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HIV concerns
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HIV concerns

Hello doctors

I had sex with other man on 16th November/12,unprotected oral sex & protected anal sex (I penetrated). I have been feeling many symptoms

WeeK=Wk

2-4 wk: 1 or 2 cankers in my throat (Inside), 1 swollen lymph node in my left side of my neck just down of my paladin

5-8 wk: I got diarrhea,it last 6 days I got 4 shots of gentamicin, Lost weight about 7 kgs, a sense of chills, light (sore throat & pain joint & muscles)

7-8 wk: itchy,burning eyes, pimples more than usual on upper back and some on face

9-13 wk: the following symptoms still:1 swollen lymph,sore throat, cankers but now in mouth

My weight was 84.5 kgs,now 81.5, I can´t recover my regular weight although I´m eating well.  

No fever no rash

I got Elisa test of 3 generation (Rapid blood test) in a lab with these results:
2 week-Negative;
6-Neg;
11-Neg;
13-Neg, I think the tests were rapid test cause the results were in the same day.

Questions

1) Is Rapid blood test are as good as lab-based test? I read some of your posts saying sometimes they are not reliable and they give false negative

2) What could be the reasons for my persistent symptoms?

3) What other STD Do I have to be tested?

4) Could Gentamicin affect the result of the tests?
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

You did not catch HIV.  That's a definitive, 100%, final conclusion.  Stop worrying about it.

There is a lot of information in your question, but the only important items are the test results.  The HIV tests are among the most accurate diagnostic tests ever developed, for any medical condition.  It is simply not possible to have HIV with the test results you report, at the times the tests were done after the last possible exposure.  And yes, the rapid blood test results are every bit as reliable as the lab based tests. Neither your exposure nor your symptoms are relevant; the tests prove you weren't infected and that HIV is not a possible cause of the symptoms.  (That said, this was a very low to zero risk exposure, and your symptoms are not typical of a new HIV infection.)

To your specific questions:

1) Recent discussion on rapid test reliability have mostly been about the oral fluids test.  New research has led to better understanding that it becomes positive somewhat less quickly than the blood tests, both rapid and lab based.

2) On this forum, we try to avoid speculating on causes of symptoms other than HIV.  There are at least a hundred potential causes.  Your test results prove it isn't HIV.  I'll leave it there.  

3) Unprotected oral could have resulted in gonorrhea, nongonococcal urethritis, herpes or, very unlikely, syphilis.  Any of these usually would have caused obvious symptoms by now. But if you remain nervous about it, you could be tested.  If I were somehow in your situation, I wouldn't feel the need -- but then, I wouldn't have been tested for HIV either.  

4) Neither gentamicin nor any other antibiotics have any effect on HIV test reliability.

Really, it's time to stop worrying about HIV.  See your doctor if your symptoms continue to bother you, but it is exceedingly unlikely you have any infection from the sexual exposure you have described.

Regards--  HHH, MD
7 Comments
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Avatar_m_tn
Thanks doctor Now everything is clear, Just 2 more questions:

1) An Internal Doctor asked to me to be tested for the 3 types of Hepatitis (A,B,C) 2 of them are a little expensive, I just want to ask you if you think that it is neccesary.

2) If I decide to get tested for hepatitis, is a rapid test a good option?, I found two labs in my city, 1 of them has rapid test (I guess becasue the result is in the same day) and the other lab the result is in 5 days, Of course the prices are very different for this reason.
Thanks for your help
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239123_tn?1267651214
There is definitely no need to test for any of the hepatitis viruses after this sort of exposure.  Don't waste your money on any of them.  Also, even in high risk situations, only hep B is sexually transmitted with significant frequency.  We don't test for A or C in my STD clinic except in special and unusual circumstances.  Because we do little hepatitis testing, I have no experience with the rapid tests -- I can't help you there.
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Avatar_m_tn
Hello Doctor, I went to my doctor as you sugested , but He told me some information that I wanted to share with you and recevied a good and final advice from you.
He said that the rapid tests are not as good as lab-based ones, and that My tests are not conclusive and they don´t lead to a reliable diagnosis, He said that I have to get a Lab-based test during 2 years (3-6-9, etc, etc), other comment He said was that anal sex with condom is a high risk when blood are on the condom, and it is normal in this type of sex.
Honestly I´m so confused and with fear now,
Do I have to look for another doctor?
Thanks doctor for your time and advice.
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239123_tn?1267651214
Either you misunderstood your doctor or he is behind the times and doesn't understand the currently used HIV tests; see the thread linked below.  There is also misunderstanding about how condoms work.  I stand by my opinion and advice.

http://www.medhelp.org/posts/show/1704700

That will end this thread.
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Avatar_m_tn
Please if you can answer this last comment, tonight I was cheking my Email, and I recieved I Medhelp update notification, and I read all the post and in the end I read something that drove me crazy againg

http://www.medhelp.org/posts/HIV--Living-With-/Newly-Diagnosed-Not-been-to-ID-Specialist-have-questions-on-testing/show/1889784?camp=watch_list

You said this statement
"Your previous results were definitive, and I would assume the most recent test is falsely negative, especially if it was an oral fluids test.  Recent research has shown that the oral fluids tests often take longer than the blood tests, including the rapid blood tests, to seroconvert. "

All my tests were rapid blood tests, So My results are o are not conclusive? please tell me the thruth even It would be hard. Do I have to test againg? If so, What would be the correct time? Is there another kind of test that definetly tells That I´m HIV free?
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239123_tn?1267651214
My initial reply included "...the rapid blood test results are every bit as reliable as the lab based tests."  I was very careful to specify blood tests, i.e. not the oral fluids test, for the reasons covered in the thread you have cited.

I suggest you carefully re-read my replies above, concentrating carefully on every word; stop searching the web or otherwise looking for further information about your situation; and do your best to accept the reasoned, science based reassurance you have had without second guessing it.

That's defininitely my last comment on this thread.  It's time for you to move on.
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