Does Ciclopirox affect HIV Window Period

[Jarvi616]

I am a 45yo. Male that engaged in receptive oral sex 11 weeks ago from a male who claim to be HIV negative. During the course of oral sex, I received a lot of ejaculate in my mouth and swallowed a fair amount of semen. I had no noticeable mouth sores or other oral problems at the time. I took a HIV Gen 3 blood test at 6 weeks 5 days post exposure which was negative. I also took an Oraquick swab test at 11 weeks which was negative.
Prior the the potential exposure, I was prescribed a topical nail fungus medication (ClearNails Pro) that is fat soluble and claims to penetrate to the nail bed. This medication contains a drug called ciclopirox which was recently discovered to kill hiv infected cells in vitro. The percentage of ciclopirox is 6 percent.

1. Since my fungal medication is fat soluble and contains ciclopirox, will it enter the blood stream in enough concentration to affect the accuracy of an hiv antibody test?

2. Would the window period be affected by this medications ability to be absorbed throughout the skin and possibly into the bloodstream?

3. Can I feel comfortable with my current antibody test results?


Tom

[Edward W Hook, MD]

Welcome to the forum.  I'll try to help.  While ciclopirox is known to kill HIV in laboratory studies there are no studies regarding its utility in humans.  The drug is widely used however for treatment of a variety of fungal infections (as you did).  There are no studies of how the drug might affect HIV infection in humans however, with a drug this widely used, if it did have a major effect on HIV, I suspect we would have heard about it by now.

The exposure you describe was very, very low risk   Your partner said he was HIV negative and thus probably was (most people tel the truth).  Even if he did have HIV, the risk of infection from performing oral sex on an infected partner is tiny- less than 1 infection per 10,000 exposures and some experts argue that there is no risk at all.

I would be skeptical that cicloprox effects HIV antibody production in any way.  The concept of a "prolonged window" period is a biologically incorrect concept that was a concern early in the HIV epidemic and has been prolonged by the internet misinformation.  The "window" period of HIV is the time it takes for the body to produce antibodies to the virus.  There are no data to suggest that cicloprox interferes in any way with antibody production.  

My advice is to believe your test results.  I see no reason for concern and no reason for further testing.  I hope this comment is helpful to you. EWH

[Edward W Hook, MD]

I'm glad I could help. EWH

[Jarvi616]

Thanks for the information and advice doc. I feel much better that I can move on and not have to worry about this situation anymore. Your information was very helpful.

Tom