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Negative Test at 13 Weeks, But Immunosupresive Drugs
Dear Dr.,
Thanks so much for your time and patience. I want to lay out my situation as clearly as I can. On July 5th, I had an unprotected oral exposure with an unknown man. I have no idea if he was hiv positive or not. He did ejaculate in my mouth and I spit it out as best I could of course, and I was very upset that he did this. I have been a kidney transplant patient for many years. During the time of the exposure, I was taking a small dose of immunosupresive meds (cyclospirin 200mg)quite sporadically (I missed them about half the time, probably more than that). I felt fine for several weeks after the event, but at about 9 1/2 weeks I had diarhea and a low-grade fever for several days. Could this have been ARS? About two weeks before my HIV test, I saw a nephrologist, who put my on a more regular dose of cyclosporin, (100 mg, twice a day) and a dose of Cellcept (500 mg, twice day). I was also, just before the test, on a run of antibiotics, Levaquin, for seven days, which turned out to not have been necessary. Three days before my test, I was given pre-op testing, for surgery on a urehtral stricture (a surgery which I now deem unnecessary) and I was cleared for surgery (I assume this means my immune system was find and should be able to make antibodies, but what do I know). Anyway, I finally got my test at 13 weeks and 1 day after the exposure, an oraquick test, and it was negative very quickly (within about 2 minutes the nurse knew that it was negative). I have pieced together the following information, to help ease my mind:
1) the chances of oral sex one time leading to HIV are 1 in 10000. Is this true for me as well? Even though I was on the low dose of immunosupressives, which I don't believe I took that day.
2) the chances of a test at thirteen weeks being a false negative are much less than 1%. Is this also true for me?
3) if so, my odds are less than 1 in 10,000,000, correct? Or should I calculate my odds much lower?
4) Should I stop having sex with my now monogomous partner?
5) Should I stop taking my immunosupressive drugs for a few days and get retested?
6) I would prefer to put this behind me now. Is that possible?
Thank you for your time.
Thanks so much for your time and patience. I want to lay out my situation as clearly as I can. On July 5th, I had an unprotected oral exposure with an unknown man. I have no idea if he was hiv positive or not. He did ejaculate in my mouth and I spit it out as best I could of course, and I was very upset that he did this. I have been a kidney transplant patient for many years. During the time of the exposure, I was taking a small dose of immunosupresive meds (cyclospirin 200mg)quite sporadically (I missed them about half the time, probably more than that). I felt fine for several weeks after the event, but at about 9 1/2 weeks I had diarhea and a low-grade fever for several days. Could this have been ARS? About two weeks before my HIV test, I saw a nephrologist, who put my on a more regular dose of cyclosporin, (100 mg, twice a day) and a dose of Cellcept (500 mg, twice day). I was also, just before the test, on a run of antibiotics, Levaquin, for seven days, which turned out to not have been necessary. Three days before my test, I was given pre-op testing, for surgery on a urehtral stricture (a surgery which I now deem unnecessary) and I was cleared for surgery (I assume this means my immune system was find and should be able to make antibodies, but what do I know). Anyway, I finally got my test at 13 weeks and 1 day after the exposure, an oraquick test, and it was negative very quickly (within about 2 minutes the nurse knew that it was negative). I have pieced together the following information, to help ease my mind:
1) the chances of oral sex one time leading to HIV are 1 in 10000. Is this true for me as well? Even though I was on the low dose of immunosupressives, which I don't believe I took that day.
2) the chances of a test at thirteen weeks being a false negative are much less than 1%. Is this also true for me?
3) if so, my odds are less than 1 in 10,000,000, correct? Or should I calculate my odds much lower?
4) Should I stop having sex with my now monogomous partner?
5) Should I stop taking my immunosupressive drugs for a few days and get retested?
6) I would prefer to put this behind me now. Is that possible?
Thank you for your time.
I have a lymph node in the back of my neck that swells at night and then drains during the day, sending slight tingles down into my shoulder. Is this likely from post-nasal allergies? I've read on line that it may be, but wanted your expert opinion. Also, since it is only mildly swollen--I have to press into my skin to feel it--is it likely nothing to worry about? Other than the lymph node, I feel ok.
MEDICAL PROFESSIONAL
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HHH, MD
But if you chose a username or provided other information that seriously compromises your identity, you can make your request to MedHelp administration using the "contact us" link.
HHH, MD
Can you please delete my thread for the sake of my privacy? Thank you very much for your time and patience.
Dr.
