[Question #8337] HIV risk

46 months ago

Hello Doctors, I had a protected sex with a girl working in a massage parlor. I believe the condom was intact , but not sure. After a week, I felt light sore throat and fatigue and weakness increased day by day. I also lost about 7 to 8 lbs within 2-3 weeks. I took an HIV RNA PCR test at day 15 from the date of possible exposure, HIV 4th gen combo antigen/antibody tests on day 25 and also on day 36 ( from the date of exposure) . The RNA test came as not detected which the labs say -Negative and Combo tests were non reactive. Can I rely on these tests and conclude that I am Negative as per the test on day 36 or should I retest again after 45 days. As per CDC , the window period is 45 days and also some say we have to re test after 3 months for final confirmation. I am anxious. Kindly help me with your valuable suggestion.

Edward W. Hook M.D.

46 months ago

Welcome to our Forum and thanks for your question. I’ll be glad to comment. The short answer, for several reasons which I’ll list below, is that you can be completely confident that you did not acquire HIV from the exposure you describe. No need for continuing concern, no need for further testing. Here are some of the reasons:

1. Most masseuses/commercial sex workers do not have HIV.

2. More importantly, condom protected sex is safe sex as long as the condom does not break and your condom did not break (when condoms break, they break wide open, leaving no doubt that they have broken. Thus, you were condom protected.

3. Your tests prove that you were not infected. Most experts believe that HIV PCR results beyond 11-12 days following exposure are conclusive and we have never seen someone with a negative PCR test at 12 days or beyond become positive. Further, your day 36 ( and 25) test results confirm the PCR results.

You’re in the clear. No need for further testing. You did not get HIV from the exposure you describe. EWH

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46 months ago

Dear Sir, thank you very much for your valuable reply. Just wanted to clear a doubt, about the window period. Is there a chance that P24 antigen not detectable in window period (18-45 days) and antibodies may take time till 2 -3 months for getting detected for results to be 100% accurate. Kindly excuse me, I believe only experts like you can guide us in the right path. Thank You.

Edward W. Hook M.D.

46 months ago

Brief, direct answer. This is not a concern. Once infected, the virus, and therefore the p24 antigen, is present until antibody levels get high enought to reduce the detectability of the antigen. Believe your test results. It’s time to put your concerns behind you. EWH ---

46 months ago

Thank you very much. Between the day, I feel a sense of fatigue, which starts from head and moving down and a feeling of chill , I don't know whether it is due to anxiety or repeated concern/stress. I am confident on your words and believe it will give me the courage to put the concerns behind and move on.

Edward W. Hook M.D.

46 months ago

I applaud your decision. I understand that when one just doesn’t feel quite right following an encounter that come up in retrospect, they have concerns about it is natural to I think the worst. You are not at risk for any STI from the exposure you have described. Take care. Stay safe. EWH---

45 months ago

Dear Dr Hook,

Good day. I really do not know whether you would appreciate the need for coming back, but I forgot to ask one point.

1) Regarding the conclusiveness of the 4th gen Ag/Ab tests, as now this forum advises for 6 week , I took a 4th gen test lab based Ag Ab test on 46th day and it was non reactive. I hope it is conclusive.

2) I am taking antihistamine- famotidine for gastritis for almost a month - 20mg in morning and 20mg in evening, so 40mg a day. Just wanted to know that this do not affect the test or test results. I read in this forum were you and Dr HHH has assured no medication has any effect on test, but again some like biotin may have effects on Rapid POC tests.

Once again I appreciate the services rendered by the experts on this forum which heals the mental agony of millions for their act knowingly or unknowingly. To be honest with you, this was my only encounter in my life so far (that too protected and lasted only for some seconds) and I never thought I will ran into this type of stress. I hope I come out of this quickly and move forward in life after what this has taught me.

You can also close this thread and I appreciate answers for point 1) and 2). Thank you very much.

Edward W. Hook M.D.

45 months ago

We provide up to three responses to each client’s questions. This will be my final response:

1. Your results are conclusive and should be believed. There is no reason for further testing.

2. Antihistamines and/or famotidine and other medications have no effect on HIV test results.

Take care. Please don’t worry. Time to move forward without further concern. EWH

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