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Have Chronic Kidney Disease. On Allopurinol. Will It Take Longer To Show In HIV Test?
Question: I have Stage 4 Chronic Kidney Disease. My GFR varies between 21 to 24. I am also on allopurinol which was recently reduced to 100mg but for a long time I've been taking 300mg. I know that allopurinol dampens the immune system. Am I immune compromised so that it will take longer for antibodies to show in an HIV test? I understand that 3 months is long enough for "normal" people - but how about someone in my kidney/allopurinol situation?
Hi and thank you so much for posting.
I am sorry to hear about your battle with CKD.
CKD and allopuronol consumption compromises the immune system. This will take longer for the body to be able to mount an immune response to any infection including HIV. About your worries, I suppose you were maybe exposed and wish to find out whether you were infected with the virus or not. If it is rather for informational purposes, please disregard the above assumption.
There are two ways of testing individuals for the presence of HIV infection. The simplest and most common one relies on the presence of antibodies in the system and this is closely linked to the immune response of the individual. In immune depressed individuals it may take longer but I think within 3months there will be an appropriate level of antibodies to tell whether this test is positive or not unless otherwise.
The other one(PCR) does not depend on the immune response and the presence of antibodies. It looks for viral particles directly. And if you are concerned with the above method, then this one will provide definite answers to you. It is more expensive and cannot be done everywhere but the advantage is that you will get results very fast and may not have to wit for up to 3months before being sure of your HIV status.
So because of this concern, doing a PCR is the best way forward supposed you have it in your milieu. However, if it is impossible, then I think the rapid one that depends on antibodies would be reasonable and the results will not be too different fro findings in the general population.
I have reviewed your laboratory findings and they are very well explained. I have nothing to add to at this time unless you do request for additional information o something specific.
I hope this answers your query fully. Please, feel free to ask me related follow up questions if need be.
Thanks and wish you good health.
Dr. Ditah, MD.
I am sorry to hear about your battle with CKD.
CKD and allopuronol consumption compromises the immune system. This will take longer for the body to be able to mount an immune response to any infection including HIV. About your worries, I suppose you were maybe exposed and wish to find out whether you were infected with the virus or not. If it is rather for informational purposes, please disregard the above assumption.
There are two ways of testing individuals for the presence of HIV infection. The simplest and most common one relies on the presence of antibodies in the system and this is closely linked to the immune response of the individual. In immune depressed individuals it may take longer but I think within 3months there will be an appropriate level of antibodies to tell whether this test is positive or not unless otherwise.
The other one(PCR) does not depend on the immune response and the presence of antibodies. It looks for viral particles directly. And if you are concerned with the above method, then this one will provide definite answers to you. It is more expensive and cannot be done everywhere but the advantage is that you will get results very fast and may not have to wit for up to 3months before being sure of your HIV status.
So because of this concern, doing a PCR is the best way forward supposed you have it in your milieu. However, if it is impossible, then I think the rapid one that depends on antibodies would be reasonable and the results will not be too different fro findings in the general population.
I have reviewed your laboratory findings and they are very well explained. I have nothing to add to at this time unless you do request for additional information o something specific.
I hope this answers your query fully. Please, feel free to ask me related follow up questions if need be.
Thanks and wish you good health.
Dr. Ditah, MD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer. I am concerned because 1 hour before meeting with a woman, I shaved my testicles and the sides of the penis where the testicles XXXXXXX the penis. I used shampoo which i use on my hair. Afterwards I place some skin lotion on the shaved area.She and I began by her performing oral sex on me including sucking my testicles. I gave her anal sex wearing a condom but di not ejaculate. I pulled out and noticed some of the lube mixed with feces and I guess anal secretions on the part of my shaved pubic area not covered by the condom. She then had me remove that condom and replace it with a new one for vaginal sex. Again, when I pulled out I noticed her vaginal fluids on my shaved pubic areas. I need a doctor's comment! Some people say that because no blood was visible on the shaved area I had no risk because there were no visible cuts for the fluids to get into. Some say that the razor made microscopic cuts that the fluid can get into even though there was no blood. Some say that the skin started making a translucent layer quickly after it was shaved. Some say that the body lotion prevented that. Some others say that when she performed oral sex on me she licked off the lotion and opened the shaved area - even if only microscopically. If there were no visible cuts and no blood coming from any - even microscopic - do I have a risk? Her status is unknown and I lost track of her.
Thanks for this follow up.
I understand how troubling this is and for sure we all get this anxiety in similar situations.
From this information. there was exposure and whenever there is exposure, no matter how minimal the risk of transmission is, it is never zero. Please, consider getting tested and being more careful next time about ensuring proper and total protection.
Your risk is clearly very very minimal but I will not also call it zero. so, do a follow up with your doctor to get to know your status.
I wish you well and best of health.
Dr. Ditah, MD.
I understand how troubling this is and for sure we all get this anxiety in similar situations.
From this information. there was exposure and whenever there is exposure, no matter how minimal the risk of transmission is, it is never zero. Please, consider getting tested and being more careful next time about ensuring proper and total protection.
Your risk is clearly very very minimal but I will not also call it zero. so, do a follow up with your doctor to get to know your status.
I wish you well and best of health.
Dr. Ditah, MD.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Could you clarify the chance that by 1 hour after shaving my testicles and side areas, the skin had or had not already started forming a protective layer? In addition, can HIV get into hair follicles that have been shaved? I looked at a skin diagram and it looks like the hair follicles are separated from the blood vessels. So, if there was no blood, and it was shaved an hour prior, is there a way for any assumed hiv to wiggle or move from the shaved hair follicles to any blood vessel?
Hi and thanks for this follow up.
please, there are no well conducted studies which talk of a protective layer forming and protecting against HIV. Also, even in people who have not shaved, once they are exposed they are at risk and so we cannot run to talking about this to suggest that infection could not have taken place.
These are all hypotheses and I will not comment on it now because there is no well controlled scientific findings.
please, I understand your anxiety but the only answer to whether you were contaminated or not depends on the outcome of your tests. As i mentioned earlier, your risk is very very minimal but not zero. Just stay relaxed and tell yourself unless you are extremely unlucky the chances of having an infection from this encounter are very unlikely.
Hope it helps.
Dr. Ditah, MD
please, there are no well conducted studies which talk of a protective layer forming and protecting against HIV. Also, even in people who have not shaved, once they are exposed they are at risk and so we cannot run to talking about this to suggest that infection could not have taken place.
These are all hypotheses and I will not comment on it now because there is no well controlled scientific findings.
please, I understand your anxiety but the only answer to whether you were contaminated or not depends on the outcome of your tests. As i mentioned earlier, your risk is very very minimal but not zero. Just stay relaxed and tell yourself unless you are extremely unlucky the chances of having an infection from this encounter are very unlikely.
Hope it helps.
Dr. Ditah, MD
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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