[Question #7582] HIV Test Conclusivity?

2 months ago

Hello Doctor,

I had potential Exposure 10 weeks back with Sex worker. It was fully protected. 2 days after that I got burning sensation while urinating and burning on anus. I went to doctor and he gave me Azithromycin (500mg * 2) orally taken and Ointment to apply on anus. I felt better after 4 days.

But I was anxious about contracting HIV and then got multiple symptoms in 3rd and 4th week like Mild fever, Throat Infection, one swollen lymph node on right side of throat (submandibular), Swollen Uvula, Knee joint pain, skin burning sensation behind knee joint, Itchy skin, dry palm and feet, random diarrhea.

I tested for HIV ag/ab (4th Gen test) as below,

Post 4 weeks & 2 days: Negative

Post 5 weeks & 5 days: Negative

Post 7 weeks & 1 days: Negative

Post 8 weeks & 3 days: Negative

Post 9 weeks & 5 days: Negative

I tested for Other STI as below,

Post 5 days: Chlamydia- Urine: Negative

Post 5 days: Gonorrhoea- Urine: Negative

Post 7 weeks & 1 day: Syphilis: Negative

Post 7 weeks & 1 day: HSV 1 & 2 (Igg antibodies): Negative

Post 8 weeks & 3 days: HEP B: Negative

Post 8 weeks & 3 days: HEP C: Negative

My doctor gave to antibiotics to treat throat infection and not seems improving then he ordered for Throat Ultrasound for swollen lymph node, but it shows normal. But doctor can physical feel one small swollen lymph node (submandibular).

Currently, I’m having symptoms as below (post 10 weeks 3 days): One Swollen lymph node (submandibular), Uvula touching tongue but not swollen, Knee joint pain, Dry Palm and Feet, lately feeling frequent heart burns.

Is my HIV test Conclusive or retest required after 12 weeks?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Welcome to the forum. Thanks for your confidence in our services.

You had a very low risk exposure that carried no signficant risk of any STD; and almost certainly none of your symptoms were due to any infection from that event.

As for HIV, the test results you had are 100% proof you do not have it. Your 4 and 5 week test results were almost conclusive, and the 7 week result proved it for sure. the 8 and 9 week tests were unnecessary and you should have no more HIV tests. Twelve weeks for conclusive results is old news, going back to earlier HIV tests no longer in use. The AgAB tests are nearly conclusive by 4 weeks and 100% certain after 6 weeks.

If the condom failed in a way you didn't recognize, you could have acquired gonorreha or chlamydia. But probably you did not:  even after taking azithromycin 2-3 days earlier, if you had either of these STDs your urine test at 5 days would have been positive. Your syphilis blood test at 7 weeks and hepatitis B anbd C results at 8 weeks were conclusive. The HSV test was done too early -- with new herpes, it takes up to 4 months for the blood test to be conclusive. However, there is nothing in your symptoms that suggests herpes, and the exposure carrlied little or no risk for HSV.

No STD causes the symptoms you describe. Almost cerrainly your submandibular lymph node, knee discomfort, anal irritation, and all your other symtpoms are entirely unrelated to the sexual exposure you have described.

Check back with your doctor if you continue to have symptoms that concern you, but you can be sure you have no worries from an STD/HIV standpoint. 

I hope these comments are helpful. Let me know if anything isn't clear.

2 months ago

Thank you, Dr. Hunter Handsfield for your time and efforts to review the case and comments.

My doctor also told me HIV Ag/ab test conclusive post 6 weeks. And He is going to refer me to ENT specialist for throat infection and swollen submandibular lymph node after 2 weeks.

But I was so scared seeing recent comments from doctors on Healthtap about HIV testing at 3 months and even 6 months.

I got final follow-up questions doctor, Please 

1)    Yes, I took Azithromycin (500mg * 2) one day before submitting urine sample. Hope that wouldn’t have impacted my Chlamydia & Gonorrhoea results?

2)    How common is HIV2 in Australia?

3)    Is there any chance of contracting HIV or other STI from bedsheet or Towel considering no open wound on body?

4)    Is there any chance of acquiring HPV from this exposure ( I'm not vaccinated with HPV)?

Thank you so much !

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
1) As I said above, this should not affect your test results.It takes a few days for antibiotic treatment to make the test negative.

2. As best I know, HIV2 is very rare in Australia. But this doesn't matter. The tests you had detect HIV2 as well as HIV1. You can be sure you have niether one.

3. No risk, no worry. HIV and STIs are not transmitted by such indirect contact, only by sex itself.

4. Condoms don't work well against HPV, because of skin contact above tthe condom. There could be some risk. But everybody gets HPV anyway -- it really can't be prevented. The best prevention is to be vaccinated, to prevent infection with the 9 types of HPV that cause 90% of health problems from HPV.
2 months ago
Probably most of the symptoms could be because of my anxiety as few days were like I couldn't even sleep because of anxious thoughts and googling symptoms.  

Thank you so much, Dr. Hunter Handsfield for your time and efforts. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
I agree your symptoms could result from anxiety -- and when someone suspects his or her own symptoms have a psychological origin, usually s/he is correct. And internet seaching by anixou persons certainly leads many to selectively find information that reinforces the anxiety and to miss reassuring information. In the future, it's best to concentrate on professionally run or moderated sites -- or to lay off the internet altogether.

Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.