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HIV testing follow up and symptoms
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HIV testing follow up and symptoms

Dear Dr Sean
I am a 35 yr old male from Brazil. I have recently gone through a tough situation in which I put myself into risk of getting HIV infected. I had 3 sexual encounters with another male who had just found out he was HIV positive. Indeed, after checking out some details of his story I found out he was seroconverting by the time I met him. The 3 encounters were: mutual oral sex 2 times although I performed it on his penis briefly and there was no ejaculation involved (the last episode was on October 24th); the part that worried me the most was related to insertive anal sex (I was on top) followed by breakage of the condom I was wearing - I realized it had broken right away and took my penis out of him (it was on October 17th).
First testing was on December 17th (54 days after last oral and 61 days after condom incident) - the test used was a Rapid Test HIV1/2 approved by government health staff -  in testing centers in Brazil they perform two rapid tests from two different producers at the same time - BOTH NEGATIVE
Second testing was on January 7th (75 days after oral and 82 days after condom incident) - again, two Rapid Tests HIV1/2 at the same time - BOTH NEGATIVE
Third testing was on January 19th (87 days after oral and 94 days after condom incident) - at that time I went to a private laboratory and was tested by a 4th Generation ELISA (ag/ab) which came back NEGATIVE.
I have had nose/throat problems since the beginning of January and after a "nasofibrolaringoscopy" they found a somewhat enlarged left adenoid which was biopsied and the result was "adenoid hyperplasia without signs of malignancy". Also, lots of larynx signs of gastroesophageal reflux.
My questions are:
1 - Am I negative? Why in USA they say that people after HIV exposure to a known HIV positive person have to be tested at 6 months. Do you agree with that?
2 - Would this adenoid hyperplasia be a sign of early HIV infection?
Thank you and congratulations for such a great job!
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Hi there,
I am afraid that my colleague Dr Sean Cummings is not available at present.  I hope you do not mind if I reply to your post.
As follows I will try to answer your questions:

1 - Am I negative? Why in USA they say that people after HIV exposure to a known HIV positive person have to be tested at 6 months. Do you agree with that?
YES, YOU ARE INDEED HIV NEGATIVE.  DIFFERENT COUNTRIES HAVE DIFFERENT GUIDELINES.  WHAT IT IS IMPORTANT IN YOUR CASE IS THE RELIABILITY OF THE TESTS PERFORMED AND NOT THE LEVEL OF RISK.  YOUR SEXUAL ENCOUNTER INVOLVED CERTAINLY A RISK BUT AS INSERTIVE ANAL INTERCOURSE WITH A CONDOM BREAKING, THIS RISK WOULD BE RELATIVELY LOW EVEN IF THE OTHER GUY WAS HIV POSITIVE.
THE HIV RAPID TESTS PERFORMED AT 87 AND 94 DAYS WERE FULLY CONCLUSIVE, AS WELL AS THE 4TH GENERATION ELSIA TEST.  THERE IS NO NEED TO PERFORM ANY TESTS AND THAT WOULD BE THE GENERAL RECOMMENDATION HERE IN THE UK.

2 - Would this adenoid hyperplasia be a sign of early HIV infection?
NOT AT ALL.  FIRST OF ALL, YOU HAVE ALREADY CONFIRMED THAT YOU ARE NOT HIV POSITIVE WITH ALL THE NEGATIVE TESTS THAT YOU HAVE HAD. IT IS NOT USUALLY ASSOCIATED WITH HIV AT ALL.  IT IS MORE LIKELY TO BE A SIGN OF ANOTHER OROPHARYNGEAL INFECTION, BUT IT MIGHT ALSO BE RELATED TO EXCESSIVE ACID DUE TO GASTRO-OESOPHAGEAL REFLUX, AS YOU MENTION.

I hope this is helpful.
Best wishes,
Dr Jose
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