[Question #6810] Follow up Question #6774 - HIV fear due to TSH change after Handjob

63 months ago

Dear Dr,

My apology as i am still very anxious and worried about HIV infection after thinking about my TSH level is abnormal after the previous unprotected handjob episode. My BP just rised up to 150/100, i am panic. Appreciate if i can asks few more questions

1) I read several article and studies in the internet that TSH level did get afected among the new HIV patients, do you think this claim is substantiated ?

2) if the masseur's hand or finger has blood (even fresh cut or active bleeding) , Hand ulcer, sore, Hepatic whitlow , Genital secretion / vaginal dischargea and if i have cut on my penis, would that lead to HIV due to the handjob ?

3) I forgot to mention previously that I am NOT circumcised, would that change your assessment with the above (no 2 question) condition?

4) My wife has Hyperthyroidism and on medication Carbimazole 5 mg for 2 years. The medication is considered as immunosuppresive ? (i read from internet), if this is true, would that prevent her from ARS symptoms ? She is also taking long term supplement which believe boost her immunity (active ingredient IP-PA1) would that prevent her from ARS symptom too ? because so far she did not show any ARS symptoms except for the menstruation problem as mentioned earlier

5) I just realized i had 2 tooth decay, i am not sure if i was bleeding in my mouth due to this dental problem or was having gum bleed and infect the lady whom i had deep kissing for few times ?I am very worried because she shows all the ARS symptoms especially night sweat, weight lose, consistent abdomen cramping etc

I am very comfused now and started to think again whether i remember the date of the last exposure correctly, what if i remember wrongly and the test result is less than 3 months window period and it is not conclusive yet.Sorry Dr for bothering you again on this, appreciate if you can help me, thanks

H. Hunter Handsfield, MD

63 months ago

Welcome back, but I'm sorry you found it necessary. I reviewed your discussion with Dr. Hook and suggest you go back and re-read it as well. That would be a much better use of your time than continuing to search the internet for rare and arcane manifestations of HIV.

The main take-home message from Dr. Hook and me is that the HIV blood tests, including the ones you had, are among the most accurate diagnostic tests ever developed for any medical condition. When done sufficiently long after the last possible exposure, as yours were, the results overrule all other considerations. No matter how high the risk of HIV at the time of exposure and no matter how typical the symptoms, lab abnormalities, or other medical issues might be, the test results rule. Your test results prove you do not have HIV. Period, full stop: there has never been an exception. Nobody with your test results at those times has ever turned out to have HIV. It doesn't happen.

1) TSH levels fluctuate naturally and yours are irrelevant to HIV. If you are in care for a thyroid condition, discuss with that doctor or clinic, but stop obsessing about HIV.

2,3,5) As I said above, the level of risk during a potential exposure event doesn't matter. Whatever the chance of HIV exposure, your HIV test results show it did not happen.

4) NO medicines alter the reliability of the type of HIV tests you had. The possibility that immunosuppressive drugs could do so goes back to older HIV blood tests, and only to tests measuring antibody alone. Even then it almost never happened. With the antigen-antibody (4th generation) tests, it simply does not occur. Your wife's drugs make no difference. And no, carbamezapole is not immunosuppressive anyway.

The only reasons you are "confused" is that you are ignoring or choosing not to believe the reasoned, science based reassurance we have given you; and that you continue to waste your time and emotional energy searching the internet. Like many anxious persons, you are being drawn to information that inflames your fears and missing or entirley ignoring the ressuring information that also is present.

Let me know if anything isn't clear. But think before you ask: please do not repeat questions whose answers are obvious from these comments and those from Dr. Hook.

If all this sounds a bit harsh, I apologize. Call it tough love if you like, but the goal is to convince you to stop worrying and help you put all this behind you and go on with your life. And please do go back and re-read your previous thread with Dr. Hook. Best wishes.

HHH, MD

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63 months ago

Thank you very much Dr for your kind and prompt reply, it helps me a lot

I am sorry, can i clarify the question 4, i m not sure if it is due to minor typo, is carbamezapole and my wife medication Carbimazole (anti-thyroid action for Hyperthyroidism) the same ? Indeed my question was whether this medication wil pevent ARS symptom, do you think so ?

Is high or low BP a indicator of new / existing HIV infection ?

If you can recall, can i ask generally how many percent of HIV infected people who do not have ARS symptom at all ? Is it common for peole who acquire the infection without any ARS symptom ?

