HIV risk & testing

[y2do]

2 exposures which i have mentioned, one on HIV & other STD forum (answered by HHH). The 1 st one was related open sore on testicle which was noticed by me post the protected sex & unprotected oral. I am at 7 week on that exposure. 2 nd exposure was related to condom slip on withdrawal which was 4 weeks ago. Both these questions were answered respectively.

My anxieties led me to discuss this with my health care provider, who suggested HIV ultra DUO, when it was 3 weeks from my 2 nd exposure & 6 weeks from my 1 st exposure. The test results for antibodies & p 24 antigen came negative. I have read several posts on this forum having mixed opinion about this test at early window period. The health care provider was reassuring that the tests were reliable. This helped my anxieties to cool down, but since last 2 days i have got a small blister on the testicle (similar open sore) which was alike the 1st exposure. I showed this to VD & explained the risks. Also, i have a history of recurrent such blisters (which the VD mentioned was herpes) In past these used to reoccur once or twice a year & heal on its own without any medication. Is the reoccurrence anything to do with HIV risk.

I feel feverish but no fever. I have burning feeling in palms & sole & now this blister/herpes on testicle.

My concerns are:
Is this blister of any concern indicating HIV infection?
How should i consider the reliability of the test & considering both exposures at 3 & 5 week exposures?
Will HIV PCR be a concluding test?

You reply will be appreciated.

[y2do]

Awaiting your reply to earlier post. The HIV Duo was negative at 5 weeks. Its been now 7 weeks since the last encounter & have been feeling sore throat with almost a week of feverish feeling. Also have a mouth ulcer under the upper lip.

Is it a concern? Your reply will be appreciated.

[y2do]

Dr.Jose,

I took the DUO test again at 5 weeks, with same negative result.

However, have been feeling feverish for almost a week (ranging from 96 to 98 deg F) with sore throat. Burning sensation in palms & sole, all this keeping me still worried with anxiety.

[y2do]

Also, a last one, the duo test done at the lab took not more than 5-6 hours & the report was given next day to provide value & range?

Does that sound genuine about the testing time. Should i enquire about the equipment, etc.?

[y2do]

Thanks for your response.

Testing at 4 weeks from the last exposure or counting 4 weeks from now?

Does this test also cover the earlier exposure which was at 6 weeks when tested & reason i ask is that lot of info on the forum is mentioned about non detection of p24 antigen after a certain period.

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post and welcome to our HIV forum.
From the point of view of HIV infection, I would like to reassure as I agree with the health care worker you consulted.  First of all, your sexual encounters did not involve any significant risk of HIV infection at all whatsoever.  To confirm that you also had a negative HIV Duo test at three weeks following the last encounter.  This test is highly sensitive and very reliable, able to pick up the p24 antigen already after 2 weeks.  It is true that the guidelines recommend this test after 4 weeks.  However bearing in mind your absence of any risk and the high sensitivity of the test after 2 weeks, one can conclude that you are definitely HIV negative.  It sounds like your symptoms are msot likely to be related to herpes and nothing else.  Let me answer each of your questions here as follows:
-Is this blister of any concern indicating HIV infection? NO
-How should i consider the reliability of the test & considering both exposures at 3 & 5 week exposures? I EXPLAINED THIS ALREADY ABOVE
-Will HIV PCR be a concluding test? NOT NECESSARY.  FOR PEACE OF MIND, YOU COULD HAVE THE HIV DUO REPEATED AT 4 WEEKS, EVEN THOUGH I REALLY BELIEVE THIS NOT TO BE NECESSARY.

I hope this helps.
Best wishes,
Dr. José