[Question #6601] Please don't delete- legitimate question

14 months ago
Doctors

I fingered an unknown gal with a small gash on Nov 7, 2019.  I tested negative at 42 days and 60 days using the alere rapid duo.  Results were negative.

At the end of December I got a bad sinus infection.  The doctor first prescribed a z pak, then 10 days doxy, now 14 days augmentin.  He also had me take a methlyprednisolone 4 mg 21 tablets over a week using the taper down method.  I finished this course on this past Sunday.  

Yesterday I went to the ENT and he gave me Prednisone.  I am to take 30mgs for three days, 20 mgs for three days and 10 mgs for three days.  So far (yesterday) I took 30 mgs of the new steroids.

Today I woke up with white scores / thrush on my mouth roof near front teeth. I had a few last week as well.  It's 90 days post exposure today.

1.  Are my existing tests valid?

2. Can these sores be ars?

3.  Do I need more testing?

4. If the the thrush sores is ARS would a rapid duo test today confirm or deny the sites area result of ars.?

5.  Would the steroids I took affect testing accuracy if I test today
?

6.  When can I sleep with my partner?

** I am still being treated from PTSD**

Thank you. 


2.  Could I get




14 months ago
Lastly if I go for a test today I have a choice of the alere determine duo or the insti HIV 1 and 2 antibody only test.  What would be better?
14 months ago
I also was told to use Flonase in my nose.
14 months ago
 I am sorry question 4 had a typo.  Correct below.

4.If the the thrush sores is ARS would a rapid duo test today confirm or deny the sores area result of ars.?
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Welcome back to the question.  Many but admittedly not all of your questions have been answered in the course of the past 10 interactions you have had with Dr. Handsfield and me.  Because of the time interval I will provide answers.  Straight to those questions:

1.  Are my existing tests valid?
Yes, both your 42 and 60 day results are conclusive and prove that you did not get HIV from the exposure you described.  There is no need for further testing. 

2. Can these sores be ars?
No!  Thrush is a common complication of taking antibiotics and prednisone.  You can be confident you do not have HIV.

3.  Do I need more testing?
Absolutely not.

4. If the the thrush sores is ARS would a rapid duo test today confirm or deny the sites area result of ars.?
Another test is not needed.  If you test again, the results will again be negative, again proving that your thrush is not related to HIV including the ARS.  If you do chose to test again (I recommend against it), my advice is to use the Alere Determine Duo rather than the antibody only test. 

5.  Would the steroids I took affect testing accuracy if I test today?
No

6.  When can I sleep with my partner?
There is no reason to abstain from unprotected sex with your regular partner related to the encounter you describe above. 

I hope this information is helpful.  Please do not worry.  There is no need for further testing. EWH
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14 months ago
Doctor Hook 

Thank you for your concise answers.  I know I get two follow-up exchanges so here goes:

I took the methlyprednisolone 4 mg 21 tablets over a week using the taper down method.  I finished this course on this past Sunday Feb 2. 

Sinuses were still bothering me so Tuesday I went to the ENT and he gave me Prednisone.  I am to take 30mgs for three days, 20 mgs for three days and 10 mgs for three days.  Tuesday I took 30 mgs of the new steroids.  That's as far as I got with this new course of steroids before the test described below;

Yesterday I did go and have the rapid alere duo test.  The results were negative at 90 days post risk.   My questions are;

1.  Was the thrush sores (89 days past risk ) to late for ARS?

2.  Was the thrush sores being ARS ruled out because I tested a few hours after getting it?  Sometimes I see you say if you have symptoms you will test positive and sometimes I have heard you say the test must be a few days after the symptoms start.  Please clarify.

3.  In your response you stated the steroids I took (listed above) would not affect the accuracy of my results (meaning antibody /antigen production). They were taken from January 27 to Feb 2.  Basically during the 12th and 13th week of the window period.  In the past I heard you say it could affect the results.   

Is your rationale because I am so far along in the window period that I would already have antibodies / antigens in my system if I was infected, so the steroids would not affect what should already be there if infected?

