Assess My Risk

[needypatient984]

Dear Doctor,
following is the history.
• In last July 2011 I had unprotected sex with on girl I picked up from bar then I went to India and carried out my entire profile test on 29th August 2011 and all comes negative except HBsAg+ and HBeAg-. But doctor told me that there is no reason to worry about this as this could be from birth. Doctor has prescribed all possible tests and assured him self and myself that I don’t have any complication right away.
•Then I went to lots of massage parlor during this 1 year time where hand job was performed by girls on me but no sex activity during this massage parlor visit. Yes I have sucked their nipple and lick their nipple to get pleasure.
•On 23rd May 2012,2nd July and 5th August I had protected sexs with High profile Asian escort. It was protected virginal sex through condom and I believe condom doesn’t break or slipped.  
•My last exposer was on Jan 16th 2013 and it was again protected by condom provided by escort. I have used 3 different condoms for different acts. But used same condom once for oral followed by virginal.
•Now from 3rd week I have fever and when I meet my physician he informed me that its due to bad weather and there is troth infect I have. Body temperature was 101 and now it comes down and in the range of 98.5 to 99.8 in ear.
Now doctor I am going to start my life with my wife again because during this period of one year we were having some differences and we were not physically and mentally attached to each other.so our entire sex and personal life was disturb. But we have decided to start our life again. Because I have one more month to start my life with my wife.
So please assess my risk and let me know if I have to go for some test before I can start my sexual life with my life partner.

[Edward W Hook, MD]

Glad to help.  EWH

[needypatient984]

thanks doctor for you valued and detail reply....in future i will avoide out side relationship.
thanks again

[Edward W Hook, MD]

Thanks for the clarification- I understood your test to be closer to yoru last exposure.  If the test was between 6 and 8 weeks, then you should count on those results as defintive and do not need further testing.  EWH

[needypatient984]

Dear Doctor,

appreciate you reply. i just want to mention the specific date of unprotected sex. it was on 1st July and i carried out test on 29th August 2011. which is near to 8 weeks. doctor suggested the test was hiv speciliest and he prescribe p24 test like that.(sorry i dont remember)

wheter this date given to you will minmize 10% chance.
can i simply start my life with my wife now.
and one more thing that my fever since 7th Feb 2013 is in the range of 98.5 to 99.8 after touching 101.1(medicine taken as per doctor)
pls reply

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  As I understand it, over the past year all of your sexual encounters involving intercourse have been condom protected.  If this is the case, the only unprotected encounter that you mention above was in August 2011 when you were tested for HIV and other STDs about 4 weeks after your last unprotected sexual encounter.  If all of this is correct, then there is no risk that you have acquired HIV over the past year.  However, your HIV test in August of 2011, while able to detect over 90% of recent infections would not have detected all and would have missed about 10% of recent infections.  Thus, while your risk for infection is quite low, if you have not been tested since then, there is a very, very, very small chance that the August test missed an infection.  Personally, I would not worry about this but those are the facts.

There is no risk for HIV from the condom protected sex, receipt of masturbation or breast/nipple sucking that you describe.

Finally, one comment about your hepatitis tests.  If you are correct and your test was HbsAg+, then indeed you may be a chronic carrier of this infection and, if that is the case, you may be able to transmit this infection to others, including your wife.  As the doctor told you in 2011, you may well have had this infection since birth but that does not mean that you cannot transmit the infection to others through sex, nor does it not mean that you might not have problems related to it in the future.  Chronic hepatitis B can cause complications for you later in life.  I suggest that you have your hepatitis tests repeated and if you are still HbsAg+, that you seek the care of a liver specialist who can follow you over time to keep you and your loved ones healthy.  Further discussion of the management to chronic hepatitis B infection is beyond the scope of this Forum so I will not comment further on this topic.

I hope that my comments are helpful to you.  EWH