My final question, I swear. So, the liteature suggests a theoretical connection between chemotherapy and seroconversion delay, but not between imunosuppresion and delay, correct? Also, is the fact that my white count, ect, was normal, suggest that I would be unlikely to be a late converter?
My final question, I swear. So, the liteature suggests a theoretical connection between chemotherapy and seroconversion delay, but not between imunosuppresion and delay, correct? Also, is the fact that my white count, ect, was normal, suggest that I would be unlikely to be a late converter?
MEDICAL PROFESSIONAL
Most immunosuppressive drugs have roles in chemotherapy for some malignancies, and most chemotherapeutics are immunosuppressive.
But you are correct, I was inappropriately loose in my terminology: in the doses and for the condition you take those drugs, your treatment is properly called immunosuppression and not chemotherapy. Sorry for the confusion.
White-coated tongue and thrush (oral yeast infection) are entirely different conditions. Coated tongue is normal in anyone from time to time, sometimes associated with colds, other viral infections--but often without obvious trigger. It is unlikely your coated tongue is due to thrush.
HHH, MD
But you are correct, I was inappropriately loose in my terminology: in the doses and for the condition you take those drugs, your treatment is properly called immunosuppression and not chemotherapy. Sorry for the confusion.
White-coated tongue and thrush (oral yeast infection) are entirely different conditions. Coated tongue is normal in anyone from time to time, sometimes associated with colds, other viral infections--but often without obvious trigger. It is unlikely your coated tongue is due to thrush.
HHH, MD
MEDICAL PROFESSIONAL
You're splitting hairs. The theoretical concerns apply to all drugs used for immunosuppression and chemotherpy. It probably applies only to chemotherapeutic doses.
Move on. You're clear. The chance you have HIV, given the near-zero chance you were infected plus the rarity of negative test results, is far less than the chance you will die of an unexpected accident or illness in the next week. I won't have any other comments on this thread.
HHH, MD
Move on. You're clear. The chance you have HIV, given the near-zero chance you were infected plus the rarity of negative test results, is far less than the chance you will die of an unexpected accident or illness in the next week. I won't have any other comments on this thread.
HHH, MD
Ok, sorry to ask a follow-up, but immunosuppresion and chemotherapy are different things, right? I mean, I've never had chemo, so there is no theoretical risk from immunosuppresion for kidney disese, is this right? Also, if white tongue can be scrubbed away, or diminishes with tooth-brughing, does this mean it is not thrush? sorry to be so bothersome.
I'll let good Dr. comment and put your mind at ease, but he will say your risk is much much lower, like nonexistent. Oral sex was zero risk activity to begin with, and I don't think the drug you mentioned would interfere with your 13 week result (but I could be wrong), which in my view is conclusive.
MEDICAL PROFESSIONAL
1) That is the standard estimate for transmission risk by receptive oral sex, if your partner had HIV. The real risk is lower, you don't know he is infected.
2) Your test result almost certainly is reliable. The cautions about chemotherapy interfering with test results are theoretical; if it occurs at all, I doubt it applies to the drugs and doses you are taking.
3) I suppose your odds calculation is more or less right. It shows the risk to be truly zero; I haven't done the math.
4) You can have sex with your partner.
5) You do not need retesting. I will not advise you about your immunosuppresive therapy. But follow your own health care providers' advice on both points.
6) Move on.
This is a good lesson for you and all persons whose lifestyles put them at particular risk for HIV, such as gay men. You should not have had sex, even planned safe sex, without asking and discussing your HIV status with the other guy. As you found, intentions for safer sex (e.g., no ejaculation in your mouth) often fail in the heat of the moment. ALWAYS ASK AND SHARE HIV STATUS!
Good luck-- HHH, MD
2) Your test result almost certainly is reliable. The cautions about chemotherapy interfering with test results are theoretical; if it occurs at all, I doubt it applies to the drugs and doses you are taking.
3) I suppose your odds calculation is more or less right. It shows the risk to be truly zero; I haven't done the math.
4) You can have sex with your partner.
5) You do not need retesting. I will not advise you about your immunosuppresive therapy. But follow your own health care providers' advice on both points.
6) Move on.
This is a good lesson for you and all persons whose lifestyles put them at particular risk for HIV, such as gay men. You should not have had sex, even planned safe sex, without asking and discussing your HIV status with the other guy. As you found, intentions for safer sex (e.g., no ejaculation in your mouth) often fail in the heat of the moment. ALWAYS ASK AND SHARE HIV STATUS!
Good luck-- HHH, MD
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