Drinking and STD results

[Sung102]

Dear Dr.

I had unprotected event 7 weeks ago.
I got several tests;

HIV PCR DNA test at 29th day after the event: negative
HIV antibody test at 6 weeks after the event: negative
Syphilis RPR test at 6 weeks after the event: negative

I had felt good because I'd gotten all negative results, but I got new concern. Does excessive alcohol comsumption may give false negative results? I heard alcohol may suppress immune system.
I have drunk a lot for many years. Especially, after this event 7 weeks ago, I drank a lot. 3~4 times a week. I drink 6~12 bottles of beer, 1~2 bottles of wine, or a half bottle of whisky per night. Now I try to reduce my alcohol consumption.
If alcohol prohibit the antibody production, what should I do?
I have to take HIV PCR DNA again? I have to take syphilis test again? Please let me know what to do.
Thanks.

[H. Hunter Handsfield, M.D.]

Six weeks is plenty for the RPR.  The other doctor probably was just being conservative and careful.  In any case, simply not developing a sore at a sexually exposed site is strong evidence against syphilis even without testing.

That will end this thread.  Take care and try to move on without worry about all this.

[Sung102]

Some other MD posted this: "The hiv dna test is close to 100% for picking up hiv as early as 6 days and would be positive by 28 days. There is a significant false positive rate. The RPR is another story. It could very well still be negative even if you were infected. It is most sensitive in the middle stages and not very good at picking up early syphilis. You should repeat at 3 months."
Why this doctor say 3 months for syphilis?

[H. Hunter Handsfield, M.D.]

For HIV, see See http://www.medhelp.org/posts/show/1704700

There is no debate about syphilis blood tests.  I have never heard anyone say that testing needs to be delayed until 3 months.

[Sung102]

Thank you very much, doctor.

I am not drinking for more than 2 weeks.
I have simple question. Why do others say  3 month is the right time for get conclusive results for HIV and Syphilis? It is because they are lagged in newly developed test kits?

[H. Hunter Handsfield, M.D.]

You didn't get any of your tests too early.  Syphilis is completely reliable at 6 weeks.  And the combination of your negative HIV PCR at 4 weeks and antibody at 6 weeks is 100% assurance you didn't catch HIV.

Good luck on controlling your alcohol problem, but I didn't tell you not to "drink too much".  I advised you to obtain professional medical care for your alcohol addiction.  I hope you do so; I doubt you'll be able to significantly decrease your drinking on your own.

[Sung102]

Thank you for your kind answer. I will follow your recommendation not to drink too much. Here is my last question. For syphilis, 6 weeks are enough time to get right results? Is it same for HIV antibody? (I know for HIV I got PCR DNA so little bit different story). Thanks again.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

Responding first to the title you selected for your question, before reading anything else:  "Drinking and STD results" sggest you are concerned that alcohol intake -- either being intoxicated or perhaps chronic alcohol abuse -- might affect the reliability of STD testing.  As far as we know, it does not.  You could be stewed to the gills, or have entirely uncontrolled alcoholism:  if you were tested sufficiently long after your last possible exposure, the results are as reliable as in anybody else.

Now I have read the question.  Nothing you write changes my comments above.  Chronic alcohol abuse probably does have effects on some parts of the immune system, especially the ability of white blood cells to phagocytose (eat) some bacteria; and in the level of white blood cells.  However, there is no known effect of any significance on developing antibody, or on the relibility of any diagnostic tests for any infection -- both STDs and others.

So your test results are 100% reliable and you do not need any more testing.  (By the way, the HIV PCR test isn't an antibody test, so even if alcohol could affect antibody testing, it wouldn't influence this result.

Therefore, my response to "Please let me know what to do" is 1) don't worry about HIV, syphilis, or any other STDs for which you had negative test results, regardless of how high risk your exposure(s) may have bee; and 2) seek medical attention for your alcohol abuse.  That would appear to be your most important health problem by far.

Good luck--  HHH, MD