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Protected sex, sore throat, VDRL, HIV TRI DOT test, ELISA, antibiotics

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General & Family Physician
Practicing since : 2011
Answered : 243 Questions
Dear Doctor,
Hi , This is XXXXXXX from Calcutta,India,I had protected sex with a sex worker about 26 days back .I was recipient of oral sex from her and i kissed her for 2 times. couple of weeks after that i had a sore throat for which i had taken antibiotics . On 20th day , I went for the VDRL test along with the HIV TRI DOT test. Both came as negative .On 26th Day again i went for the VDRL testing along with the ELISA test using 4th generation p24 antigen and antibody testing which again has come up as negative.
I have lost nearly 1.5 kg in the last 27 days and i have become paranoid by thinking only what would happen if I have got infected .
Now please help me understanding the relevance of ELISA test using the 4th generation p24antigen and antibody testing kit .
Looking forward for your kind response in this regards at the earliest please .

Thanking you...
yours sincerely , XXXXXXX

Posted Sat, 5 May 2012 in HIV and AIDS
Answered by Dr. Sapan J. Pandya 1 hour later

You are well-informed enough to have protected sex with a commercial sex worker. Oral sex by her would not pass on any HIV infection to you if the skin of your penis was unbroken, that if there was no bleeding from your penis. Same goes for kiss. A kiss will not pass on HIV infection to you.

As far as I understand you have repeated sore throat in your medical history. So do not link this sore throat with your sexual act.

I also believe that you are having a lot of apprehension and suffering from guilty conscience for that sexual act.

The TriDot test is an antibody test, which tests your blood to see if your immune system has developed antibodies to fight HIV-1 or HIV-2, which indicates probable HIV infection. TriDot test was found to have a sensitivity of at least 99.48% and specificity of at least 99.7%.
The TriDot test is considered somewhat outdated when newer methods are available.
The fourth generation HIV screening assays are the latest advances in HIV serological testing because of their ability to simultaneously detect HIV antibody and HIV-1 p24 antigen. Developed to detect both acute and latent infections in a time- and cost-efficient way, most of such fourth generation diagnostic assays (e.g. ELISAs) are highly sensitive and specific. The HIV infection can be detected from 16th day itself. When it is coming negative on 26th day, I believe that you should not worry at all. Its efficacy is the highest among all the tests.
P24 antigen tests is effective during the infectious window period (when an infected person can transmit the virus, but have not yet developed detectable levels of antibodies in blood). So it is effective in very early period. Checking of HIV antibody by the same test checks later stage when the antibodies develop against HIV Infection in body.

Hope I allayed your anxiety.
Above answer was peer-reviewed by
Follow-up: Protected sex, sore throat, VDRL, HIV TRI DOT test, ELISA, antibiotics 33 hours later
Dear Doctor,

Thank you so much for your assurance .

I have still some doubts in my mind and below are reasons for which my thought process is getting diluted again and again.Even though this time the test result has come as negative , i have a strong feeling that it would come as positive next time.

Today I went for Blood checkup and below mentioned are the figures :

WBC - 7400 per cumm
RBC - 5.34
HgB - 15.1
HCT - 47.1
MCV - 88.2
MCH - 28.3
MCHC - 32.1
RDW - 14.3
Platelets - 0000 per cumm
Neutrophil - 79 %
Lymphocyte - 17%
Monocyte - 03%
Eosinophil - 01%
Basophil - 00
E.S.R(Westerngen Method 1st Hr reading) - 10

In the month of Feb'2011 , i had undergone the same test and there the lymphocyte count was 27% and neutrophil count was 66%.E.S.R was 7 .

Hence my question is that , as the counts have changed , is it because of a probable HIV infection ?

Moreover I have lost nearly 2.5 kg in the last 27 days allthough i am feeling hungry at regular intervals.

Should i opt for a PCR test now..will this test help in detecting the antibodies at this stage.
I shall be highly obliged if you can kindly respond against the above mentioned queries please.

Thanking you in anticipation
yours sincerely , XXXXXXX .
Answered by Dr. Sapan J. Pandya 1 hour later
Welcome back XXXXXXX

No, the rise of NEUTROPHILS is suggestive of Bacterial Infection rather than HIV Infection.

Your 2.5 kg weight loss may be because of your anxiety rather than HIV infection.

The accuracy of detection of HIV RNA by PCR, is widely accepted "gold standards". To totally remove all your apprehensions, you may undergo the test.

Wish you good health.
Above answer was peer-reviewed by
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