Help needed.....

[rgrg786]

Hello Doctor,


I am from India and need help regarding possible HIV exposures.


I had protected sex on 5th October 2012 with a CSW. Got tested in 10 weeks (4th generation duo test) with a negative result. I was told this is conclusive and I moved on.


In September 2013 I was involved with a masseur, the encounter involved open mouth light kissing, masturbation (she touched my penis) and nipple sucking. (Her underwear never came off and she or me never touched her Vagina)


In September 2013 my wife got pregnant and was tested for HIV alongside other things. She was tested negative on October 25th 2013 and January 04, 2014. (Elisa tests conducted at 2 different labs)


In March 2014 (6 months after the masseur incident) I was diagnosed with facial Molluscum Contagiosum and was also suffering from fever for around 2 weeks with some weight loss. Out of sheer fear and anxiety, I decided to get tested again. The result came back today and it's negative (4th generation duo test on March 30, 2014).


On April 9th, 2014 I was tested positive for Pleural Effusion (water in lungs) and after the diagnosis of the fluid, my doctor concluded that it is because of tuberculosis which is very prevalent in Indian subcontinent. I have past history of TB (way back in 2001) and unfortunately I wasn't able to complete my medication course due to some unavoidable reasons.


I tested for HIV again on 9th April, 2014 (this time a HIV 1+2, antibodies Elisa test at a different diagnostic center which also runs a blood bank). The results were again negative (this was 6 months and 9 days after the masseur incident)


Extremely stressed, please advice if I need further testing or these tests should be conclusive.

[Edward W Hook, MD]

This is a forth generation test.  The results are conclusive.  You do not have HIV.  

This is my final reply.  Further questions will be deleted without comment.  EWH

[rgrg786]

Dear Doctor,

I am feeling much better now thanks to the TB medicines, my anxiety is also cooling off a bit.

I found out that the last test I took (Elisa) was of 2nd generation. Hence, I took another test & also got my wife tested just to be 100% sure. The results came "Non Reactive".

I have one final question, this appears to be a Rochi Cobas 4th generation combi test which covers all the subtypes. Have there ever been reports of these tests giving wrong or incorrect results in the past due to error of lab technician or the test itself? The lab I am using is best in the city and is accredited with NABL which is the biggest accredition body in India.

I really want to move forward as it has been almost 18 months since my last protected sexual encounter & 7 months since the masseur incident which involved light kissing and masturbation (she masturbated me and her underwear never came off nor she touched her private parts)

I am also scheduled to see a mental health counsellor next week in case my fear persists.

Thanks Doctor.



Test Results Below
_______________________________________


HIV  1 + 2  Ag/Ab Combi Assay   @
(Electro- Chemiluminenscene Immuno Assay "ECLIA")
NON-REACTIVE
HIV-1 p24 Antigen & Antibodies to HIV 1&2 (HIV-1&2 Combi) :


Also available ‎:‎Viral Load ‎(‎Quantitative‎) ‎Real Time ‎(‎RT‎)- ‎PCR FOR HCV‎,‎HBV‎,‎HIV ‎
NOTE ‎:‎ ‎All Positive HIV ‎(‎1‎+‎2‎) ‎Test to be Confirmed by Western Blot Test‎.‎
Also available‎:‎ ‎Flow Cytometry studies for CD‎4 ‎and CD‎8 ‎followup of Positive cases‎.‎


NOTE ‎:‎ * ‎A negative test result does not completely rule out the possibility of an infection with ‎
HIV‎. ‎Serum or plasma samples from the very early ‎(‎pre‎-‎seroconversion‎) ‎phase or the late phase ‎
of HIV infection can occasionally yield negative findings‎.‎
* ‎For diagnostic purposes‎, ‎the result should always be assessed in conjunction with the patients ‎
medical history‎, ‎clinical examination and other findings‎.‎
* ‎In patients receiving therapy with high biotin doses‎. ‎Sample should be taken after at least ‎8 ‎hours ‎
after the last biotin administration‎.‎
* ‎As with all tests containing monoclonal mouse antibodies‎, ‎erroneous findings may be obtained ‎
from samples taken from patients who have been treated with monoclonal mouse antibodies or ‎
have received them for diagnostic purposes‎.‎
* ‎In rare cases‎, ‎interference due to extremely high titers of antibodies to streptavidin can occur‎.‎

[Edward W Hook, MD]

The new information in NO WAY changes my assessment or advice.  Accept that you do not have HIV and deal with your other medical issues. EWH

[rgrg786]

Dear Doctor,

I am currently being treated tor Pleural Effusion (Tuberculosis)

This tuberculosis alongside the Molluscum contagiosum is still giving me a hard time accepting how this occurred to me as I am a healthy person. ( Even though TB is somewhat common here in India and I had a past history of untreated TB)

I have one more additional question about HIV testing. I was in South Africa in September 2011 and had protected sex with 4 CSWs. I got myself  tested after the 3 month mark and the result was negative (Elisa test for HIV 1 +2)

Rest of the points have already been shared with you in chronological order in my previous post. I would request you take a look at them again in conjunction with the new info I provided and provide me your valuable comments on the following points


1) Does this change anything as far my status goes?

2) Can there be any possible rare HIV stain the tests are not able to detect even after 2.7 years?


I know some of the questions might be repetitive for you but your insights will go a long way in helping me.

Thanks doctor.

[Edward W Hook, MD]

Yes, I would urge you to move on with yoru life without further concerns. Take care. EWH

[rgrg786]

Dear Dr. Hook,

Thanks alot for responding to my post.

I have many more questions but I believe all of them are "what ifs" around the incidents I described in detail through my earlier post which hold no relevance if I go by the responses I have read in some of the other threads on this forum.
So I would certainly not waste your time with the same repeatitive stuff.

I would just want a final word of advice from you, Can I now move on with my life without worrying about all this?

Thank you so very much Sir

[Edward W Hook, MD]

Welcome to our Forum.  I agree with the comments made by Teak and Nursegirl.  The testing that you have had absolutely proves that you did not get HIV from the exposures that you have described and there is no further testing needed related to those exposures.  Your plueral effusion is unrelated to your sexual exposures  and should be evaluated through working with your doctor.  You should not be worried that it is related to HIV.  

I see no reason for further HIV testing related to the events you have described.  EWH