[Question #7320] Low Risk Exposure

8 months ago
Hi, 
On Sept 27, I had a massage with a handjob and fingering ending. The handjob was without a glove but the fingering was. Prior to the massage, my forskin was scratched by my finger nails. Tiny part of the skin scrabbed and I bled but at the massage I don't recall any bleeding from this scrabbed skin. Anyways, on October 11,  14 days post exposure, I woke up with a sore throat. Next few days I started having nasal congensation/runny nose and sneezing 6-7/day. October 15-16 I started having diarrhea . 
These symptoms triggered me to have a 3rd generation Antibody test (Insti) done on Friday October 16 (19 days post exposure), 

Now 
1. Are these symptoms related to this exposure. I know this exposure is a zero risk but the timing and the type of symptoms I had suggest HIV . 
2. Lets say IF these symtoms were related to HIV, would they have showed up on the type of test I had. Remember, the Insti test only looks for antibodies and it was done from my finger. 
3. Should I have another test done? 

Thank you
8 months ago
I forgot to mention, the test was negative for antibodies. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Welcome back to the forum. but sorry you found it necessary.

This was a zero risk exposure. Your symptoms are NOT typical of a new HIV infeciton, which does not cause nasal congestions or wheezing. You caught a cold. Further, your negative blood test PROVES that HIV isn't the cause. If symptoms are due to HIV, the test is always positive.

Those comments answer your questions, but to assure no misunderstanding:

1) Your symptoms are not from the sexual event described.

2) I do not agree with the premise. But if HIV were causing these symptoms, this blood test would have been positive.

3) You do not need any further HIV testing.

HHH, MD


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8 months ago
Thank you for your reply, 
Do you still stand by your decision that this is a zero risk exposure with these new information 

1. Persisting sore throat 
2. Dry throat almost everyday 
3. Persisting Diarhhea  
4. Runny Nose 
5. Presisting Phlegm in the throat. 

Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
These symptoms are not at all typical of a new HIV infection. As I said above, you caught a cold. And as I also said, your test results prove HIV is not the cause. Symptoms of new HIV infection always have positive antibody tests.

Try to think rationally. Commonj colds are very frequent, occuring once or twice a year in most people. In contrast, new HIV infections are rare -- and even these occur in people at real risk

Do your best to move on without worry!
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7 months ago
Hi
I did couple more tests on 
OCT 20 DUO 4TH GENERATION NEGATIVE ( 23 post exposure )
OCT 23 Insti antibody negative (26 post exposure) 

1. How accurate are these results for a such low risk ? 
2. Do you think these results should be considered conclusive for such low risk. 
3. If I get more symptoms , would they related to hiv? How late can seroconversion be ?

Further , I remember you said somewhere in the forum that a female colleague of your overseas have concluded that a 4th generation 4 weeks post exposure is considered conclusive. Do you stand by her decision 
Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
7 months ago
These results are around 90% conclusive. So if the chance you caught HIV was, say, 1 in 10 million, with these results the odds are now 1 in a hundred million. Stop testing. If you get more symptoms, they will not be due to HIV from the exposure described.

I've said nothing about any "female colleague overseas" (or anywhere else) and HIV test reliability. Some experts consider the AgAb (4th generation, "duo") tests conclusive at 4 weeks, but most experts now advise 6 weeks.

That completes the two follow-up exchanges included with each question and so ends this thread. Move on without giving HIV another thought unless and until you have a genuine exposure.
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