here is my story from germany

[efexus]

doc, pls help me.

here is my story from germany:
i am male, 35
i had sex with a girl on 17th dezember, but somehow the condom slipped while having vaginal sex, so i think i had unprotected contact to her vagina at least for 1 or  2 minutes
i dont know her hiv status but she has had many sexual contacts before.
and then i gave oral sex to a prostitute on dez 28th.
she always gives b-j without condoms, and maybe also lt the clients cum into her mouth sometimes. she did it one jear ago with me also.
2 days later i got a bad diarrhea, which lastet for a week with fever symptoms. lost about 4 kg weight
then i went almost crazy and did the following tests listed above:

22 days after risc contact number 1 / 12 days after risc contact number 2 -
pcr rna quantitative for hiv1 (>20copies/ml) negative ( not detectable)
duo test ( antibody/antigen p24) negative

26 days after risc contact number 1 / 16 days after risc contact number 2 -
pcr rna quantitative for hiv1 (>20copies/ml) negative ( not detectable)

40 days after risc contact number 1 / 30 days after risc contact number 2 -
pcr rna quantitative for hiv1 (>20   copies/ml) negative( not detectable)
pcr rna quantitative for hiv2 (>250 copies/ml) negative ( not detectable)
duo test ( antibody/antigen p24) negative

52 days after risc contact number 1 / 42 days after risc contact number 2 -
only antibody rapid test - negative

so doctor, please tell me your opinion, do i need further tests?
can i go on living or still be a zombie without taking part of life outside.
my girlfriend will kill me, when i dont change my behaviour and i can not tell her the truth.

kind regards

[efexus]

finally i got my negative antibody rapid test after 12 weeks.
it was a realy hard time and still i have some littel concerns but i am working on them.
the most important thing is to believe in your test results!!!!!!!!!!!!!!!!!!!!!
the rapid test used in germany is the
http://www.biomerieux-diagnostics.com/servlet/srt/bio/clinical-diagnostics/dynPage?doc=CNL_PRD_CPL_G_PRD_CLN_46

so with a good sensivity!!!

thank you doc for your help here, will never forget.

[Edward W Hook, MD]

See response above.  Of course your test result will not change, whether you are tested at 12 weeks or beyond after the expsoure you described.   EWH

[negative101]

The doctor clearly stated that any further tests is a waste of money and time. Why would he change his mind now?
You are negative. No HIV for you, none, done deal, finito.

[efexus]

hello doc again,

i did a antibody rapid test at week 10, which was also negative.
is there a chance of getting positive at the 12 week mark?

kind regards

[Edward W Hook, MD]

As you know, For all practical purposes both of these types of test perform comparably and provide accurate information on the presence or absence of HIV infection in virtually everyone at 8 weeks following exposure.  The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.   Sorry for your experience. EWH

[efexus]

i think finally i can believe that i am negative after performed my 8 weeks 3th generation rapid test at doctors office. this damn german official guidelines are making me sick, they are saying that accurracy of a 8 week ab test is only 90 % . why are they making such guidelines? are they more carefully?

[Edward W Hook, MD]

Your test result is no suprise to me.  Your tests have already proved that you do not have HIV.  Further testing is a waste of time and money.  EWH

[efexus]

yesterday i did another rapid ab test at doctors place, result was negative

[Edward W Hook, MD]

As I've indicated, I suggesst you close the chapter.  That's all for this thread.  Take care.  EWH

[efexus]

so i can definetly can close this chapter? i do not have hiv according to my tests, and also the possibility of pcr quantitative can miss some subtypes of hiv1 is not given , due to the 30 days combo test and also the 6 weeks antibody test, all being negative?

[Edward W Hook, MD]

Teak is not a physician and is, appropriately; quoting figures from reliable sources such as the U.S. CDC.  On the other hand, Dr. Handsfield and I have access to more current infromation.

Teak and his colleagues in the MedHelp Community site provide a tremendous service.  They are incorrect however about having to test out to 3 months.  EWH

[efexus]

thank you very much for your answer.
the only thing i am concerned about i the answers from TEAK, saying that nothinh below 3 month mark is conclusive. i read many of your posts and you and dr.hhh always say there is a very great accuracy for the duo test done at or after 28 days. why is this so?

[Edward W Hook, MD]

Welcome to the Forum.  the exposures you describe are rather low risk for HIV.  Few heterosexual women in Germany have HIV and 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.  thus your exposures were low risk.

Your tests now prove that you did not let HIV from the exposures you describe. While we do not recommend PCR tests for HIV diagnosis, the fact is that a negative PCR at 30 days following exposure, particularly when combined with a negative antibody test is proof that you do not have HIV. there is no need for concern or for further testing.  EWH