There's a common internet-driven belief that having hepatitis C virus (HCV) delays HIV antibody production in newly infected people. It's based on a single report over 20 years ago, which has not been replicated. If it's true at all, it happens only in people already infected with HCV before contacting HIV. And with the antigen-antibody tests (which were not yet in widespread use back in 2001), the theoretical result would be to speed up test positivity, not delay it:  the delay in antibody would result in higher levels of the antigen component. In any case, the real-world universal experience is that this is a non-issue in HIV diagnosis. Could cytomegalovirus (CMV) do something like this? There are no such reports that I know about.

Contrary to common beliefs (and misleading internet discussions), HCV is NOT an STI except sometimes in men who have sex with men and also participate in potentially traumatic anal sexual practices (i.e. with likely blood exposure). Even here, it's pretty much limited to HIV infected MSM. HCV is not sexually transmitted at all between men and women, or so rarely it can be ignored. (One research study of couples in which only one person had HCV calculated a transmission rate by unprotected vaginal sex to be 1 in 196,000. For a couple having sex 3 times a week, that works out to one transmission every 6,000 years.) So if your screen name reflects your gender (female), you are at little or no risk for sexual acquisition of HCV, and hence no bearing on the results of any HIV risk or testing.

CMV is primarily a childhood infection -- acquired by most people by their teen years or early 20s, sometimes during their birth to infected moms; mostly from saliva contact with other kids; and sexually in those people who reach their sexually active years having escaped childhood infection. So if you're age 25 or more, you probably already have it, and are now immune to a new CMV infection. Whether or not you have it, there is no know interaction with HIV testing or positive test results, as I noted above.

Perhaps I could help more if you would like to tell me what sort of HIV exposures or risks you have had, and perhaps your test results. But for the reasons just discussed, probably HCV and CMV are irrelevant in terms of your risk of HIV or the interpretation of your test results.

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

HHH, MD

I am a 23 year old female. my exposure was brief vaginal intercourse and oral in which there was no ejaculation in my mouth or vagina. I didn’t know his sexual history but he is heterosexual and does not use intravenous drugs nor do I. I was most recently tested for hiv at 14 weeks and it was negative. It was a blood drawn hiv 1/2 antibodies test. My partner tested negative for hiv 1/2 ag/ab  at 8 weeks after our encounter  with a 4th generation test. He also tested negative for HCV antibodies at 8 weeks post our encounter and at 20 weeks with an oraquick. I haven’t tested for HCV but have had what I feel are symptoms (spider veins  for instance) but I had a normal CMP and CBC at the time of hiv test although monocytes were elevated. I was tested for EBV and CMV and CMV was currently active. I read somewhere in the European guidelines on testing that acute infection with CMV, HCV, etc and a negative hiv test should be retested at 12 or 24 weeks. This has me completely terrified and I am so heartbroken and scared. 

As for a "currently active" CMV infection, I am doubtful. CMV test interpretation can be quite complex. Most all healthy adults test positive, and even "active" infection generally can and should be ignored. And modestly elevated monocytes on CBC usually indicates no significant health problem.

I tested negative for all STDS including RPR at 6 and 14 weeks. However I was positive for BV. 

My partner’s blood drawn AG/AB 4th generation HIV test was negative as was an in home 20 week oraquick. 

He was negative for Hepatitis A,B,C at 8 weeks. 

His RPR and all other stds negative at 8 weeks. 

You indeed might have a recently acquired CMV infection, which is one cause of "heterophile negative" mono (mononucleosis not due to EBV). That could cause your flu-like symptoms a few weeks ago and elevated monocytes, and the timing seems right in regard to the sexual exposure described. However, it isn't certain. Most adults have reactive IgG tests -- 1:32 is higher than average, but not unusual. Positive IgM doesn't mean much:  if your IgM were positive with a negative or low IgG result, it would be more consistent with new infection, and IgM antibody can reappear in people with prolonged infection. However, I'm not sure how important this is now. The natural course of CMV mono is complete resolution, without treatment; long term health problems are unusual. That said, if you want to pursue it, additional tests could be done, such as tests for various CMV antigens, and PCR to detect CMV DNA. As I said above, diagnosing CMV and interpreting tests for it is a complex business, and if you decide to pursue it, an infectious diseases consultant would be the way to go. (I certainly would not let anyone close to me accept diagnosis or management of a CMV infection without input from an experienced ID specialist.) 

Aside from sexual exposure, a common risk for CMV is close contact with young children; it's an occupational illness for day care workers and elementary school teachers, for example, who happen to have missed out on having CMV during their own childhoods. Do you have kids at home, or contact with other young children?

0.3% is a normal level of immature granulocytes -- no concerns there.

Was your UTI confirmed with culture positive for a standard cause, like E. coli or similar bacteria? And were you tested for gonorrhea and chlamydia? (Both of these can closely mimic UTI in symptoms and urinalysis; and both are common in women with bacterial vaginosis.)

I can't say much about your "numbness and weakness", or your transient electrolyte imbalance, but I'm glad to hear those issues have cleared up. They might have been nonspecific manifestations of CMV mono, but most antibiotics don't cause such things. What antibiotic were you taking? 

I stand by my comments above about HIV and HCV. You do not have either one, and whether or not you have newly acquired CMV has no bearing on those test results.

Threads normally are closed after two follow-up questions and replies, but I'd be happy to go another cycle or two if you'd like to answer my questions or have other issues you would like to clarify.

And I failed to notice your statement of negative STI testing. Undoubtedly that included chlamydia and gonorrhea.

The cmv test came around the time of the negative 14 weeks HIV test. I went to a different doctor than my gynecologist, she was a GP. I told her about the Petechaie and the flu like symptoms I experienced about 2 months earlier. She told me it was possible CMV caused my initial flu like symptoms because IGG can stay reactive for around 4 months depending on one’s immune system. 

At the time of my flu like illness, I had been with him 3 weeks before the symptoms. I do not live with young children or work with them, but in the weeks before I saw him in between jobs and at home a lot, but had been visiting the gym/ other public places. 

I was negative for  Trichonomas, Gonorrhea, and chlamydia. I had WBC, trace protein, elevated bacteria, and trace nitrates in my urine. The culture revealed <10K cfu Strep B. The Strep B was considered contamination because of elevated squamous cells in my urine, the fact that I had no symptoms of uti except some Incontience/ smell of urine. I did not have burning, pain, discharge, etc, and because the strep B was <10K. I was never told what caused the WBC, trace protein, trace nitrates, but I was given macraboid antibiotics, and when tested again at the doctor a week later, the UTI was cleared. 

At the time of the weakness and numbness I was not taking any antibiotic, although I had used intravaginal flagyl some weeks earlier for the BV. The flagyl caused numbness in my vaginal and pelvic area. The medicines that were suspected of causing the Hyponatremia were my stimulant medication mixed with my prescription sodium oxybate medicine (Xywav). I had just started Xywav a month prior. The weakness and numbness were sudden, I had facial numbness , back pain, and confusion as well. They did no scans at the ER. The numbness and weakness are now completely gone and improved after the IV fluids and discontinued one of the meds. I did have some slight nerve pain in my lower back weeks later but I am now fully recovered. 

So that concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe!

It won't help you to purchase a new question. We do not get into advice about problems other than HIV and STIs, and this discussion already has gone further down that path than usual. Keep working with your doctor(s); or, as discussed before, consider asking for referral to an infectious diseases specialist.

Best wishes to you.