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please help, finger wound, csw and symptoms
I'm really stressed out these days by ARS-like symptoms and some blood work results. The "exposure" was with a CSW here in seattle:
- I had a nail injury on the right middle finger. Although there was no visible blood, the wound was NOT healing well. Actually there was definitely inflammation going on and there was a small lump on the side of the nail cuticle with EXPOSED tissues.
I touched her externally on the vagina for ~15 seconds. It was wet. I'm not sure if her vaginal fluid got in touch with my exposed wound, most likely YES because I remember I stopped due to feeling of some touchy pain.
The finger did NOT insert into her vagina.
2. she gave me unprotected oral sex.
7 days post exposure:
- bad fatigue,
- for 4 days, had swollen glands on the neck (mostly left side) AND under the left armpit AT THE SAME TIME. right side unaffected. Swollen glands went away after 4-5 days.
- loss of appetite, light diarhear.
- Felt some swelling and pain in the spleen and liver areas
- NO fever, NO rash and NO soar throat throughout.
The symptoms lasted for 2 weeks. it's still happening now with on-and-off pattern.
Tests:
- 2 weeks post exposure, HIV antibody negative (oralquick advance, tested via finger poke). HIV RNA viral load test negative (undetected/less than 40 copies/ml).
- Monotests neg (hetero antibody), blood count had one red flag:
lymphocyte is low: 16.6% at 3 week post exposure. monocyte is on the high: 12.2%.
1. how risky is the exposure? I've read lots of posts on this forum indicating fingering poses almost no risk, but in my case, there are exposed and inflaming tissues which may have lots of T-cells, would that be concerning? the only mitigating factor was that the touch was brief and my finger did not insert into the vagina.
2 How conclusive are my test results above? I am concerned that some RNA viral load tests don't test for uncommon strains.
3 Is the low lymphocyte count a big concern?
- I had a nail injury on the right middle finger. Although there was no visible blood, the wound was NOT healing well. Actually there was definitely inflammation going on and there was a small lump on the side of the nail cuticle with EXPOSED tissues.
I touched her externally on the vagina for ~15 seconds. It was wet. I'm not sure if her vaginal fluid got in touch with my exposed wound, most likely YES because I remember I stopped due to feeling of some touchy pain.
The finger did NOT insert into her vagina.
2. she gave me unprotected oral sex.
7 days post exposure:
- bad fatigue,
- for 4 days, had swollen glands on the neck (mostly left side) AND under the left armpit AT THE SAME TIME. right side unaffected. Swollen glands went away after 4-5 days.
- loss of appetite, light diarhear.
- Felt some swelling and pain in the spleen and liver areas
- NO fever, NO rash and NO soar throat throughout.
The symptoms lasted for 2 weeks. it's still happening now with on-and-off pattern.
Tests:
- 2 weeks post exposure, HIV antibody negative (oralquick advance, tested via finger poke). HIV RNA viral load test negative (undetected/less than 40 copies/ml).
- Monotests neg (hetero antibody), blood count had one red flag:
lymphocyte is low: 16.6% at 3 week post exposure. monocyte is on the high: 12.2%.
1. how risky is the exposure? I've read lots of posts on this forum indicating fingering poses almost no risk, but in my case, there are exposed and inflaming tissues which may have lots of T-cells, would that be concerning? the only mitigating factor was that the touch was brief and my finger did not insert into the vagina.
2 How conclusive are my test results above? I am concerned that some RNA viral load tests don't test for uncommon strains.
3 Is the low lymphocyte count a big concern?
MEDICAL PROFESSIONAL
Welcome to the forum.
Almost no CSWs in Seattle have HIV; it's very rare. HIV is almost never transmitted by oral sex, and never by fingering. Your symptoms began to soon to be due to HIV; 10 days is the minimum and mostly it's 2 weeks or more. Your symptoms really don't sound like HIV; among other things, almost every case of acute HIV infection has significant fever. Minor variations in lymphocytes and monocytes in your blood count don't mean anything with respect to HIV.
And your negative HIV tests prove virtually 100% that you didn't catch HIV. An antibody test at 2 weeks is too early, but all infected people will have a postive PCR test.
To the specific questions:
1) This was a virtually zero risk exposure for HIV. "Inflamed" tisses of finger etc make no difference.
2) Your results are highly reassuring, expecially with such a low risk exposure. But talk to your health care provider about follow-up testing at 6-8 weeks to be 100% sure.
3) Your lymphocyte count doesn't mean anything one way or the other.
Bottom line: You don't have HIV from this exposure. But see a health care provider (or the Public Health STD Clinic at Harborview) if you remain concerned and follow the advice you get about follow-up testing.
Regards-- HHH, MD
Almost no CSWs in Seattle have HIV; it's very rare. HIV is almost never transmitted by oral sex, and never by fingering. Your symptoms began to soon to be due to HIV; 10 days is the minimum and mostly it's 2 weeks or more. Your symptoms really don't sound like HIV; among other things, almost every case of acute HIV infection has significant fever. Minor variations in lymphocytes and monocytes in your blood count don't mean anything with respect to HIV.
