HIV oriented

Dear Doctor , This is Peter
I had my last sexual exposure in october 2nd 2009.It was protected vaginal sex and 1 week before that i had unprotected anal sex for about less than a minute on the 27th of September 2009.I have the following questions -
1)I have been tested using the CMIA test for detection of p24 antigen and antibodies to HIV 1/2 twice , at 6 months post exposure and again at 6 months 3 week post exposure.The value was non reactive 0.18 and then 0.33.WHAT IS THIS INCREASE IN VALUE INDICATIVE OF ?
2)I also had an immunochromatography test at a different lab both of these labs are the most known in the city i live in.I had an immunochromatography tes at 7 months post exposure , then again at 8 months and 9 months post exposure.All three were non reactive , is this immunochromatography method reliable and conclusive at 8 months post exposure , and do antibodies still get detected this late ?
3)I also had a PCR , proviral DNA test , at 8 months post exposure , it said the minumum limit was 100 copies per ML.Is it possible to have a viral load lower than 100 at 8 months post exposure with no treatment for hiv or medication and with a Negative antibody test or is the viral load higher or lower ?
4)I had my Complete blood count it showed 4,900 leucocytes is this normal value and lymphocyte - 25 % , monocyte - 3 % , neutrophils 66 %.?
5)Is a negative PCR test and negative antibody test , together totally conclusive to eliminate HIV as a concern ?
6)Has is ever happened where somebody tested negative for HIV in the antibody test and PCR test at 8 months post exposure but tested positive later ?
7) I had protected Oral sex twice with two sex workers  I AM MALE AND HAD FELATION WHERE I WAS SUCKED , and their hands might have touched my penis , do i need to test again ?
8) Last question , Does the CBC , leucocyte value change daily because i had my value 8,000 leucocytes 2 months back and then now i have 4,900 , is this normal for it to fluctuate ?

[Edward W Hook, MD]

Peter:

Welcome to our Forum. the time has come for you to stop worrying about HIV.  You report multiple test results out far beyond the time needed to wait for conclusive results and all are negative.  I can tell you that without a doubt, you did not get HIV from the exposures you describe in Sept/Oct 2009.  You do not need to be concerned and do not need further testing.  To address your specific questions:

1.  The change in value represents day-to-day variation in the test baseline and is absolutely not a reason for concern. These values fluctuate in a normal range like this because of insignificant measurement variation in adding reagents, temperature variation, kit to kit variation and many, many other factors.  Do not worry about the variation you have become aware of within the negative range.
2.  Yes, these results are also reliable.   Furthermore, once a person has antibodies, they have them from then onward (they do not go away). This too is a reliable negative test result.
3.  No, PCR is the most sensitive test for HIV virus.  There is no more sensitive test. When persons have HIV their PCR tests should values in the hundreds or, more typically, in the thousands and they remain there throughout the course of infection unless a person is treated for HIV.
4.  Normal
5.  At the time you were tested, yes.  Believe that you do not have HIV, stop worrying.
6.  Not to my knowledge
7.  No need for further testing following receipt of oral sex while wearing a condom
8.  Fluctuation is normal.

Bottom line, you have conclusive evidence you did not get HIV. Believe the tests.  Stop testing, Stop worrying.  And please, no "what if" questions.  You do not have HIV.  EWH

[assafjosef]

Yes , but is oral sex a risk ? and i was the recieving partner being sucked i did not touch her vagina or any body part with my hand or penis apart from her sucking.

[Edward W Hook, MD]

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 gum disease, etc.  Put that together with the fact that is is unlikely that either of your partners had HIV and there really is nothing to worry about.  EWH

[assafjosef]

But is oral sex with condom on considered a risk ?
And does having unprotected vaginal sex with a HIV positive person have a 100 % risk of getting HIV , what is the risk rate for unprotected sex with a hiv positive person ?
Thanks

[Edward W Hook, MD]

Most exposures to infected partners do not lead to infection.  Vaginal intercorse between an infected partner and an uninfected partner leads to infection one in a thousand exposures.  

There is no need for me to repeat my answers regarding oral sex, but there is apparently a need for you to re-read it.  EWH

[assafjosef]

I recently had a test for Epstein Barr virus , i tested positive with strong positive for particular antibodies and weak positive for others.
Does this interfere with HIV test results ?
I have been feeling weak and tired and had one swollen gland on my neck before , this has been on for 3 months now.No fever and no sore throat though.

[Edward W Hook, MD]

No, EBV infection does not interfer with HIV test results but it could, concnevable be part of the reason you are feeling poorly.  EWH

[assafjosef]

Is this something very common  ? , i am 18 years old male. I have been feeling poor for 3 months now.Is it as risky as HIV ?

[Edward W Hook, MD]

EBV is a common cuase of monnueclesis which can linger.  You should discuss this with your doctor. EWH