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hiv risk after dental work
I would really like to get your opinion on my risk of being infected with HIV.
During my visit in South Africa I ended up spending time with a girl . Due to high HIV rates there I was staying away from sex, but we did end up 'deep' kissing, as well as mutual masturbation. At one point I also put a finger on my tongue for lubrication after touching her. Stupid of me. There was no insertive sex, vaginal, anal or oral.
My worries afterwards were that we both had had recent dental work, me about 18 days earlier (wisdom), and her having a molar removed only two days earlier. My teeth were healing very well and her mouth was not bleeding. Being cautious a doctor put me on Truvada about 10 hours later, with the view to me finding out her status before coming off it. She agreed to do an HIV test. When it came to collecting her results, she convinced herself that she was hiv pos as the clinic asked to meet her in person. I assured her this was routine but she didnt believe. She is from a very high risk demographic, like 20%.
I just completed a month on Truvada. It has been an unpleasant month, at first low energy, sore throat, weird dreams. Then after exactly two weeks, I got a fever, the sore throat got a lot worse. I then got swollen lymph glands around the groin and neck. Scary
Six days later I got tested in UK even though it was too early. The specialist agreed to an HIV duo test, which came back negative at 20 days. He explained that the antigen part of the test would likely to have been positive if those symptoms were connected with HIV.
Sorry for the long essay here. Just wanted to know your thoughts. I had a non specific virus a month or so earlier which had given me fever and a urine infection, plus had a wisdom tooth infection (for which I had removed and completed the antibiotics). I was hiv neg tested a few months ago and have not had sex since.
I'm obviously thinking the worst.
Any thoughts on my situation appreciated. Scared!
During my visit in South Africa I ended up spending time with a girl . Due to high HIV rates there I was staying away from sex, but we did end up 'deep' kissing, as well as mutual masturbation. At one point I also put a finger on my tongue for lubrication after touching her. Stupid of me. There was no insertive sex, vaginal, anal or oral.
My worries afterwards were that we both had had recent dental work, me about 18 days earlier (wisdom), and her having a molar removed only two days earlier. My teeth were healing very well and her mouth was not bleeding. Being cautious a doctor put me on Truvada about 10 hours later, with the view to me finding out her status before coming off it. She agreed to do an HIV test. When it came to collecting her results, she convinced herself that she was hiv pos as the clinic asked to meet her in person. I assured her this was routine but she didnt believe. She is from a very high risk demographic, like 20%.
I just completed a month on Truvada. It has been an unpleasant month, at first low energy, sore throat, weird dreams. Then after exactly two weeks, I got a fever, the sore throat got a lot worse. I then got swollen lymph glands around the groin and neck. Scary
Six days later I got tested in UK even though it was too early. The specialist agreed to an HIV duo test, which came back negative at 20 days. He explained that the antigen part of the test would likely to have been positive if those symptoms were connected with HIV.
Sorry for the long essay here. Just wanted to know your thoughts. I had a non specific virus a month or so earlier which had given me fever and a urine infection, plus had a wisdom tooth infection (for which I had removed and completed the antibiotics). I was hiv neg tested a few months ago and have not had sex since.
I'm obviously thinking the worst.
Any thoughts on my situation appreciated. Scared!
MEDICAL PROFESSIONAL
Welcome to our Forum. Let me address your risk for HIV and then make a few additional comments. As we have said more times than I can remember, the quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex. Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex. This includes by all of the people who had dental work, gum disease, etc. following dental work the mouth and gums begin to heal almost instantaneously making increased transmission risk not a concern if it ever was (which I doubt).
As a result, whether or not your partner had HIV, I have no concern that you were at risk for HIV and as a result, if you were my patient I would not have put you on PEP, subjecting you to the drug side effects that you experienced.
Finally, if your symptoms are been due to the ARS, the antigen detection portion of the DUO test would have most likely been positive at the time of symptoms and the antibody test would have been positive 4-5 days afterward.
Thus, for many reasons, you really have no reason to be concerned about HIV. I would not worry. I suspect you will have further testing to convince yourself that you did not get HIV from the exposure you describe. In most settings, this sort of follow-up should be carried out for 3 months following completion of PEP. With each passing day however, a negative test provides more and more assurance that you did not get HIV form the virtually no risk exposures you described.
I hope these comments are helpful to you. Take care. EWH
As a result, whether or not your partner had HIV, I have no concern that you were at risk for HIV and as a result, if you were my patient I would not have put you on PEP, subjecting you to the drug side effects that you experienced.
Finally, if your symptoms are been due to the ARS, the antigen detection portion of the DUO test would have most likely been positive at the time of symptoms and the antibody test would have been positive 4-5 days afterward.
