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STDs (Expert Forum)
Are my hiv and herpes tests reliable and accurate?
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Are my hiv and herpes tests reliable and accurate?
by Dr. Negative, Jan 05, 2006 12:00AM
Hi there,
I have a question regarding a situation I placed myself in after far too much alcohol one night. I am currently in South East Asia, and while I was in Singapore I had vaginal sex with a female sex worker of unknown hiv status. She is from Thailand, and insisted she was clean of everything. It was very unprotected vaginal sex, no condom. I have read the statistics of transmission rates, but in SE asia the most common subtype of HIV is E, which is thought to be MUCH more transmissible than subtype B, most common in the USA. I have heard that in fact subtype E transmission risk per episode are 1 in 30 to 1 in 50 , while subtype B is around a risk factor per episode of 1 in 1000. My questions are:
1. Is this true? Does the risk 1 in 1000 per episode chance include subtype E? Or is the 1 in 30 to 50 accurate for subtype E? (assuming one partner is positive)
Now for some better news. This unprotected sex happened 74 days ago. As you can imagine I was COMPLETELy out of my mind with FEAR and ANXIETY the next day...and for the next month continuously. The only time I had peace of mind was for 1.0 seconds immediately after waking up in the morning, until I remembered my state!
On day 2 I went and got tested for everything and was negative for everything. I had a fairly acute sense of 'discomfort' in my penis, continuously, not during urination, but no discharge. I took 2 courses of antibiotics and the sensation went away.
I then (still day 2)started to get some very small, painless, mildly itch red bumps at the base of my shaft and 1 on my penis. These bumps would come one or two at a time, and NOT in clusters. They were so tiny they looked like ingrown hairs, but I have never had ingrown hairs on the base of my penis before. They would last between 1 and 4 days, then go away on their own. This reoccured for around 3 weeks. I went to a dermatologist and he said not herpes or std related, maybe bacterial infection or eczema or nothing at all, just infected hair follicles. He gave me some cream (corticosteroid) and that cleaned that up, not to reoccur yet!
So on day 24 post exposure I went and had a PCR RNA test performed for HIV with a sensitivity of 50 copies/ml. It was NEGATIVE!!! I was very relieved and encouraged there may have been some SLIM chance I may live a full life and not actually have contracted HIV.
Then on day 40 I went and got tested for everything again, blood tests for herpes (simplex 1 and 2) and hiv(elisa for hiv 1 and 2 Ab/Ag), swab for Gonoreah, Chlamidya, and whatever else can be swabbed, Syphillus, etc. Everything was still negative.
I have heard hiv tests are not definative until 3 months post exposure. So, my question is..
2. Do you think my odds are good NOT to have acquired HIV, testing negative by RNA PCR at day 24 and Elisa at day 40(almost 6 weeks)? What are my odds?
3. How about herpes? Can it take longer than 40 days to create antibodies?
Thanks very much in advance!
I have a question regarding a situation I placed myself in after far too much alcohol one night. I am currently in South East Asia, and while I was in Singapore I had vaginal sex with a female sex worker of unknown hiv status. She is from Thailand, and insisted she was clean of everything. It was very unprotected vaginal sex, no condom. I have read the statistics of transmission rates, but in SE asia the most common subtype of HIV is E, which is thought to be MUCH more transmissible than subtype B, most common in the USA. I have heard that in fact subtype E transmission risk per episode are 1 in 30 to 1 in 50 , while subtype B is around a risk factor per episode of 1 in 1000. My questions are:
1. Is this true? Does the risk 1 in 1000 per episode chance include subtype E? Or is the 1 in 30 to 50 accurate for subtype E? (assuming one partner is positive)
Now for some better news. This unprotected sex happened 74 days ago. As you can imagine I was COMPLETELy out of my mind with FEAR and ANXIETY the next day...and for the next month continuously. The only time I had peace of mind was for 1.0 seconds immediately after waking up in the morning, until I remembered my state!
