Aa
Urgent! Help please: Am I infected?
I had vaginal sex with a prostitute in Argentina without a condom on October 13. I asked her if she had HIV and she said she hadn’t. Anyway on October 14 I started to take PEP for 30 days. Two days after I finished the PEP I did a HIV test of fourth generation (HIV duo test) and it was negative. On November 21 I had vaginal sex with another prostitute in Argentina without a condom. This second girl did a HIV test of fourth generation (HIV duo test) on November 23 and it was negative. I saw the result. Anyway I took PEP for 28 days since November 22 until December 19 and I did a HIV test of fourth generation (HIV duo test) on December 21. It was negative. I did a HIV test of fourth generation (HIV duo test) on January 11 and it was negative.
On January 21 I was with another prostitute in Argentina. I did not have vaginal intercourse with my penis. All I did was insert my finger into her vagina and after that I realized that I had a cut in that finger. That finger was not bleeding but I could see the flesh underneath the skin. The cut was 2 mm. I did a HIV test of fourth generation (HIV duo test) on January 25 and it was negative.
However, yesterday I had a sore throat and cold and today I have cold and a fever of 37.7. I have no rash or swollen lymph nodes (I think).
My questions:
1) The HIV duo test on January 25 is conclusive in respect of the two first experiences?
2) Is the fingering with a cut finger risky for HIV?
3) the sore throat, cold and fever could be symptoms of primary HIV infection? (In my country, Argentina, it is summer). Can primary HIV infection begin six days after the infection?
4) What chance I have of being infected with HIV from these three experiences?
5) Can I do some test (like PCR) to know if I’m infected without waiting? If I do a HIV test of fourth generation (HIV duo test) tomorrow or on Tuesday and the result is negative, What does that say about the symptoms I'm having? Thanks!!
On January 21 I was with another prostitute in Argentina. I did not have vaginal intercourse with my penis. All I did was insert my finger into her vagina and after that I realized that I had a cut in that finger. That finger was not bleeding but I could see the flesh underneath the skin. The cut was 2 mm. I did a HIV test of fourth generation (HIV duo test) on January 25 and it was negative.
However, yesterday I had a sore throat and cold and today I have cold and a fever of 37.7. I have no rash or swollen lymph nodes (I think).
My questions:
1) The HIV duo test on January 25 is conclusive in respect of the two first experiences?
2) Is the fingering with a cut finger risky for HIV?
3) the sore throat, cold and fever could be symptoms of primary HIV infection? (In my country, Argentina, it is summer). Can primary HIV infection begin six days after the infection?
4) What chance I have of being infected with HIV from these three experiences?
5) Can I do some test (like PCR) to know if I’m infected without waiting? If I do a HIV test of fourth generation (HIV duo test) tomorrow or on Tuesday and the result is negative, What does that say about the symptoms I'm having? Thanks!!
MEDICAL PROFESSIONAL
Hello,
Thank you very much for your post and spologies for the delay to reply. Firstly I will answer your initial questions here below:
1) The HIV duo test on January 25 is conclusive in respect of the two first experiences?
IT WAS CARRIED OUT 35 DAYS AFTER YOU FINISHED THE SECOND COURSE OF PEP. IN PRACTICE, IT CAN BE CONSIDERED CONCLUSIVE. HOWEVER CURRENT GUIDELINES RECOMMEND A TEST AT LEAST 12 WEEKS AFTER FINISHING PEP. THE REASON FOR THIS IS BECUASE PEP CAN AFFECT THE RELIABILITY OF THESE TESTS AND THEREFORE THEY CAN AFFECT THE WINDOW PERIOD. MORE RESEARCH IS NEEDED IN THIS AREA. IN MY EXPERIENCE I HAVE NEVER HAD A CASE OF SOMEONE TESTING NEGATIVE AFTER 4-6 WEEKS OF TAKING PEP, AND THEN TESTING POSITIVE LATER ON.
2) Is the fingering with a cut finger risky for HIV?
NOT REALLY. IT IS NOT CONSIDERED TO POSE A REAL RISK OF HIV INFECTION.
3) the sore throat, cold and fever could be symptoms of primary HIV infection? (In my country, Argentina, it is summer). Can primary HIV infection begin six days after the infection?
