need help high risk exposure

[helpme649]

i had unprotected sex with my partner many times (+- 10) without knowing he was hiv+ . we were together for 5 months since october 2007.
i tested negative in dec 2006 and in dec 2007,
we did not have anal sex,
we did have unprotected oral and vaginal sex no eyaculation though,
the last test was 33 days after the last high risk exposure (vaginal unprotected sex)  and was negative , ( axsym abbott MEIA)
i´m so scared, i´m living a nightmare .......
i just want to know what are the odds......'  will i seroconvert in time?
how long should i keep living this nightmare to be safe
how long should i get tested again to be sure
thanks

[helpme649]

thanks for you comments yeah you are right i am overthinking now
i tested negative with duo test at 6,5 weeks (46 days) and im going to trust that
i ll wait for my conclusive test at 12 weeks hoping is going to be negative i ll let you know
my prayers to all

[HSci34]

Stop worrying about that. Once you are infected, your immune cells mount a response. From your question stem, it is apparent you are reading too much into things. Stop thinking about it.

Test at 6 weeks - almost everyone tests positive by then
12 weeks - get a conclusive result with higher risk exposures

That's it. Nothing more. All else is irrelevent.

[regularjoey]

Look, people are either infected or not, and once one is infected his/her body starts to mount an immune response.  There has never been any evidence that smaller inoculum of virus produces slower onset of infection and thus prolongs the window period.  It's a threshold event, not a gradient.  Like HSci told you, stop overanalyzing things, follow the testing protocol and trust the result you get.

[helpme649]

i mean the antibodies will appear at the same time  ????with the elisa test ????????  no matter if it was just 500 copies or 100.000 copies that enter your mucosa barrier at the time of exposure?????  

[HSci34]

No. You need to stop analyzing things. Nothing will affect the appearance of antibodies in your body, except if you area on immunosuppresants (i.e. you are a transplant patient) or you are undergoing chemotherapy, and this has tremendously weakened your immune system.

[Teak]

NO...

[helpme649]

well thanks but i was just wondering that if my ex- partner had a low viral load at the moment of exposure that would have an influence in the time of the appearence of antibodies in my body  (window period)???

[Teak]

His infection has nothing to do with how your body handles HIV and produces antibodies. When you are first infected with HIV your immune system is not damaged, the damage happens later if one is not on HAART.

[HSci34]

That number is very arbitrary.

There is no real difference between antibody levels at 11.5 weeks vs 12 weeks vs 13 weeks. Don't get hung up on technicality - this is science and not politics :P. As long as ~3 months has passed you are in the clear with higher risk exposures. You're not going to magically seroconvert in the last week prior to week 12.

[helpme649]

does anyone know?

[helpme649]

does anyone know if the viral load can influence the window time ???
i mean if the person you had contact with is hiv + and has a low viral load , lets say you got infected (considering the risk)  ,  this low viral load can make your body recognizes the virus slowly making the antibodies appear later in the window period???
is it only your inmune system which determinds this or does it has to do anything the viral load in the time of the appereance of the antibodies ???
sorry if this is  not quiet clear but english is my second language
i hope you can understand

[ECN44120]

The guidelines realy says 3 month (becouse in stadistic a month is count for 90 days) so the window period in weeks is really 12 weeks and 6 days, but is the same if almost no one has seen an 8 week turning positive, is even less posible a 12 week becoming positive in 6 days. to answer helpe question, Drs. here said that they never saw a 6 week negative becoming positive, but if the guidelines says 90 days, that is the guideline so we should follow it.

[alienshadow]

thats your choice not mine
as for my exposure sex with an escort and condom slipped off low risk or not still a risk anyway from all the research i have done 84 days would be sufficient enough to show a positive result this day and time

[LFanswers]

I won't go into a debate about whether 12 or 13 weeks is the really magic point just consider the extremely high risk that people like help649 and I had in regards to HIV exposure: unprotected sex more than once with persons later discovered to be HIV+, were you in such a risk? going by your confidence, you sound like yours was a low risk encounter.

it won't be easy for us to get peace of mind at any week or month. like help649 said, I still can't believe the risk I was put into and that I will very likely get out of this uninfected, it is like you think of the incredibly good luck you had and you instantly want to cry.

As for me,the 2 tests that I have taken were extermely soul and energy draining so I want a VERY conclusive test ( meaning one done past 90 days, 13 weeks ).

[alienshadow]

84 to 90 days is three months if it helps any here i stopped testing at 84 days and i took the uni gold test and got the results in 10 minutes all test before then where the hiv rapid test

[LFanswers]

Hi, thanks for your concern. I decided long ago to wait until I reach the 13 weeks mark. I dont want my mind later annoying me with " 12 weeks isn't 3 months " ideas...

for practical purposes, 12 or 13 weeks is just the same but 95% of the medical world speaks about "3 months", specially the official guidlines of my country. Noone ever speaks in terms of weeks for consluvie results, its always " 3 months". SOME people say 12 or 13 weeks is the same, I'd rather wait and be absolutely,completely conclusive than leave room for doubts.