On day 2 I went and got tested for everything and was negative for everything. I had a fairly acute sense of 'discomfort' in my penis, continuously, not during urination, but no discharge. I took 2 courses of antibiotics and the sensation went away.
I then (still day 2)started to get some very small, painless, mildly itch red bumps at the base of my shaft and 1 on my penis. These bumps would come one or two at a time, and NOT in clusters. They were so tiny they looked like ingrown hairs, but I have never had ingrown hairs on the base of my penis before. They would last between 1 and 4 days, then go away on their own. This reoccured for around 3 weeks. I went to a dermatologist and he said not herpes or std related, maybe bacterial infection or eczema or nothing at all, just infected hair follicles. He gave me some cream (corticosteroid) and that cleaned that up, not to reoccur yet!
So on day 24 post exposure I went and had a PCR RNA test performed for HIV with a sensitivity of 50 copies/ml. It was NEGATIVE!!! I was very relieved and encouraged there may have been some SLIM chance I may live a full life and not actually have contracted HIV.
Then on day 40 I went and got tested for everything again, blood tests for herpes (simplex 1 and 2) and hiv(elisa for hiv 1 and 2 Ab/Ag), swab for Gonoreah, Chlamidya, and whatever else can be swabbed, Syphillus, etc. Everything was still negative.
I have heard hiv tests are not definative until 3 months post exposure. So, my question is..
2. Do you think my odds are good NOT to have acquired HIV, testing negative by RNA PCR at day 24 and Elisa at day 40(almost 6 weeks)? What are my odds?
3. How about herpes? Can it take longer than 40 days to create antibodies?
Thanks very much in advance!
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 05, 2006 12:00AM
, Jan 05, 2006 12:00AM
Your test results mean you can be 100% confident you don't have HIV. I would not have recommended PCR testing, as a waste of time and money--but the negative result is quite definitive, as is the negative antibody test at 6 weeks. Your symptoms do not suggest either HIV or herpes (or any other STD). I don't know what is going on with the penile symptoms, but if a dermatologist reassured you nothing important was going on, there is no reason not to believe him.
I can't say anything about relative transmissibility of HIV subtypes; not my area of expertise. But I am quite certain that the average transmission risk of any subtype is nowhere near the high risk numbers you quote. Anyway, the vast majority of Thai women, including commercial sex workers, are not HIV infected.
Most people develop HSV antibodies within 6 weeks, but it can take up to 3 months. However, your negative result at 6 weeks plus lack of symptoms of herpes can be taken as 100% reassurance you don't have it.
Good luck-- HHH, MD
I can't say anything about relative transmissibility of HIV subtypes; not my area of expertise. But I am quite certain that the average transmission risk of any subtype is nowhere near the high risk numbers you quote. Anyway, the vast majority of Thai women, including commercial sex workers, are not HIV infected.
Most people develop HSV antibodies within 6 weeks, but it can take up to 3 months. However, your negative result at 6 weeks plus lack of symptoms of herpes can be taken as 100% reassurance you don't have it.
Good luck-- HHH, MD
When you were gathering the stats on the transmission rates i.e. 1-30 and 1-50, did you happen to see if the transmission rate was also increased for oral sex?
Had these strains also got different 'window' periods?
For the strain to be that much more contagious, I find it hard to believe it is not more widespread.
As for subtype E transmission, I read the info on the web at:
http://www.thailandguru.com/health-hiv.html
"Using mathematical modeling, researchers estimated that the probability of female-to-male HIV-1 transmission per sexual contact was approximately 1 in 30 to 50 contacts; previous estimates for HIV-1 subtype B were estimated at 1 in 500 to 1000 contacts"
Sillybugger2, these transmission rates are for vaginal penile intercourse. Not oral. It has to do with more virus concentrated on the cervix of women. My odds of acquiring HIV are/were FAR greater than yours of oral sex