's the wrong question and the answer doesn't matter. Nobody has ever been known to catch HIV from contacting contaminated surfaces or objeccts. That includes shared razors, which is a theoretical transmission route that has never been know to happen. You didn't need PEP and your test results prove you don't have HIV. Therefore, no symptoms you have can possibly be due to HIV. The answers to your four questions are 1) No, 2) Yes, 3) No, and 4) Yes.

This will have to be your last question along these lines, but I do hope this final reply has been helpful and that you're able to move along with your life without worry. If you are not, professional counseling would make sense, which I suggest from compassion, not criticism. Your thinking and your fears really are not normal, especially after the repeated, reasoned, science based reassurance you have had.

HHH, MD

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13 months ago

Hello Dr. Handsfield,

 

Thank you very much for your response. I apologize for bringing up those questions out of irrational fear. I promise you that I will try my best to work things out and seek for professional help if needed.

 

For the username issue, sorry it has created some inconvenience for you to track down the previous post. I am not exactly sure what happened to my latest post, but I only have one account which shows me the previous post. I guess it might be due to the fact that the system allows users to login with both their usernames and emails, which links to the same account but may appear differently on the screen.

 

I have received my negative 4th generation lab test result today, which is 12 weeks post exposure and 8 weeks post Truvada. As both the US CDC and BASHH‘s 12 weeks guideline are met, I will stop testing about those two events and work on my anxious mental response. (I also found 12 weeks post exposure testing recommendation for PEP users on UCSF Clinician Consultation Center’s website:
nccc.ucsf.edu/clinical-resources/pep-resources/pep-quick-guide-for-occupational-exposures/ )

 

Here I have one more quick thing that is unrelated to the previous two exposures:

 

2 days ago, while I was baking, my right hand accidentally touched the oven and got burned with the size of roughly 1 inch * 0.5 inch on the back side. I did not take any actions about it and went to clinic today to get my 12 weeks test done and did some shopping later on. On my way back, I felt a little painful on my burned area and noticed that a small portion of burned skin was broken (about a sesame size). No bleeding was spotted but I could see a little of my blood in that wound. Since I have been to the clinic and other places, I had no idea WHEN and HOW the skin was broken. It therefore raises some of my concern that I may touched some contaminated objects to cause the broken skin.

 

Questions:

1.     Is the burned skin vulnerable to HIV or other type of virus?

2.     Does my broken skin pose any risks on me?

3.     What actions should I take?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
These are nonsense concerns. If you do not have unsafe sex and do not share drug injection equipment with other persons, you will never be at risk for HIV. No need ever to ask about any other kind of exposure.

This will be your last such question on the forum. Repeated anxiety driven questions with predictable answers are not permitted, and future ones along these lines will be deleted without reply and without refund of the posting fee. ASHA is not keen on getting paid for information whose answers already have been given; repeated answers often prolong anxiety rather than helping relieve it; and such questions have limited educational value for other readers, one of the forum's main goals. Thank you for your understanding.

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