[Question #7369] 41 Days HIV 4th Gen Combo and RNA Qualitative TMA (Quest)

57 months ago

Hey Dr Hook & HHH,

Had exposure unprotected 9/14. NEVER AGAIN. Started my period after exposure that night if it matters. Only this one time.

Vein Blood Tests- 4th Gen Ag/Ab & RNA Qualitative Early Detection Both done @ 41 Days 10/26 Both came back negative/non detected.

Oral Test- Day 40 (Oraquick negative 10/25)

(Partner status unknown technically) he says he’s clean. But I have no way to verify.

Can you verify the results are conclusive? Did the RNA early detection test eliminate the possibility of it being in my body period? Or both tests together verify conclusively? I’ve understand from other posts there may be no reason to continue to worry or retest further(In the next few weeks or post 3/6 months etc) . I’m consumed with worry and need to relax and focus back on my life. I would like confirmation if possible I’m Okay & can move on with my life as I normally would.

Thank you so much!!

Edward W. Hook M.D.

57 months ago

Welcome to the Forum. Thanks for your question. I'll be glad to comment. At 41 days, both your RNA PCR test and your 4th generation HIV antigen antibody tests are completely conclusive, proving that you were not infected.

It is now time for you to move on with no concerns about the relationship you describe. Further, there is no reason for further testing related to this exposure.

time to move on. Please don't worry. EWH

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57 months ago

Thank you for your response. That helps so much. I know can move on to the other items & relax.

I got BV after the exposure OB said it wasn’t a STD and very common (I had my period the night week 7 days from exposure and have had one since as well)

BV- I’m working on getting rid of it.

OB gave me metronidazole and tindazole with boric acid suppositories 600 MG

Question 1- Is there a better way to treat it? She found it in the swab below.

My OBGYBN did a swab for Chlamidya/Gonarhea that was negative as well. She said everything looked normal otherwise. (No bumps etc. this was @ 5 weeks roughly for the exam)

Question 2-Is there a reason to blood test if so a follow up test on the Ch/Gon?

I’m looking @ doing the herpes/hep a b c, & syphilis blood panel @ 8 weeks on 11/9/20 just based on online searching a good time to do all of those at one time?

Question 3- Is there anything else I should be testing for that has been left out or doing otherwise? And lastly If all results come out negative is a retest needed for any of them?

I want to be on top of my health and put this entire thing behind me hopefully all results are negative! Thank You!

57 months ago

I forgot one item she also gave me the gardasil shot that day & the OB.

Edward W. Hook M.D.

57 months ago

Thank you. I'm pleased that my initial replies were helpful. Further comments to your follow-up questions:

1. BV is a challenge. It is not technically an STI and results from disruption of the bacteria normally found in the genital tract, such that some bacteria overgrow and get out of balance. The therapy your doctor has provided is effective and amongst the recommended therapies. If your OB/GYN did not warn you, managing BV is a challenge. The recommended therapy typically improved symptoms but as many as one-third of women experience recurrences in the 1-3 months following initial treatment. Also glad to hear of your negative follow-up tests for gonorrhea and chlamydia.

2. I see no need for follow-up blood tests. Syphilis is quite rare and unlikely. Same for sexually acquired hepatitis, particularly if you received the hepatitis B vaccine. We specifically recommend AGAINST blood tests for herpes as these tests are not very good- they have relatively frequent false positive results, particularly amongst persons who have HSV-1, the virus that causes cold sores which is present in over 60% of American adults (including many people who did not even know that they had acquired the infection during childhood).

3. I think you're in good shape. Time to move forward without concern. Just get your regular sexual helath check ups as recommended by your OB/GYN.

Take care. EWH

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