I am not sure I can be helpful in regards to your last question but a moderator at aidsmeds.com ( apparently a person devoted to all things hiv/aids and that tests people very frequently) says that she still has to witness a 6 week negative turn into positive weeks later after the same last exposure... she claims a 10 week negative test turning into positive is "unheard of".  The docs at this site begin talking about unchanging, reliable ( though not conclusive) results around the 8 week mark ( 98%-99% of people will have turned positive by the 8th week, the docs claim, still they use an estimate of 95% for the 6 week mark. )

this all may sound encouraing but then you go to forums with HIV positive people claiming to have seroconverted as late as 7 months later after exposure. They are most likely spreading BS but one can't help to think " what the **** is going on here, isn't it 3 months?? conclusive "

I suppose there are people who turn positive later, after all I don't think a 3 month window period is there just to mess around with us, people exposed to the virus. We just have to consider that if we are basically healthy there is no reason whatsoever to no be developing antibodies at 6-8 weeks.

[helpme649]

does anyone have any stats on how many people who have had antibody tests at 6-weeks, become positive at a later date?????.

[helpme649]

hi
so how was your 12 week test?
i hope negative
regularjoey is right , the high viral load around 6 months after infection doesn´t mean a rapidly progressing disease it reflects the initial stage and im sure he is asymptomatic
but is highly infectious though ,  pretty soon his inmune system and medications will low the viral load and will be like that for many years just keep going to the infectologist as he has to and take medication as indicated.
best wishes

[regularjoey]

No, it doesn't work like that.  Viral loads are usually very high in the first months after infection - that by itself does not mean that there is rapidly progressing disease.  That's not a reason for additional concern. Regarding treatment - some doctors believe that treatment early after infection has long-term benefits.  There is no hard proof for that and many people still choose to wait until their CD4 T cell count drop to 350.

[LFanswers]

helpme, thanks a lot for the info, I wasn't sure if my partner should trust his doc.. I don't know, just a feeling.

but it seems he is right on his prescription, after all.

one more thing, since you seem to know a lot:

isn't 121000 c/ml a big number for merely 4.5 months of infection? I thought the thing progressed much slower :( ..

[helpme649]

Benefits of delaying therapy include avoiding the negative side effects and toxicities associated with the drugs, delaying selective pressures that induce the development of resistant strains of the virus, and preserving a limited number of treatment options. On the other hand, the risks of delayed therapy include the possibility of irreversible damage to the immune system, development of AIDS-related complications, and death. data from randomized trials are not sufficient to guide the decision regarding when to initiate antiretroviral therapy in asymptomatic persons,  The near-uniform finding that disease progression and mortality are significantly worse among patients whose treatment is delayed until the CD4 cell count is less than 200 per cubic millimeter
Persons who present initially with CD4 cell counts of less than 200 cells per cubic millimeter should be offered treatment as soon as the baseline evaluation and initial counseling regarding drug adherence are completed. Persons with CD4 cell counts of more than 350 per cubic millimeter generally can be observed without therapy, on the basis of data showing similar outcomes with and without therapy among patients with CD4 cell counts in this range; exceptions are patients whose plasma HIV-1 RNA level is more than 100,000 copies per milliliter, since this level is associated with an increased risk of progression to AIDS that is independent of the CD4 cell count. In persons who are being followed without therapy, a rapid decline in the CD4 cell count (i.e., a decline of more than 100 cells per cubic millimeter per year) may also be factored into the decision regarding when to initiate therapy.


i also send you this articles


1- Rates of Disease Progression by Baseline CD4 Cell Count and Viral Load After Initiating Triple-Drug Therapy  
http://jama.ama-assn.org/cgi/content/full/286/20/2568

2-  HIV Viral Load Response to Antiretroviral Therapy According to the Baseline CD4 Cell Count and Viral Load
http://jama.ama-assn.org/cgi/content/full/286/20/2560
best wishes

[helpme649]

viral load and CD4 lymphocyte count are determinants of progression to AIDS and survival, The maintenance of sequential viral load values < 35.000 copies/ml is associated with a lower risk of progression. The maintenance of sequential viral load values < 150,000 copies/ml is associated with higher short-term survival rates.
so it was the right time to initiate medications

[LFanswers]

Teak and Helpme,

I'd really like to have your opinion.

my partner had a viral load test and it said there were 120,000 copies per ml.. I don't know th CD4 number but the doctor said it was o.k. regardless, he prescribed antriretroviral medicine ( combivir+sustiva combo)...

my boyfriend got infected just 6 months ago, was it the right time to start with the medicine?

[helpme649]

well teak is right about treatment,  you dont start medication until your cd4 falls below 400 , early detection for sure gives more hope to the people who are in a situation like me , makes shorter the nightmare, and  more important i think  is prevention interventions to reduce the risk of transmission
thanks to all for your comments it helps a lot
ill keep waiting for next test .....hoping to be negative
sure i want to  yell  wooo hooo now, but i rather be conservative and wait until 12 weeks test to be negative to do so, a change in the results will be devastating for me
my prayers to all