Testing Results and use of Nasonex

[rookiet]

Good Afternoon,
I have tested negative at 1 month, 3 months by rapid and 16 weeks by western blot.  However I am on nasonex and lipitor and wonder if those drugs would effect my results.  Could using those drugs delay antibody detection or development?  I had unprotected oral sex and wonder if I should be tested again.  My HIV specialist said I could continue with testing and I don't know why, if it was for my piece of mind or for some other reason.  I would like to know your thoughts.  Is oral sex low risk?? Should I be tested again?

[Edward W Hook, MD]

Welcome to our Forum.  In preparing to answer your question I note that you have addressed a number of questions to the folks on the HIV Prevention Community site as well.  I hope that my comments below will be helpful to you in reducing your anxiety.

Your exposure was low risk to start with.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

Furthermore, your test results are to be believed.  There is really no need for further testing.  Your 3 month and 16 week results prove that you did not get HIV 16 weeks or more ago.  Nasonex is a nasal steroid medication and while some people worry that taking systemic steroid medication at the time of exposure may delay antibody responses, there is no suggestion that topical steroids such as Nasonex do this.  Similarly, there is no reason to worry that Lipitor (atorvastatin) would hinder antibody response either.  

You CAN certainly continue testing if you wish but more testing will not change the result.  You did not get HIV at your exposure 16+ weeks ago and do not NEED further testing to be confident that you did not get infected.

Hope this comment hlps.  Take care.  EWH

[rookiet]

Dr. Hook,
Thank you for your response again.  I just wanted to give you correct information as I was in error and to ask if that would change your response.  Additionally, all of this is very confusing at times, with differnet perspectives from experts, I get anxious. Some say 3 month window period, some say six month.  Oral is no risk or moderate risk, etc.,etc. I get reassured and feel confident and then It all goes quickly away as I read some more or when I think I have symptoms.  I appreciate your reponse and I hope to use it as a step to move on.
Thnank you.

[Edward W Hook, MD]

You did not need to start a new question - deleted it. I presume that your decision to re-ask this question as a new question is yet another manifestation of your anxiety related to what you have already been told is a no risk situation.  The standard for testing for HIV is to do so with an ELISA based test.  Thus you were tested appropriately.  As I have said before, your test results PROVE that you do not have HIV.  You do NOT need further testing.. You do not need a Western Blot test

One more time, you can and really need to move on.  EWH

[rookiet]

Dr. Hook,
I was mistaken.  I thought my 16 week test was a Western Blot but it was an ELiSA test.  Would that make a difference in your response that I am negative and can move on?
Thank you.

[rookiet]

Dr Hook,
Again thank you for your response.  I don't mean to be the "what if" guy, but because of all the varying information out there regarding window period, testing, risks, onset of symptoms etc., it sets up doubts and second guessing in people including myself.  My concern is for my health and protecting others(loved ones and the public).  The unknown is just scary but your information will help me get a better mind set.
Thanks!!

[Edward W Hook, MD]

Please. let's not play the "what if" game.  This is your OCD acting up.  While there is a theoretical chance that someone receiving cancer chemotherapy might not respond normally in their antibody response to an HIV infection, For all practical purposes, the only persons at risk for delayed response are those who have taken anti-HIV therapy in failed efforts to prevent getting infection.  

At 16 weeks nearly all HIV is asymptomatic and detected only by testing.

You need to move on.  EWH

[rookiet]

Dr. Hook,
Thank you for your response.  This will help move me along with clearing my mind.  Just one final questoin; when you say normal, do you mean someone in good health. I've read that those that take long to detect antibodies have severely compromised immune system on chemo, etc, is that true?  Or event those cases, detection is sooner than six months?  My mind and anxiety is playing with my mental and physical health and at times I think I have symptoms.  Would someone have symptoms after 16 weeks or is that the asymptomatic stage?
Thank you again.

[Edward W Hook, MD]

The idea that it takes any consequential number of normal persons more than 8 weeks to develop antibodies is an outdated belief with no basis in fact which serves only to frighten people for no good reason.  Put this behind you and move on.  EWH

[rookiet]

EWH,
Thank you for your information.  So, negative at 16 weeks is a good/conclusive indicator that I am negative.  I'm just concerned that I could fall in the population that takes 6 months to get a definative result.