[Question #8704] HIV-2 Assurance

40 months ago

I am a 50 yr old man. I have received all covid vax & booster. I have a history with sinus problems. In early Jan I was given two different antibiotics (cefti and doxy) for a brutal sinus infection. The infection would not go away.

Around Jan 12th I was given prednisone (20 mg). I was told to take 3 pills day one, 2 pills a day for one week and then 1 pill a day for one week. I finished Jan. 26th. I also was on flonase.

On Jan 19th I kissed & sucked a womens breasts. I also fingered her. The hand I used had cuticle cuts due to my job, and me picking / biting / scratching them. None were bleeding. There was NO oral, vaginal or anal sex. This girl was from West Africa (ivory coast) and has worked in the US for at least 10 years. We since have had a falling out. Initially I wasnt worried but on Feb 6 or 7 I got thrush lesion. I just removed it and carried on with my life. On Feb 23 I got full on thrush in my mouth. I went to the doctor and he advised thats what it was and gave me the pill form of diflucan and a mouth wash called chlorhexidine gluconate. This is what brought me to your site.

Testing:

Alere Rapid 4th Gen Rapid AG / AB was done at the

14 days

22 days

28 days (also included a hep c test)

36 days

40 days (also included a hep c test)

44days (also included an insti test)

55 days post exposure.

All tests were negative.

1. Did I have a risk that required testing for hiv?

2. Did I need testing for hep c?

3. How did I get thrush if it was several weeks after the antibiotics & steroids?

4. Most IMPORTANTLY did the steroids I described extend my window period?

5. I know testing is different for hiv 2 since it is NOT found with the antigen portion of the test. I have seen posts where you state 7 weeks to 10 weeks is necessary for HIV2.

6. How much more hiv testing do I need?

7. When can I sleep with my regular partner?

40 months ago

One last question. How long after thrush did i need to wait to test considering hiv-2 and my steroids to prove it wasnt ARS?

Edward W. Hook M.D.

40 months ago

Welcome to our Forum and thanks for your detailed description of the timeline of your events. I'll be glad to comment. Your questions are comprehensive so I'll go directly to them:

1. Did I have a risk that required testing for hiv?

Th encounter is a no risk event. You do not know that your partner had HIV (and given the amount of time she's been in the U.S. it's unlikely that she has untreated HIV) and the activities you describe- sucking on her breast, masturbation with your finger, are no risk activities. The presence of cuts and abrasions on your fingers when you masturbated her does not change this. Had you asked if you needed testing, the answer would have been no.

Why you got thrush is difficult to say. As you imply, many cases of thrush are associated with recent antibiotics or, somewhat less commonly, steroids' but in the majority of cases there is no clear precipitating factor. While Googling "thrush" quickly leads to discussion of HIV, the fact is that only a very small proportion of persons with thrush have HIV. Further, when HIV is associated with thrush, it is associated with far advanced infection which has been present for many years, not recently acquired HIV.

2. Did I need testing for hep c?

No, this was a no risk event for hepatitis C and from the sounds of thins, your partner was low risk. Yur 40 day test results go a long way towards proving that you do not have hepatitis C, if that is still a concern.

3. How did I get thrush if it was several weeks after the antibiotics & steroids?

See my reply to no. 1. We may never know. Your antibiotics and steroids may have contributed but that's hard to say.

4. Most IMPORTANTLY did the steroids I described extend my window period?

5. I know testing is different for hiv 2 since it is NOT found with the antigen portion of the test. I have seen posts where you state 7 weeks to 10 weeks is necessary for HIV2.

HIV-2 is diagnosed only o the basis of antibodies to the virus. Tests for HIV-2 antibodies (part of the regular 4th generation tests, are conclusive at 8 weeks).

6. How much more hiv testing do I need?

How long after thrush did i need to wait to test considering hiv-2 and my steroids to prove it wasn't ARS?

If you had the ARS or HIV predisposed you to thrush, your tests would have already been positive. No need for continued concern.

I hope this information is helpful. EWH

none

7. When can I sleep with my regular partner?

Nothing you have describes suggests any need to abstain from unprotected sex with your regular partner.

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40 months ago

Dr. Hook,

Thanks for your reply. I took some time to digest what you said. Please note the women I had the exposure with does return to the Ivory Coast to visit friends and family.