Thanks again Dr

H. Hunter Handsfield, MD

63 months ago

Sorry, I misread carbimazole for carbamazepime, an anti-epileptic drug. But carbimazole is not immunosuppressive -- and as my reply makes clear, even if it were, it would make no dfference in your HIV test reliability. Your blood pressure question also is irrelevant. About half of people with new HIV have no ARS symptoms. This also is irrelevant to your situation.

What exactly did you not understand about this statement above??? "When done sufficiently long after the last possible exposure, as yours were, the results overrule all other considerations. No matter how high the risk of HIV at the time of exposure and no matter how typical the symptoms, lab abnormalities, or other medical issues might be, the test results rule. Your test results prove you do not have HIV. Period, full stop: there has never been an exception. Nobody with your test results at those times has ever turned out to have HIV. It doesn't happen." DO NOT ASK ABOUT ANY OTHER MEDICATIONS, HEALTH ISSUES, OR OTHER FACTORS THAT YOU WORRY MIGHT AFFECT YOUR HIV TEST RESULTS. IF YOU DO, I WILL IMMEDIATELY CLOSE THIS THREAD.

You do not have HIV. Believe it and move on. If you cannot, you clearly will need professional counseling. These are not normal thoughts and worries given all you have learned.

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63 months ago

Thanks Dr and I am so sorry to make you feel frustrated.

Please do not feel angry and give me a last chance to clarify

1) The HIV 4th Ag/Ab Combo Generation Test is 100% conclusive at 6 weeks regardless of which company developed it ? or it only limited to the specific reputable company's test only ? I am confident all the test i done are more than 6 weeks but i worry if i have miscalculated the date of last exposure and certain test indeed have not reached 12 weeks or longer

2) Is HIV PCR test still reliable after 3 months since the exposure ? because i heard the theory that the number of virus would decrease after 3 months so the PCR test may generate false negative results

My apology again

I sincerely hope you may answer my this 2 last question, really appreciate it, thanks a lot to your time

63 months ago

Sorry Dr, another reason i asked whether the 4th combo test 100% conclusive at 6 weeks is that although i know the tests were either based on ECLIA but i don't know which company develop it (the lab report indicate that they started to use this principle since year 2014, can i still trust this test conclusive at 6 weeks as it has been 6 years ago from now and do you think it will cover all the important subtype for Hiv 1 and 2 ? Thanks again Dr

63 months ago

Sorry Dr, please please do not close this thread, i know i am not supposed to ask these questions anymore but you are the only who only can help me, please

i understand you may feel frustrated, plesse help me for this last time

In order to avoid confusion, please allow me to summarize my last 2 questions as follow

1) The HIV 4th Ag/Ab Combo Generation Test is 100% conclusive at 6 weeks regardless of which company developed it ?

or it only limited to the specific reputable company's test only ?

I am from Malaysia and i am not sure the lab technology here is up to date

For example, the 4th Ag/Ab Gen Combo blood test i went thorugh was based on ECLIA but i don't know which company develop it, the lab report indicate that they started to use this principle since year 2014

Can i still trust this test conclusive at 6 weeks as it has been used since 2014 (6 years ago from now)?

and do you think it will cover all the important subtype for Hiv 1 and 2 ?

(sorry i asked the same question to Dr Hook but i did not mention they had used this principle since 2014) that's why would like to clarify again , i am sorry.

2) Is HIV PCR test still reliable after 3 months since the exposure ? because i heard the theory that the number of virus would decrease after 3 months so the PCR test may generate false negative results

My apology again

I sincerely hope you may answer my this 2 last question, really appreciate it, thanks a lot to your time, many many thanks

H. Hunter Handsfield, MD

63 months ago

1) All 4th gen tests by any and all manufacturers, and in all countries, are equally valid and accurate. 6 weeks is always conclucive.You can trust the results have had in 2014. They detect infection with both HIV1 and HIV2 and all subtypes.

2) Once positive, the AgAb tests remain positive for life. Your negative result at 3 months also was valid. If you choose to test yet again, it will still be negtive if you have not had a high risk exposure in the meantime. You do not have HIV.

That completes the two follow-up comments and replies included with each question, and so ends this thread.

The forum does not permit repeated questions on the same topic or exposure, especially when obviously driven by anxiety. This is your second with exactly the same questions and will have to be your last one; future new questions about this exposure, testing, and your fears about HIV will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

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