SYMPTOMS ARE NON-SPECIFIC AND THEY COULD CERTAINLY BE SYMPTOMS OF ACUTE HIV SERO-CONVERSION. HOWEVER THE TIMING IS WRONG AS THEY WOULD NOT NORMALLY HAPPEN BEFORE TWO WEEKS AFTER THE INFECTION. MY IMPRESSION IS THAT YOUR SYMPTOMS HAVE NOTHING TO DO WITH HIV. PEOPLE CAN STILL GET VIRAL INFECTIONS AND COLDS IN THE SUMMER.
4) What chance I have of being infected with HIV from these three experiences?
IF THE LADIES WERE TO BE POSITIVE, THE RISK FROM THE FIRST TWO WHEN THERE WAS UNPROTECTED PENETRATION WOULD BE ESTIMATED AT AROUND 0.1% (1 IN 1,000) PER SEXUAL ENCOUNTER. NOT KNOW THEIR STATUS WOULD REDUCE THIS DRAMATICALLY. THE FACT THAT THE SECOND LADY TESTED NEGATIVE A FEW DAYS LATER, IT IS ALSO HIGHLY REASSURING EVEN THOUGH ONE WOULD ALSO HAVE TO TAKE INTO ACCOUNT THE WINDOW PERIOD IN CASE SHE HAD BEEN RECENTLY INFECTED AND MIGHT HAVE NOT BEEN DETECTED BY THE TEST PERFORMED. HOWEVER THE ESTIMATED RISK WOULD BE EVEN LESS.
5) Can I do some test (like PCR) to know if I’m infected without waiting? If I do a HIV test of fourth generation (HIV duo test) tomorrow or on Tuesday and the result is negative, What does that say about the symptoms I'm having? YOU MENTIONED THAT THE LAST TEST WAS NEGATIVE. THEREFORE THAT WOULD INIDCATE THAT YOUR SYMPTOMS ARE NOT RELATED TO ACUTE RETROVIRAL SYNDROME OR ACUTE HIVE SERO-CONVERSION SYMPTOMS - THIS WAS PERFORMED 6 WEEKS AFTER FINISHING PEP, WHICH CAN BE CONSIDERED HIGHLY RELAIBLE AND CONCLUSIVE IN PRACTICE. IF YOU WERE TO ADD A PCR RNA TEST, WHICH I AM PRETTY CONFIDENT THAT WILL BE NEGATIVE, YOU CAN BE REASSURED THAT YOU HAVE NOT BEEN INFECTED. IN SUMMARY, I AM CONFIDENT THAT YOU ARE ABSOLUTELY FINE EVEN THOUGH CURRENT GUIDELINES WOULD STILL RECOMMEND A FINAL TEST AFTER 12 WEEKS OF FINISHING PEP.
MY ADVICE TO YOU IS NOT TO CONTINUE HAVING UNPROTECTED SEXUAL INTERCOURSE IN THE FUTURE, ESPECIALLY WITH SEX WORKERS. IT IS NOT A VERY GOOD HABIT!
Best wishes,
Dr José
Thank you very much for your post and spologies for the delay to reply. Firstly I will answer your initial questions here below:
1) The HIV duo test on January 25 is conclusive in respect of the two first experiences?
IT WAS CARRIED OUT 35 DAYS AFTER YOU FINISHED THE SECOND COURSE OF PEP. IN PRACTICE, IT CAN BE CONSIDERED CONCLUSIVE. HOWEVER CURRENT GUIDELINES RECOMMEND A TEST AT LEAST 12 WEEKS AFTER FINISHING PEP. THE REASON FOR THIS IS BECUASE PEP CAN AFFECT THE RELIABILITY OF THESE TESTS AND THEREFORE THEY CAN AFFECT THE WINDOW PERIOD. MORE RESEARCH IS NEEDED IN THIS AREA. IN MY EXPERIENCE I HAVE NEVER HAD A CASE OF SOMEONE TESTING NEGATIVE AFTER 4-6 WEEKS OF TAKING PEP, AND THEN TESTING POSITIVE LATER ON.
2) Is the fingering with a cut finger risky for HIV?