Since our correspondence the following has transpired:

I was tested on day 70 post exposure using the rapid Alere 4th gen ag / ab rapid test. It was negative. The testing person did not wait one minute to put the buffer solution. I asked her about it and she said it was not an issue and she explained why. At the same appointment I tested negative for Hep C using a rapid test.

The problem I am having is I continue to have symptoms. This makes it very hard to move on. I see many people on this forum seem to have the same problem. So here is what happened:

On April 3rd I got another thrush lesion on my inner cheek. I scraped it off and tried to carry on. Unfortunately yesterday April 6th at lunch time I had what appeared to possibly be another thrush lesion. I scratched at it and removed it.

**Please review the dose and length of the steroid I took in my initial post. The date I was using the steroids was approximate. I also stated the antibiotics I had taken. Thanks! **

Follow-ups:

1. Could ARS / thrush hit this late (after 10 weeks) and could it have been delayed by the steroids or because it is HIV-2?

2. Today 4/7/22 I had yet another HIV rapid 4th generation at right around 78 days post exposure. The result was negative. Does this exclude that the thrush lesion either on April 3rd or more importantly April 6th was not ARS?

3. Could the steroids and antibiotics I took have delayed testing positive especially for hiv-2 since that is only found via the antibodies?

4. How much more HIV testing do I require to feel I am totally in the clear?

5. When are hep c tests conclusive?

6. When can I sleep on protected with my partner?

The truth is this hookup was a very big mistake. I can accept I made a bad decision but I could never hurt another person.

Thanks for your time!

Edward W. Hook M.D.

40 months ago

Thanks for your follow up. The fact that your partner periodically travels back to the ivory coast in no way changes my opinion or advice. What’s again, this was an entirely no risk event. In response to your specific questions:

1. No, this is not the ARS. The ARS typically occurs 2 to 3 weeks following an exposure 10 weeks is far too far outside the window. Your concerns about HIV-2 are unwarranted and not germane to your question.

2. You’re 55 de test results were conclusive. So is your 78 day results. And yes, this does prove that you are thrush was in no way related to HIV.

3. No

4. As I told you in our previous interaction, there is no need for further testing. That is still the case at this time. Your results are conclusive.

5. You are hepatitis see results are conclusive as well. Please be aware that hepatitis see is not transmitted through sexual contact other then receptive anal intercourse.

6. Like many of the answers above, repeating this question does not change the answer. There is no medical are scientific reason for you to abstain from unprotected sexual contact with your regular partner.

I hope that these answers, reaffirming the responses that I provided to you 10 days ago are helpful to you and what are you to move forward. EWH

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40 months ago

Dr. Hook

I appreciate your response. My final questions are;

1. Does taking a daily multivitamin with Biotin 40 mcg affect my testing in the past or in the future ? Tell me how to proceed please.

2. Does taking vitamin D2 1.25 MG (50,000 unit) twice a week affect testing? This was prescribed by my doctor. He said he has been prescribing it during Covid?

3. I continue to have mouth problems ( coatings / thrush) and if I have more mouth issues in the future do I need more hiv testing?

4. Should I get more testing considering the above. Around here the offer the alere rapid 4th gen duo.

Thanks for the expert information you provide!

40 months ago

Dr. Hook,

Also please remember the steroids I took when considering my situation. I will do whatever you recommend. I just want to move forward.

5. Would you feel comfortable that I am safe even if the girl had hiv2 that I am in the clear?

Edward W. Hook M.D.

40 months ago

Straight to your final questions:

1. Does taking a daily multivitamin with Biotin 40 mcg affect my testing in the past or in the future ? Tell me how to proceed please.

No, this dose of biotin would have no meaningful impact on your test results. There is a theoretical concern that taking huge doses of biotin (many times what you are taking) MIGHT interfere with tests but this is virtually never seen in persons taken in persons taking supplemental biotin

2. Does taking vitamin D2 1.25 MG (50,000 unit) twice a week affect testing? This was prescribed by my doctor. He said he has been prescribing it during Covid?

No, no impact whatsoever

3. I continue to have mouth problems ( coatings / thrush) and if I have more mouth issues in the future do I need more hiv testing?

No, not for the contacts you describe. Your results are conclusive, as I've already said

4. Should I get more testing considering the above. Around here the offer the alere rapid 4th gen duo.

The Alere test is a very good test but you really do not need further testing.

5. Yes

I hope my comments have been helpful. Take care. Please don't worry. EWH

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