Welcome to the HIV forum. The bottom line is that I agree with the BASSH statement, and you can be certain you don't have HIV.
Even if your partner was infected, you were at little or no risk. It is unlikely she re-used a condom, but even if she did, the basic fact is that your exposure was condom-protected. And the odds are she didn't have HIV anyway. And remember that even with entirely unprotected sex, the average transmission risk for vaginal sex (female to male) is around once for every 2,000 exposures -- which is equivalent to having unprotcted sex once daily for 5 years and maybe never being infected. (This is why most spouses of HIV infected people don't become infected themselves.)
HIV-2 is rare in all African countrires, and entirely absent in most of the continent. It may be true that the p24 antigen component of the Duo test doesn't cover HIV-2 (I had never heard this before), but the antibody component does. The large majority of newly infected people have positive antibody tests by 4 weeks, and your negative Duo test result is highly reliable. As for your symptoms, they are not highly suspicious for HIV, especially in the absence of fever; and antibody tests are pretty much always positive within a week of onset of symptoms, so there's yet another level of reassurance.
All those factors considered, there is no realistic possibility you have HIV. You probably will want to have another antibody test 6-8 weeks after the exposure as final reassurance; you can expect it to remain negative. Finally, if the clinic you refer to was a GUM clinic in Ireland or th UK, you were under very expert care. If any doubts persist, return there for their direct evaluation and advice.
Regards-- HHH, MD
A related discussion,
Please help!! was started.
Assuming no new exposure since the one described above, your test results to date prove your symptoms are not due to HIV -- and they don't sound like HIV anyway. My understanding, in contrast to what you were told by HPA, is that the tests you had in fact are valid for HIV-2. Either way, HIV-2 is too rare in most industrialized countries (including UK, I assume) to worry about.
The best expertise on all this in the UK can be found at any of the NHS GUM clinics. If you continue to be concerned about all this, visit your nearest clinic for their advice.
That will be all for this thread. I won't have any further replies.
Dear Prof Handsfield
Just to let you know I restested at 6 weeks and the DUO result came back negative for Ab/Ag and P24.
My symptoms of enlarged sore lymph nodes and sore throat still persist (duration now 6 weeks, commencing 2 weeks post-exposure to present i.e. 8 weeks) and in the last week or so I have been feeling constantly sick. Another notable feature in the last week or so is the emergence of discrete pain centres around the backs of my arms near the elbows (epitrochlear node area), my goin area, back of neck, around the knees and I have also developed a distinct feeling of what I can only describe as a 'taught' and 'sunburnt' skin sensation around my neck and over my shoulders. I have not had fever or rash since the onset of my other symptoms 6 weeks ago.
In light of my 6-week negative test, I turned to my GP for standard blood tests, the results of which have not shed any light on the cause of my symptoms. The only episode of significance in my life in the last 8 weeks which I can attribute the cause to is my encounter with the west african CSW. In light of my concerns over HIV-2, I have read a few papers which suggest the window period for this strain may be prolonged compared to HIV-2, due to lower viral load relative to HIV-1 in the acute infection stage. I have also pretty much confirmed by research of authoritive literature and consultation with the UK Health Protection Agency that P24 antigen is really only applicable to HIV-1 early detection ahead of antibody production. In fact, the 4th generation assay test kits often specify 'HIV 1/2 and HIV-1 P24' which is a bit of a giveaway.
Could it be possible that I have had the above-mix of HIV-2 related symptoms for 6 weeks now and not produced antibodies to this strain, therefore yielding negative test results. I am 100% sure it is not HIV-1 as I had a viral load test at 22 days at my GUM clinic which came back negative - I don't believe the PCR viral load test would have detected HIV-2 as again I believe it was developed for HIV-1. I'm sure I have read similarly that there is no HIV-2 licensed vrial load test in the U.S. either.
I am off for another DUO test tomorrow (8 weeks post-exposure) to see where it takes me....specifically the HIV-2 antibody component of the test. I'll let you know how I get on.
Regards
J
Two days makes no difference. The data on seroconversion window aren't that precise. Your anxiety about HIV is definitely unwarranted.
Thanks Prof Handsfield.
Your response is very re-assuring, albeit I wonder if you might clarify an element of your reply. In your response you state that "the bottom line is that I agree with the BASSH statement, and you can be certain you don't have HIV".
You will note from my original posting that I tested at the 26-day mark and not the BASHH recommended 28-mark. Is this an oversight on your part, or have you taken this into consideration in your response. In other words, is my anxiety about HIV unwarranted despite testing 2 days before the stated 28-day threshold recommended by BASHH.
Regards and thanks in anticipation.
J