Risky situation

[xxxjason]

Hi Dr. I am a male from Colombia. I am really worried since i recieved unprotected oral sex from a sex worker in my country, and had protected (with condom) vaginal sex afterwards. A few days after this i was diagnosed with viral meningitis, I was hospitalized since i was presentig confusion a extreme headaches. At my stay at the hospital they performed a rna test since Drs were suspecting it was due to acute hiv infection, and the result was undetectable (less than 20 copies). After i left the hospital y have had sore throat, i had an apisode of fever, and my transaminase were elevated to around 250. I performed an hiv test at two months and another one at three months after the episode of meninigitis and they were both negative. I dont know what type of test it was but they were performed in the best hospital of my city (colombia). After my episode of meningitis i havent had any risk situations. I am verry worried since ive had a lot of symptoms. I am really scared that i have infected my girlfriend since she experienced night seats two days ago. The thing that worries me the most is not finiding a cause for my meningitis and the fact that it was about two weeks after my risky situation.

1. Is the last test at three months conclusive 100%, or should y take further tests?
2. If the meningitis was due to acute hiv infection would a test three moths after have to be positive?
3. What is the risk of receiving oral? (For the person being sucked?)
4. Can i have unprotected sex with my girlfriend or is it a risk for infecting her?

I have a lot of anxiety and cant even sleep. Please help me doctor, i know your words can put my mind at rest.

[Edward W Hook, MD]

Antibody tests are typically positive a week or so after person develops symptoms from acute HIV infection.  You do not have HIV.  EWH

[Edward W Hook, MD]

It is becoming clear that you cannot control your anxiety over this no risk exposure so that I need to help.  I will do so by making this the last answer. Further questions will be deleted without comment.  If you had HIV you would have a positve PCR.   Believe your tests.

this ends this thread.  EWH

[xxxjason]

Is it common for a rna pcr test to give a false negative? I want to know this so that i can be sure i can rely on the test i had in the hospital (pcr) being negative.

[xxxjason]

Doctor, Can a person have symptoms of acute hiv and have undetectable levels of it in the blood? with a pcr rna test?

[xxxjason]

Please doctor i know im kind of a pain for insisting so much but i want to end this and continue with my life.

[xxxjason]

What i really want to know is how long does it take for antibodies to be detectable by an hiv test after one has experienced primary hiv infection symptoms?? I want to know this so i can be completely confident (100%) that my meningitis was not due to primary hiv infection. Please one last answer. Would really help end this anxiety in my mind.

[xxxjason]

If i hadnt taken a pcr test at the time of my meningitis, would a two month hiv test post meningitis mean it the meningitis had nothing to do with primary hiv infection?

[Edward W Hook, MD]

No, this changes nothing.  The evidence is still clear- you do not have HIV.  EWH

[xxxjason]

Doctor, One las questión i promisse. i was reviewing the timeline of the events and i thought the las HIV test i has was three months after my meningitis, but i realized it was less time. It was exactly 2 months and 3 weeks. Does this change anything or you would think the same about me being negative for HIV. I promise this is my las questión. Thanks a lot.

[Edward W Hook, MD]

Correct.  You DO NOT have to worry about infecting your girlfriend.  EWH

[xxxjason]

Dr, thank you very much for your words, they are very helpfull. I am sorry but i didnt understand the last part of your post (my english isnt that good). You say i DO NOT have to worry of infecting my girlfriend and i CAN have unprotected sex with her? Thanks again for your help. You do a wondefull job helping out people in this forum.

[Edward W Hook, MD]

Welcome to our forum.  I cannot fault your doctors for working to be sure that you did not have the ARS when you presented with viral meningitis.  In fact, they should be congratulated for this.  At the same time, and in part reflecting the fact that most viral meningitis is not caused by HIV, you can now be completely sure that you did not get HIV from the exposures you describe.

I say that you do not have HIV with confidence for several reasons:
1.  Your exposures were low risk.  Both condom protected genital sex and unprotected oral sex are safe sex.
2.  You had a negative PCR for HIV.  If your viral meningitis had been due to HIV your PCR would have shown hundreds of thousand, if not millions of HIV copies.  Your test was negative.
3.  You have negative HIV tests 3 months following the episode.  This too is definitive evidence that you do not have HIV.

Thus, to summarize, you can be completely sure that you did not get HIV and that your viral meningitis was not due to HIV.  There is no reason related to these concerns not to worry about unprotected sex with your girlfriend.

I hope my comments are helpful to you. Take care.  EWH