HIV Risk and Testing

[scraedguy1982]

Hi Doctor,

I am a 27 year male from INDIA and below is my exposure details.

I had a protected sex with an escort in UK around 12 weeks back. It was a brief vaginal intercourse for 1 min. I verified that the condom did not broke after the intercourse however I am not sure which lube she used and whether it was water based or not. 10 weeks passed without incident.

After that in 11th week I developed a low grade fever (99.6), and loss off appetite. So I went into hospital and got a HIV1 & HIV2 Antibodies, Combo Test Includes p24 Antigen (Chemiluminescent Immunoassay) done. The result came out as negative. The fever and loss of appetite got coupled with a chest pain which lasted 1-2 days It freaked me like hell and then I went to the doctor he told me to relax and ordered a RNA PCR. I got my RNA PCR done at around 73 day mark. I got my 2nd AB/AG combo done at 11 week mark. I am negative in RNA PCR and also in the second AB/AG test. Now in 12th week I have developed a sore throat, with sometimes watery stool discharge and the fever is still on going even after 5 days of antibiotics. So on 82nd day I got the 3rd combo AB/AG test done again. The AB/AG test was again negative.

Now I have following questions
1. What was my risk with the protected sex and the usage of unknow lubricant by the CSW assuming it could damage the condom
2. Can ARS come this late almost 11 weeks and whether my symptoms looks like ARS
3. Is the RNA PCR at 73rd day a definite conclusive test. I have heard different opinions about this test even on Med Help forums. Since I am negative in both RNA PCR and AB/AG test at the same time is it possible if I am having HIV infection as both Viral Load and anitbodies are not there.
3. Do I need further testing at 3 months (13 weeks)
4. Is there a chance of 82 days -ve test turning to +ve
5. How accurate is this combo AB/AG test in India
6. If i do get tested at 13 weeks should I get the combo test or I take only the antibody test

[Edward W Hook, MD]

Dr. Handsfield is away so I will provide a single follow-up in the hopes of relieving your concern.  that your sore throat has persisted for a week proves only that you did not have a bacterial sore throat.  On the other hand, it is not at all unusual for a "typical" community acquired sore throat to last more than a week.

Your test results outway ALL symptoms.  You do not have HIV. If your sore throat bothers you, please see your docotr for symptomatic treatment but do not worry about HIV. You do not have it from the exposure you described.  End of discussion.  EWH

[joggen]

We can discuss further in your thread in the community forum, but not here.

Anyway, Dr. HHH is the expert, not me; I suggest that you re-read his reply (including the part about no follow-up questions) and move on.

[scraedguy1982]

Dear Joggen,

Thanks a lot for you comment.

However when you say no need to test in my case are you sure there has been no case of HIV transmission with protected sex at all? or there has been no case of a -ve test turnning +ve after 81 days (for a perfectly healthy person with no chemo or organt transplants)? Thats the reason I asked the question. I know probably I am sounding stupid here. Anyways you guys are the expert here I am just stupid guy who made a mistake and nows prays to god that get me clean this time and I will be loyal to my would be wife for the rest of my life.

[joggen]

"people on medhelp public form say that 12 week test is conclusive"

You're confused. That only applies to people who had UNPROTECTED exposures (i.e. not you). You were told you never needed testing.

[scraedguy1982]

Dear Doctor,

Sorry for botheing you again but I am having a condition that is driving me to the wall. I am having low grade fever and sore throat for the past one week and i am also feeling some pain in my groin area. The fever is low grade but it is continous and not going after 7 days of antibiotics. I am also having fatigue and low appetite.
As you have said I dont need further testig but people on medhelp public form say that 12 week test is conclusive. Please advice me what should I do further as I am getting crazier every second. Anxiety can cause faigue but not such fever. Is this ARS? Am i going to found that I am the one who would be the rare case in history by having protected sex and tetsing negative after 81 days is still HIV positive. I have never been an hypocondriac andI have never been ill in such a fashion. Please advice

[scraedguy1982]

Thanks a lot doctor I just wanted a confirmation from an expert I can sleep well now even with a sore throat :)

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  Because the same questions are among the most common on this forum and have been asked innumerable times, my replies will be brief.

Test results always outweight symptoms as an indicator of HIV infection. Your negative test results prove your symptoms cannot possibly be due to HIV.

1) It doesn't matter how high your risk was.  Whatever the risk, the test results show you were not infected.  But the risk was zero anyway.  (In the UK, less than 1 in 1,000 commercial sex workers has HIV, and you used a condom.)

2) ARS always starts within 2-3 weeks.

3, 4, 6) Zero chance a future test will become positive; you do not need further testing with the combo or any other test.

5) Highly accurate.  There are no inaccurate HIV antibody tests on the market anywhere in the world, including India.

Let's not have any "yes but" or "what if" follow-up questions.  There is no information you can provide that would change my opinion or advice.  If you need more reassruance, use the search link to find many discussions of these questions, or just scan the last couple weeks of threads.

Regards--  HHH, MD