[Question #6774] HIV fear- TSH declined than normal range after handjob

11 months ago
Hi, i went to massage several time and the thai lady did handjob on my penis each time before finished. Not sure if their hand or finger had sore or blood and i am not sure if my penis had cut. Can the blood go into the pee hole and infected me ? last exposure was 28th Nov 2019. Total 4th Gen Combo test done  - 4 times (blood test ECLIA & CMIA) at 8 weeks, 11 weeks, 13 weeks and 2 times 4th Gen Combo test done (rapid finger prick)- 12 weeks, 14 weeks. All reports are negative. However, my TSH drops to 0.357 vs normal range 0.4-4.7 mIU/L, FT4 & FT3 in normal range but my blood pressure is consistently high around 130/90 although on Norvasc 5 mg daily. I am worried if the TSH and high blood pressure are due to HIV not detected by the test yet. I never have problem with my TSH and high blood pressure before this. My endocrinologist feel there is risk and ask me to test HIV again at 6 months. It really worries me, i am extremely stress since January, feel like in hell everyday, can I say the HIV tests are conclusive ? any risk of HIV 2  not pick up yet due to late seroconversion? can't wait until 6 months, can i say the TSH and high blood pressure is due to stress ? Thanks for your help
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Welcome to our Forum and thanks for your question.  No matter whether your masseuse had a sore or blood on her hand and/or whether you had a cut on your penis without knowing it (all of which are unlikely) these encounters did not put you at risk for HIV.  Thus testing related to them was unnecessary.  The testing you have had however at 8, 11, 12 (twice) and 14 weeks are ALL entirely conclusive and serve to confirm that the encounter you describe did not put you at risk and that you did not get HIV from them.  Be confident of this- once again, you did not get HIV from the encounter you described.  These comments are true for HIV-2 as well. 

Thus, any change in your TSH and elevation of your BP are not related to a hidden, undetected  HIV infection.  With all due respect to your endocrinologist, you can be confident that this is not HIV and there is no need for testing. 


Please do not worry. There is no need for further testing for HIV of any sort related to the events you describe above.  EWH

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11 months ago
Thanks Dr to your reply, it really helps me a lot,

Appreciate if i can ask few more questions

1. I am from Malaysia and the lab here using the ECLIA and CMIA for the HIV 4th Gen blood test and Alere HIV 4th Gen combo for finger prick, rapid test. May i ask whether all these tests are similar with the window period you shared earlier for conclusive results at 6 weeks ?

2. Both rapid test and lab blood test are same and as effective in providing conclusive result at 6 weeks ?

3. i had unprotected sex with my wife, after that she lose her weight (for 3 kg) and now her body weight maintained, no further drop. Her menstruation in Feb did not end as expected, prolonged bleeding (minor) until she tooks medication and the Dr said that it is due to hormone change. After which, during her Mar menstruation, it only last for 3 days whereby the volume was excessive on 1st day, could this due to hiv infection ? i google and read that HIV virus might interupt the female hormone and affect their menstruation

4. I had needle pricking or tingkling sensation around my left chest (under nipple),abdomen and left upper abdomen, anyway it does not happen consistently, sometime it last for few minutes or few hours, after which it stopped for few days and it might come again, is this a sign of HIV neuropathy ?

5. I had an enlarged lymph node under my right armpit, it was painful when touched, it took about 2 weeks to resolve, is this considered HIV related ?


My apology if i had repeated any question, thanks again to your help and advice
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Straight to your follow-up questions:

1. I am from Malaysia and the lab here using the ECLIA and CMIA for the HIV 4th Gen blood test and Alere HIV 4th Gen combo for finger prick, rapid test. May i ask whether all these tests are similar with the window period you shared earlier for conclusive results at 6 weeks ?
These tests are all well known and reliable.  For each of the 4th generation tests, results are reliable at any time more than 6 weeks after exposure.


 2. Both rapid test and lab blood test are same and as effective in providing conclusive result at 6 weeks ?
Yes


 3. i had unprotected sex with my wife, after that she lose her weight (for 3 kg) and now her body weight maintained, no further drop. Her menstruation in Feb did not end as expected, prolonged bleeding (minor) until she tooks medication and the Dr said that it is due to hormone change. After which, during her Mar menstruation, it only last for 3 days whereby the volume was excessive on 1st day, could this due to hiv infection ? i google and read that HIV virus might interupt the female hormone and affect their menstruation
I cannot tell you what is causing your wife's problems but each of the problems you mention can be caused by many things.  What I can assure you is that you do not have HIV from the events you describe and cannot have transmitted HIV infection to her.  These are separate problems


 4. I had needle pricking or tingkling sensation around my left chest (under nipple),abdomen and left upper abdomen, anyway it does not happen consistently, sometime it last for few minutes or few hours, after which it stopped for few days and it might come again, is this a sign of HIV neuropathy ?
Absolutely not.  HIV neuropathy is a problem which occurs with far advanced, long standing HIV.  You do not have HIV.  This is not a concern. 


 5. I had an enlarged lymph node under my right armpit, it was painful when touched, it took about 2 weeks to resolve, is this considered HIV related ?

No, lymph node swelling is non-specific.  If your lymph node swelling had been due to HIV, it would most typically be non-tender and would not have resolved.


Your follow-up questions suggest that you have been searching for information on the internet.  Please stop. Particularly when it comes to HIV, much of what is found on the internet is out of date, misinterpreted, taken out of context of just plain wrong.  I hope this responses are helpful. EWH

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11 months ago
Thanks Dr for your kind reply,
Indeed, i am still quite anxious about the changes of my TSH (Thyroid Stimulating Hormone), because it never happen in my previous annual medical check up and start thinking 

1 Whether the labs in my country, Malaysia (south east asia)still not as advanced (especially the blood test  ECLIA and CMIA) and they just acquired the technology from western country whereby asia subtype has been missed and leading to the negative results ? 

2. Indeed, i had deep kissing with a lady for few times and she developed various symptoms which quite similar with ARS including persistent night sweats (2 months) after kissing.
I feel very guilty and I should not do that to her, i feel very sad and blame myself for have made this mistake and dissapointed my wife
Do you think i have given her HIV ?

3. I learnt from your previous sharing that there is no reported case of acquiring HIV via kissing. Can I clarify the case that reported by CDC and CNN in 1997 whereby the couples had transmitted HIV due to gum disease and bleeding ? Is it because the case is still considered questionable to confirm transmission via deep kissing ?

I am very nervous now and really hope you can provide me your advice, i understand that this is my final follow up question, i will purchase another new question for follow up if needed, thanks again Dr
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
As you know, we provide up to three responses to each question.  This will be my third and final response.  I’m sorry you continue to be anxious regarding the NO RISK events you describe.  Further repetitive questions will not change my assessment however.

1.  You have tested multiple times with reliable tests.  Your results are all conclusive.  I urge you to believe them.

2.  HIV is not transmitted by kissing, including deep kissing and you cannot transmit something that you do not have.  Her symptoms may be due to some other none HIV non-STI community acquired virus.  It is not HIV that you transmitted to her.

3.  Correct, the case that you are referring to is alarmist and remains questionable.  

This will complete this thread.  I hope that my comments have been helpful.  You need to more on and should not continue to worry.  EWH
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