NOT REALLY. IT IS NOT CONSIDERED TO POSE A REAL RISK OF HIV INFECTION.
3) the sore throat, cold and fever could be symptoms of primary HIV infection? (In my country, Argentina, it is summer). Can primary HIV infection begin six days after the infection?
SYMPTOMS ARE NON-SPECIFIC AND THEY COULD CERTAINLY BE SYMPTOMS OF ACUTE HIV SERO-CONVERSION. HOWEVER THE TIMING IS WRONG AS THEY WOULD NOT NORMALLY HAPPEN BEFORE TWO WEEKS AFTER THE INFECTION. MY IMPRESSION IS THAT YOUR SYMPTOMS HAVE NOTHING TO DO WITH HIV. PEOPLE CAN STILL GET VIRAL INFECTIONS AND COLDS IN THE SUMMER.
4) What chance I have of being infected with HIV from these three experiences?
IF THE LADIES WERE TO BE POSITIVE, THE RISK FROM THE FIRST TWO WHEN THERE WAS UNPROTECTED PENETRATION WOULD BE ESTIMATED AT AROUND 0.1% (1 IN 1,000) PER SEXUAL ENCOUNTER. NOT KNOW THEIR STATUS WOULD REDUCE THIS DRAMATICALLY. THE FACT THAT THE SECOND LADY TESTED NEGATIVE A FEW DAYS LATER, IT IS ALSO HIGHLY REASSURING EVEN THOUGH ONE WOULD ALSO HAVE TO TAKE INTO ACCOUNT THE WINDOW PERIOD IN CASE SHE HAD BEEN RECENTLY INFECTED AND MIGHT HAVE NOT BEEN DETECTED BY THE TEST PERFORMED. HOWEVER THE ESTIMATED RISK WOULD BE EVEN LESS.
5) Can I do some test (like PCR) to know if I’m infected without waiting? If I do a HIV test of fourth generation (HIV duo test) tomorrow or on Tuesday and the result is negative, What does that say about the symptoms I'm having? YOU MENTIONED THAT THE LAST TEST WAS NEGATIVE. THEREFORE THAT WOULD INIDCATE THAT YOUR SYMPTOMS ARE NOT RELATED TO ACUTE RETROVIRAL SYNDROME OR ACUTE HIVE SERO-CONVERSION SYMPTOMS - THIS WAS PERFORMED 6 WEEKS AFTER FINISHING PEP, WHICH CAN BE CONSIDERED HIGHLY RELAIBLE AND CONCLUSIVE IN PRACTICE. IF YOU WERE TO ADD A PCR RNA TEST, WHICH I AM PRETTY CONFIDENT THAT WILL BE NEGATIVE, YOU CAN BE REASSURED THAT YOU HAVE NOT BEEN INFECTED. IN SUMMARY, I AM CONFIDENT THAT YOU ARE ABSOLUTELY FINE EVEN THOUGH CURRENT GUIDELINES WOULD STILL RECOMMEND A FINAL TEST AFTER 12 WEEKS OF FINISHING PEP.
MY ADVICE TO YOU IS NOT TO CONTINUE HAVING UNPROTECTED SEXUAL INTERCOURSE IN THE FUTURE, ESPECIALLY WITH SEX WORKERS. IT IS NOT A VERY GOOD HABIT!
Best wishes,
Dr José
I have the result of the HIV DUO test I did yesterday (six weeks after the end of the PEP and one week and one day after the fingering with a cut finger). It is negative. Please consider this result to answer the questions I did before in the central part of my message and in the comment. A clarification: when I talk about primary HIV infection I mean ARS (Acute Retroviral Syndrome). Thank you very much!!
I'm going to do a HIV DUO test today (Monday 30) and the result will be tomorrow. So I would like to know what happens with p24 antigen during the primary HIV infection. If I'm passing the primary HIV infection, p24 antigen should be detected by the DUO test or it dissappears just before the primary infection. And what happens with the antibodies during the primary HIV infection: if I'm passing the primary HIV infection, the antibodies should be detected by the DUO test or they appear just after the primary infection. If the result of this test is negative, how likely is it that I have been infected? Thak you very much!!
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