[Question #9766] Follow up 9639 and 9666, Hiv and Chlamydia

29 months ago

Dear Doctor, This question is related to the Exposure (insertive Unprotected Oral Sex from a Transgender From UAE), As part of completing the protocol I did the complete STD panel after 90 days (HIV(4th Generation), HCV, HBsAg, Chlamydia, Syphilis, HSV 1 & 2 IGM and IGG). All negative Except Chlymedia IGM with an Index value of 1.4, and IGG is a negative index value is 0.28. The doctor (from INDIA) said it indicates a recent infection most probably reinfection and prescribed Doxy. I was wondering never had another exposure outside marriage. All sex with the wife was condom protected as I am waiting for the 90 days mark. The only unprotected sex was oral sex with my wife that to 45 days before the test. Since I am in UAE it does not get medicine without a prescription hence I saw Doctor who ordered a urine test for Chlamydia and Gonorrhea and for which the result is not detected. I was in confusion how these tests are behaving differently and how IGM is positive without exposure. The Urine sample given was not the first catch(first 20 ml) as there was no instruction from the lab and I was not aware at that time . Can you please advise what may be the reason for the IGM positive do I need to take Doxy? Also Chlamydia IGM positive will affect the accuracy of HIV results?

H. Hunter Handsfield, MD

29 months ago

You continue to over react to an essentially zero risk event.

The chlamydia blood tests are useless and never used by legitimate chlamydia/STD experts, and IgM testing is especially unreliable. In theory, IgM antibody develops first to many infections, so positive result sometimes accurately reflects recent infection. But the chlamydia IgM test simply doesn't work and your positive result does not indicate chlamydia, which also is almost never acquired by oral sex; and your negative urine test confirms you were not infected. (Almost all IgM tests for any infection are very susceptible to false positive results, and this occurs especially frequently with the chlamydia IgM. That test should not have been done at all.) Your negative urine test was reliable regardless of clean catch or not; despite the recommendation for first catch urine, in practice that makes no difference in test accuracy. There is no need or reason for you to take doxycycline.

Please note the forum policy against repeated anxiety driven questions on the same topic. This being your third, it must be your last that asks anything about the sexual exposure described here or your concerns about any infection from that event. Thank you for your understanding.

If you remain concerned, please go back and read every word of both your previous threads and my replies above.

HHH, MD

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29 months ago

Thank you Doctor. If you dont mind can I ask one clarification these is for my knowledge. There is an Igm test included in hiv test too what about the reliability of the same

H. Hunter Handsfield, MD

29 months ago

To my knowledge, there is no stand-alone HIV IgM antibody test. All tests are IgG only or, in some cases, both IgG and IgM in combination. There is no issue about the reliability of the results.---
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