Thus, for many reasons, you really have no reason to be concerned about HIV. I would not worry. I suspect you will have further testing to convince yourself that you did not get HIV from the exposure you describe. In most settings, this sort of follow-up should be carried out for 3 months following completion of PEP. With each passing day however, a negative test provides more and more assurance that you did not get HIV form the virtually no risk exposures you described.
I hope these comments are helpful to you. Take care. EWH
MEDICAL PROFESSIONAL
Taking Truvada PEP can modify and delay HIV test positivity however, the symptoms you describe are very non-specific and could be caused by any number of other problems including community acquired viral infections that many travelers get. Furthermore, if your symptoms were due to HIV it is most likely that your DUO test would be positive. As I told you, the exposures you described are very, very low risk for HIV. My advice would be for you to discuss your symptoms and concerns with your own doctor. EWH
Hello Dr Hook
Since your last response, I went for a full std checkup at the clinic and came back negative for hiv and all the others. I had tested negative for hiv at 20days.
However I am increasingly worried about the symptoms I am going through, as I still have swollen lymph nodes in the groin area and getting worse, still have a badly sore throat and now the past couple of days very achy muscles and joints. Never had this before. No rash though. I had fever two weeks ago which lasted a couple of days. I had taken truvada for one month up until the test four days ago.
My question is about the negative result from this recent duo HIV test and whether they loose any significance as I had taken Truvada for a month. It feels like I have had all the symptoms of HIV the last couple of weeks but not sure if it would have showed up or not in the test due to pep. Or put a different way, if these symptoms were due to hiv, would that mean that the pep had failed and it would have shown up in the test.
This is new question so I'll make a donation..
many many thanks again...
Since your last response, I went for a full std checkup at the clinic and came back negative for hiv and all the others. I had tested negative for hiv at 20days.
However I am increasingly worried about the symptoms I am going through, as I still have swollen lymph nodes in the groin area and getting worse, still have a badly sore throat and now the past couple of days very achy muscles and joints. Never had this before. No rash though. I had fever two weeks ago which lasted a couple of days. I had taken truvada for one month up until the test four days ago.
My question is about the negative result from this recent duo HIV test and whether they loose any significance as I had taken Truvada for a month. It feels like I have had all the symptoms of HIV the last couple of weeks but not sure if it would have showed up or not in the test due to pep. Or put a different way, if these symptoms were due to hiv, would that mean that the pep had failed and it would have shown up in the test.
This is new question so I'll make a donation..
many many thanks again...
Hello Dr Hook
thank you so much for such a quick and considered response. It is reassuring to hear it was still a low risk situation, despite all those factors I am scared of.
With regards the PEP, it feels to me that the side effects combined with anxiety, confusion, depression have perpetuated my illness. Almost like a catch 22 situation where I felt I needed to continue to the end despite continually feeling worse, in fear that if I stopped it could lead to infection. Ironically, I was feeling strong, fit and sporty only a month ago, and now a month later feeling paranoid about experiencing ars symptoms, having lost 7kg, regularly experiencing insomnia, and feel like half a person, mentally and physically etc. In fact for me this particular drug felt like a poison from the first day I took it, though many, many others handle it absolutely fine.
My specialist here said the same as you in that he wouldn't have prescribed pep but it was a difficult knowing what to do at the time, I was abroad and I hadn't discovered this forum at the time.
Obviously part of me still fears the worst, but your response helps in the meantime (anxiety comes in waves and I'll try and keep this in mind during the low points). I also hope my African girl friend is ok.. that story is classic example of the stigma / fears of the culture there, no one talks about it, they all keep it secret. I am really looking to help myself in this cause after my current scare.
Well, looking forward now to my first nights sleep without pep,
Thanks again... for this and for all the work you guys do on this forum..
thank you so much for such a quick and considered response. It is reassuring to hear it was still a low risk situation, despite all those factors I am scared of.
With regards the PEP, it feels to me that the side effects combined with anxiety, confusion, depression have perpetuated my illness. Almost like a catch 22 situation where I felt I needed to continue to the end despite continually feeling worse, in fear that if I stopped it could lead to infection. Ironically, I was feeling strong, fit and sporty only a month ago, and now a month later feeling paranoid about experiencing ars symptoms, having lost 7kg, regularly experiencing insomnia, and feel like half a person, mentally and physically etc. In fact for me this particular drug felt like a poison from the first day I took it, though many, many others handle it absolutely fine.
My specialist here said the same as you in that he wouldn't have prescribed pep but it was a difficult knowing what to do at the time, I was abroad and I hadn't discovered this forum at the time.
Obviously part of me still fears the worst, but your response helps in the meantime (anxiety comes in waves and I'll try and keep this in mind during the low points). I also hope my African girl friend is ok.. that story is classic example of the stigma / fears of the culture there, no one talks about it, they all keep it secret. I am really looking to help myself in this cause after my current scare.
Well, looking forward now to my first nights sleep without pep,
Thanks again... for this and for all the work you guys do on this forum..
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