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HIV-2 Question

Hello Doctors and Community,

So this has been a bit of a roller coaster but let me just give the facts.
1. Had unprotected sex on Dec 21 2019
2. Developed a sort of red patch/ulcer which was slightly bloody on the head of my penis with pain in my groin on Dec 23rd.
3. Got blood work done for STDs on Dec 24th which came back with HSV IGM positive at 1.99. HIV was negative. HSV IGG was negative. Redo of bloodwork at a different lab on Dec 25th which gave HSV 1 IGM and HSV 2 IGM both negative. Dec 26th redid the HSV IGM and IGG test at a third lab and that came back positive for HSV IGM at 1.64 but not IGG.
4. The partner I was with also tested and she came out HIV negative but HSV 1 IGG positive. At that point I thought that maybe it was Herpes which was the infection. I started antiviral valacyclovir 500mg morning and evening after this on day 14 for 3 weeks as I thought I got a cold sore in my mouth, but it very well could have just been an ulcer (Not sure).
5. I took an HIV-1 qualitative test and I asked my partner to do the same and we both came back negative.
6. I took another HSV IGG test at 3 months and that came back negative. I also took an HIV Elisa test at 12 weeks and a western blot at 13 weeks which also came back negative.
7. Now the only thing left which can be is HIV-2 which has not been ruled out because I have not been able to do a PCR for HIV-2 due to the Corona virus.

My questions are as follows:

1. Can antiviral interfere with the production of antibodies because the virus was not able to replicate.

2. Is there a delayed seroconversion (>3months for hiv-2) which would explain why my partner's tests were also negative and mine continue to stay negative.

3. My doctor who is an expert on STDs says that HSV IGMs tend to get elevated repeatedly when HIV is present so that is why he is saying my results even at 3 months is not conclusive. Has anyone ever had elevated HSV IGMs before they seroconverted for HIV-2?

Look forward to hearing back from Doctors and the general community.

Thanks,
2 Responses
3191940 tn?1447268717
COMMUNITY LEADER
You don't need any more HIV tests.  Your HIV ELISA and WB tests at 12 and 13 weeks are conclusively negative for both HIV-1 and HIV-2.  There is no need to continue testing for HIV.

The anti-virals you were taking for HSV would not affect your HIV tests.  If you want more information about herpes, you can visit that forum: https://www.medhelp.org/forums/Herpes/show/195

I don't know why your doctor suggested that you keep testing, but his recommendation is out of line with the medical consensus of other HIV experts.
3 Comments
Thank you CurfewX for your response. I guess my Doctor's point is that HSV IGM testing is very non specific and it tends to cross react with other viruses. HIV-2 is also very uncommon in the West but in the East it does come from time to time.  The CDC guidelines are also pretty vague about HIV-2 because it is not common in the U.S.

Just curious are you a Doctor or a Nurse or lay person? Who would be an HIV expert for HIV-2 to ask such a question to directly. Maybe you know of such a person given your vast experience dealing with so many cases.

Thanks again for your time.

Best Regards,
If you ask in the herpes forum, you'll find that IgM testing is almost worthless.  

I have worked in the medical field, but am not a doctor or a nurse.  ALL of the information we give here is based on the advice of experts, which you can find publicly, and on information from trusted resources such as the WHO and CDC.   I am not aware of specific doctors who are taking online questions, who are also HIV experts.  There are some sites that offer doctor answers, but you have to be careful because sometimes you just get ANY doc answering, rather than one who specializes in HIV - and some of their answers aren't right.

You might look for Drs. Hook and Handsfield elsewhere on the internet.
Thank you for your response. I will try to get in touch with them on other platforms. Best,
188761 tn?1584567620
COMMUNITY LEADER
I completely agree with CurfewX. You have no reason whatsoever to speculate HIV 2 infection. No antiviral medication but only antiretroviral-HIV can cause False negative or undetected PCR result.

At 13 weeks, there is no way an antibody test could miss an HIV 2 infection, if you were to be already infected with it. Another great test that signifies the above statement is the Western Blot. There is no need for a PCR. You would rather see a therapist to overcome this fear of HIV, I am saying that out of compassion as I firmly believe that no one is entitled to live with anxiety and depression.

Good luck.
2 Comments
Thanks for your valuable advice. So the Elisa antibody was done on day 81 which was negative
Western blot done on day 92 which was also negative.
I guess the point is can igm come up later say after 90 days or so because western blot only looks at igg where as elisa considers both igg and IGM right?
As stated before at 90 days, your negatives are conclusive. There is no point in microanalysis of tests since your result wont change. It is time for you to move on.
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