And your negative HIV tests prove virtually 100% that you didn't catch HIV. An antibody test at 2 weeks is too early, but all infected people will have a postive PCR test.
To the specific questions:
1) This was a virtually zero risk exposure for HIV. "Inflamed" tisses of finger etc make no difference.
2) Your results are highly reassuring, expecially with such a low risk exposure. But talk to your health care provider about follow-up testing at 6-8 weeks to be 100% sure.
3) Your lymphocyte count doesn't mean anything one way or the other.
Bottom line: You don't have HIV from this exposure. But see a health care provider (or the Public Health STD Clinic at Harborview) if you remain concerned and follow the advice you get about follow-up testing.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
The symptoms are due to the body's immune reaction to the virus, so it makes sense that antibodies--which are part of the immune response--should be detectable by 7-10 days after onset of symptoms. Certainly by 2 weeks if not always 7-10 days.
The important part of test timing isn't really symptoms, especially when the symptoms don't suggest HIV -- which is certainly the case here. Once you have had a negative antibody test 6 weeks after the exposure, you're home free for sure.
And I stress again that your risk was so low you don't even need testing at all. Every test you do is for psychological reassurance, not because there is an actual risk of HIV.
That will end this thread. I don't need to hear about your negative test results. Take care.
The important part of test timing isn't really symptoms, especially when the symptoms don't suggest HIV -- which is certainly the case here. Once you have had a negative antibody test 6 weeks after the exposure, you're home free for sure.
And I stress again that your risk was so low you don't even need testing at all. Every test you do is for psychological reassurance, not because there is an actual risk of HIV.
That will end this thread. I don't need to hear about your negative test results. Take care.
Dr HHH, thanks again for your reassurance! This will be my final question to this thread, and i'm ready to move on and put this behind me.
Yesterday I took the "oralquick advanced" antibody test via a finger poke, and the result was negative. This is 3.5 week post exposure and 2.5 week after symptom onset.
Is it true that virtually all infected people would be tested positive 1 week to 10 days after symptom onset?
Thanks!
Yesterday I took the "oralquick advanced" antibody test via a finger poke, and the result was negative. This is 3.5 week post exposure and 2.5 week after symptom onset.
Is it true that virtually all infected people would be tested positive 1 week to 10 days after symptom onset?
Thanks!
MEDICAL PROFESSIONAL
I repeat thatyout symptoms do not suggest HIV. In most cases like yours, no cause can be found; I suggest you stop trying.
Thanks for your thanks about the forum. Please try to use your confidence about it to accept my reassurance that HIV isn't an issue here.
Thanks for your thanks about the forum. Please try to use your confidence about it to accept my reassurance that HIV isn't an issue here.
Dr HHH, much much appreciate your fast reply and reassurance! Thank you! I will definitely do the follow-up test at 6-8 weeks post exposure to be conclusive.Actually I've decided to go for an antibody test anyway today which is 3.5 weeks post exposure, and 2.5 weeks after symptoms began. I will keep this post updated.
I do realize given my exposure and the characteristics of my symptoms, odds are strongly in my favor that I do not having HIV. However, two sets of blood works to detect mono and hepatitis infection failed to find any reason for my symptoms (by the way I have not felt this bad in many years). Then I read some posts on thebody.com and one doctor said low lymphocyte count is a characteristics of acute hiv infection, that really freaked me out. Thanks again for the clarifying information.
In the past couple of weeks i've been so anxious and i've spent tons of time reading posts on medhelp and really learned a lot from you and other wonderful doctors/experts posting here. You guys are really doing a wonder here to the general public to help a lay people like me informed and become knowledgeable about HIV transmission and prevention. In contrast, quite a few medical professionals are far less versed in this area, such as my GP. He would take the RNA viral load test result being undetected as a conclusive diagnostic decision and never told me to do an antibody test as a follow-up.
Thanks again for all your wonderful work here.
I do realize given my exposure and the characteristics of my symptoms, odds are strongly in my favor that I do not having HIV. However, two sets of blood works to detect mono and hepatitis infection failed to find any reason for my symptoms (by the way I have not felt this bad in many years). Then I read some posts on thebody.com and one doctor said low lymphocyte count is a characteristics of acute hiv infection, that really freaked me out. Thanks again for the clarifying information.
In the past couple of weeks i've been so anxious and i've spent tons of time reading posts on medhelp and really learned a lot from you and other wonderful doctors/experts posting here. You guys are really doing a wonder here to the general public to help a lay people like me informed and become knowledgeable about HIV transmission and prevention. In contrast, quite a few medical professionals are far less versed in this area, such as my GP. He would take the RNA viral load test result being undetected as a conclusive diagnostic decision and never told me to do an antibody test as a follow-up.
Thanks again for all your wonderful work here.
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