4.  Do all the antibiotics I took  affect hiv test results?

5. When is HIV -2 ruled out since it is only found via the antibody component of the test?

Thanks for your time and consideration!



 

Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

You are repeating your earlier questions which have already been answered.  As you have also been told, repeating questions does not change the answer.  Brief answers:

1.  Was the thrush sores (89 days past risk ) to late for ARS?
YES

2.  Was the thrush sores being ARS ruled out because I tested a few hours after getting it?  Sometimes I see you say if you have symptoms you will test positive and sometimes I have heard you say the test must be a few days after the symptoms start.  Please clarify
You are mistaken.  I have always stated that if your symptoms were due the ARS, your DUO test would be positive.

3.  In your response you stated the steroids I took (listed above) would not affect the accuracy of my results (meaning antibody /antigen production). They were taken from January 27 to Feb 2.  Basically during the 12th and 13th week of the window period.  In the past I heard you say it could affect the results.   
You are incorrect again.  If you were going to produce antibodies, you would have done so by then.  Further, prednisone would have NO effect on the antigen portion of the DUO test.

Is your rationale because I am so far along in the window period that I would already have antibodies / antigens in my system if I was infected, so the steroids would not affect what should already be there if infected?
Correct.

4.  Do all the antibiotics I took  affect hiv test results?
No

5. When is HIV -2 ruled out since it is only found via the antibody component of the test?
at 8 weeks

EWH
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14 months ago
Dr. Hook

Good morning.  I just want to clarify the dates (I made a mistake) I took steroids, on top of the antibiotics: (for awful sinus issues)

  • They were taken from January 27 to Feb 2.  ( methlyprednisolone 4 mg 21 tablets over a week using the taper down method)
  •   I went to the ENT last week and he gave me Prednisone.  I am to take 30mgs for three days, 20 mgs for three days and 10 mgs for three days.    They were given Feb 4 thru today Feb 11.  
  • Basically during the 12th and 13th week of the window period I had steroids.
I tested negative with the alere duo 42 days after risk
I tested negative with the alere duo 60 days after risk
I tested negative with the alere duo on Feb 5th (90 days after risk)

This is what I learned /takeaways:

1.  Any thrush or mouth sores at 89 days post risk or going forward is to late to be ARS?
2. The alere rapid duo at 90 days rules out the thrush at day 88 and 89 had anything to do with HIV infection / ARS?
3.  Even if the the steroids would have any affect on rapid duo testing.  I would have already developed antibodies / antigens so my 90 day test is conclusive?
4. The two courses of steroids mentioned above would not affect antibody / antigen production?
5.  I didnt have a risk in the first place?
6.  My 42 day and 60 day alere duo tests were conclusive to rule out HIV (and prior to steroids)?
7. I can sleep unprotected with my regular partner?

MOVE ON WITH MY LIFE !!

Thanks Dr. Hook for all you do.  I will see a doctor for my mouth issues and continue my counseling.

  


Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Your questions are repetitive and have already been answered.  You are quibbling about nuances which have no bearing on the FACT that the event you describe was NO RISK and that the tests you took PROVE that you do not have HIV.  This sort of repetitive questioning is the sort of behavior that has led to warnings for you in the past:

Brief, final answers.  Further questions regarding this episode may be deleted without a response:

1.  Any thrush or mouth sores at 89 days post risk or going forward is to late to be ARS?
Correct

2. The alere rapid duo at 90 days rules out the thrush at day 88 and 89 had anything to do with HIV infection / ARS?
Correct

3.  Even if the the steroids would have any affect on rapid duo testing.  I would have already developed antibodies / antigens so my 90 day test is conclusive?
Correct

4. The two courses of steroids mentioned above would not affect antibody / antigen production?
Correct

5.  I didnt have a risk in the first place?
Correct

6.  My 42 day and 60 day alere duo tests were conclusive to rule out HIV (and prior to steroids)?
Correct

7. I can sleep unprotected with my regular partner?
Correct
This thread will be closed shortly without further responses.  EWH
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