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Avatar universal

Changes/Odd of hiv

hi all, I'd appreciate if you can read my post and comment.  Four weeks ago I had protected (condom) oral and vaginal sex with a hooker (stupid of me I know I regret it, I've learned my lesson).  During vaginal sex the condom slipped out and I found out almost right away (there might have been some contact) and put on a new condom.  

I'm so stupid for doing this I would not do it if I had a chance to do it over.  Two weeks later I got some stomach cramps and bloating when I eat food.  It is still present sitting now at four weeks.  Also I have ringing in my ears which I usually don't get so I know I have something that is not right with my body.  I don't seem to have any other symptoms.  I checked my temperature today and it is at around 98.8 F.  I have no other diseases and now know how important it is to protect ones body and stop taking risks.

At one week after the initial exposure I took the HIV DNA PCR test along with all of the other STD tests and all were negative.  Now at four weeks (today) I took the HIV DNA PCR test along with the antibody test and I'm waiting for the results.

I'm very scared and I'm dreading it might be HIV, based on my symptoms and what happened is there any change this is something else and not HIV?

Thanks for your time.
17 Responses
Avatar universal
You never had a risk of contracting HIV on withdraw.
Avatar universal
Hello,

What the Doc may tell you is that statistically HIV prevalence in the escort community is low. Statistically your odds are less than 1 in 1,000. Your exposure was brief, so your odds are much better.

Finally your PCR test was negative. It would be a statistical oddity if you had HIV. Relax.
Avatar universal
PCR-DNA test are not approved diagnostic tests.
Avatar universal
"PCR-DNA test are not approved diagnostic tests."

That is what scares me that my one week test being negative is not reassuring, what worries me even more is that the condom came out and I might have had some contact with her, I so stupid by taking this chance.
Avatar universal
There is no tests that you can take that early that would be reliable.
Avatar universal
Im not sure I would completely agree with that, if anything there may be a higher rate of false positives, but false negatives? You can get this test routinely in the UK at health clinics.
Avatar universal
UK uses the same guidelines as the US. Three months is you can obtain a conclusive test result.

Post-test discussion

The need for a repeat HIV test if still within the window period after a specific exposure should be discussed. Although fourth generation tests shorten the time from exposure to seroconversion a repeat test at three months is still recommended to definitively exclude HIV infection.

http://www.bhiva.org/documents/Guidelines/Testing/GlinesHIVTest08.pdf
Avatar universal
Yes, that is true but we are looking at 99% conclusiveness at 8 weeks, 95% at 6 using a standard antibody test. P24 tests are conclusive for negative results in or around 16 days, PCR after 5 days. What we need to look at is the demarcation between false positive results and false negative results. This may have been discussed here before, im just not sure. For instance a p24 test may be 100% conclusive at 16 days for a negative result but may only be 80% conclusive for a positive result, maybe the experts can shed some light on this?

Standard practice at the clinics ive seen in the UK is to offer the HIV Duo at 28 days, the confirmatory test is to catch rare exceptions stemming from people with exceptionally weak immune systems etc.
Avatar universal
P24 tests have never been able to give a conclusive result.
Avatar universal
There are no tests maketed or sold to give a conclusive negative test earlier than 3 months.
Avatar universal
Uses of the p24 Antigen Test

There are several uses, and mis-uses, of the p24 antigen assay. It is important to realize that the p24 antigen test detects soluble p24 antigen, presumably following viral replication, and does not specifically identify live virus. Therefore, a positive antigen test does not confirm that a sample is infectious, and should not be used for that purpose. The only means available to demonstrate that a sample contains infectious virus is by virus isolation and culture. A negative result for antigen does not rule out infection, because the test lacks exquisite sensitivity; i.e., the test should not be used to verify noninfection. Antigen detection signals infection, however, and positive results in seronegative individuals can be an effective, although not cost effective, means to identify early infection.

The p24 antigen test is most useful in detecting antigen in supernatants from cultures that have been inoculated with cells from a patient suspected of being infected (viral culture and isolation). The antigen test is the method of choice for detecting the presence of free antigen in culture, and it is two orders of magnitude more sensitive than the reverse transcriptase assay.(13) The test is most useful for detecting viral antigen in culture fluids because large quantities of antigen are exuded in the supernatant fluid during viral replication.

The antigen test can be performed on fluids other than those of culture and serum. Evidence determined from the testing of cerebrospinal fluid (CSF) indicates that many patients with HIV dementia and encephalopathy have detectable antigen in CSF, most likely due to active replication of the virus in cerebral tissue.

The p24 antigen test can be of value in blood screening, for identification of acute infection, for monitoring infection, andto assist in the diagnosis of infection in the newborn (each is discussed subsequently). It has been used for detecting early infection in rape cases, identification of infection after occupational exposure, and for assisting in the resolution of indeterminate Western blot results. The degree to which p24 antigen assays can detect p24 antigen from all clades of HIV-1, HIV-2, and HIV-1 Group O, however, is unknown.


All DUO/Combo tests are conclusive at 3 months post exposure

Avatar universal
I'm note sure where you were going with that but your copy and paste paragraph does not support your last sentence.

Remember 3 months isnt some kind of magic figure, it was chosen as the safest time in which all normal and exceptional infections can be detected. The bottom line is that most infections will be identified at 4 weeks using a HIV DUO, and 6-8 weeks using a standard antibody test.

Like i said, a DUO at 28 days may not catch the rare exceptions but go a very long way to secure confidence among those who may be anxious. I am sure there are plenty of people that would like to know that they are 99% sure of being HIV negative.  But I guess this discussion has strayed from the original posters question.

We can never be sure that taking a DUO or PCR test within the 3 month default period is conclusive but perhaps we can be 99% confident :)

No doubt I will leave Teak with the last word!


  
Avatar universal
by Emily_MHModerator , May 06, 2010 07:28AM


On MedHelp, we follow the guidelines set by the Centers for Disease Control (CDC), test manufacturers, FDA, and our experts, Drs. HHH and Hook.

For this forum, it is 3 months. Yes, a 6 or 8 week test may be accurate, but it's not conclusive until 3 months. Saying that the 6 or 8 week test is a good indicator is fine, but to be conclusive, testing must happen at 3 months. It is also this forum's position that oral sex by itself does not require testing.

You can quote doctors, but make sure you say that. Doctors are licensed to practice medicine and can say that given the particulars about exposure, timing, etc., that someone doesn't need more testing. However, unless you are a doctor, you can't say that.

Emily
MedHelp
Avatar universal
I finally had the guts to call and get my results at 4 weeks (DNA PCR and antibody test) because I was really afraid it was HIV.  I was told it was negative.  Should I get further testing?  What are my odds at this point?  I feel much better now but I still have some of the symptoms (some stomach cramps/pain and bloating, ringing in ear seems to have gone away) but noticed I'm getting muscle twitching sometimes in different parts of my body and get pain in my forearms and legs.
Avatar universal
Reread the replies you have been given.
Avatar universal
'Standard practice at the clinics ive seen in the UK is to offer the HIV Duo at 28 days, the confirmatory test is to catch rare exceptions stemming from people with exceptionally weak immune systems etc.'

I really really do not understand as I was thinking on doing this test and everywhere it claims that it has 99.8% accuracy.


http://www.better2know.co.uk/page/28-day-hiv-duo-testing

http://www.medhelp.org/posts/HIV-Prevention/HIV-Duo-Test----28-Day-Test/show/255682


but what I understood from your posts here, you cant trust this tests and need to do a diff test after 3 months?

Thanks.
Avatar universal
No that is not correct. A duo test is just not conclusive until 3 months post exposure.
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