Kenalog shot

I had an exposure may 26 2012...here are the details..

Got tested 9.5 weeks  negative

Started kenalog shots for a skin issue...these were in the skin not intramuscular about 14 weeks post exposure..

Had 3 shots 1 month apart sep, oct, nov

Got tested again at 6 months after exposure negative.

I have seen you say it is possible to delay antibody production...as I never started the shots to 14 weeks after exposure would this be the case with me?  Or because there was enough time passed (14week) I would have developed antibodies?  Do the antibodies always stay even during the course of these shots?

I asked the dermatologist and he said it would take a lot to surpress your immune system and he also said he uses kenalog 40 but it is diluted it is not a concern as far as suppressing the immune system....he said oral steriods can do this....also I had a couple surgeries and my blood work was always normal (WBC were always in the high norm) would your WBC show low numbers if your immune system was surpressed?

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

You don't describe your exposure, so I cannot judge your risk from that standpoint.

Your dermatologist is correct:  your local corticosteroid injections cannot have any effect on HIV testing. Potent, high dose immunosuppressive drugs, including ora high dose corticosteroids, in theory can delay conversion of HIV antibody tests to positive. (I stress "in theory". Even with these drugs, there are few if any actual known cases in which this happened.) But local triamcinolone (Kenalog) injections don't count. As implied by your doctor, this product is designed to produce high doses at the site of injection, but not enough of the drug is absorbed into the bloodstream to have any effect at all on HIV testing.

WBC counts normally vary widely. My own count in a recent medical evaluation was around 5,000, whereas it was 8,900 a few months ago. The differences mean nothing for either your immune system, or your general health, or for my own.

For those reasons, you can rely 100% on your negative HIV test results.  Even the result at 9.5 weeks was 100% reliable; there was no reason for testing any later than that.  For more information about HIV test timing, take a look at the thread linked below.

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

So all is well.  I hope this has helped.  Best wishes--  HHH, MD

[Justcheckin209]

Great thank you...just one follow up...

Once a person allows enough time in my case 14 weeks to develop antibodies even with high dose steriods would the antibodies still be detected if started after the 14 weeks?  Or do the drugs deplete the antibodies?

[H. Hunter Handsfield, M.D.]

No, drugs do not "deplete" antibodies.  Once an HIV antibody test is positive, it remains positive for life.

[Justcheckin209]

Not sure if this matters but I performed  cunnilingus on a stripper...it was very brief but might have had some irritation on my inner gums at the time...when I say brief it was less than a minute...

Is this high risk to begin with?

[H. Hunter Handsfield, M.D.]

Oral sex rarely if ever transmits HIV, and nobody has ever been reported to catch HIV by cunnilingus.  But anyway, your level of risk for HIV is totally irrelevant.  The test results always rule. You could have mainlined HIV infected blood and my reply would be the same:  your test results prove you were not infected.  Believe it, accept it, and move on with your life.

There are no other extenuating circumstances or "what if" thoughts that might come to your mind that would possibly change my opinion or advice, so that will end this thread.  Take care.