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Unprotected oral and protected vaginal sex,acute retroviral syndrome symptoms,HIV-1,HIV-2 all tests negative

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General & Family Physician
Practicing since : 2010
Answered : 126 Questions
Hi Doctor,
Am 33 years old middle eastern male and i had a possible exposure with an african CSW 4 weeks ago, i had unprotected oral and protected vaginal but my condom failed and i pulled out immediatly within 2 seconds or so
I started to develop ARS symptoms at day 10, and i mean all of them me and my regular partner simultanously.
I have done HIV-1 RNA on day 12 - Negative
HIV-1&2 DNA-PCR (By SRL Mumbai) on day 15 - Negative
HIV-1&2 ab / P24 ag on day 27 - Negative
HIV-1&2 DNA-PCR (By SRL Mumbai) on day 28 - Negative
But am still have those symptoms.
Am more confident am clear of HIV-1 but what do u suggest to rule out HIV-2? is DNA test by SRL is reliable and accurate and trusted in India?, not as a stand alone but with the other combination of tests i have done
Posted Sun, 6 May 2012 in HIV and AIDS
Answered by Dr. Tulasi Raman.P 1 hour later
Hi Hussun,

Thanks for your query.

From the test reports it is most likely that you are free from HIV 1 & 2 infection. Yes, SRL Mumbai reports can be trusted because they have a good reputation for their procedures and reliable reports till date.

Now coming to the part about you and your regular partner developing ARS is not related to HIV. Because for you to transmit HIV to regular partner you should be HIV positive which i consider you are not.

Even if we consider the possibility that you might have might have contracted HIV from an African CSW it is definitely not possible for to infect your regular partner with HIV in such a short duration. Because HIV virus needs time to enter and multiply in your body to reach a certain concentration and only then it can be transmitted to others.

So you and your partner's ARS symptoms are no way related to HIV infection.

If you are in doubt you can wait for three months after which you can get HIV test by Western Blot method done. But this is not necessary though.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.
Above answer was peer-reviewed by
Follow-up: Unprotected oral and protected vaginal sex,acute retroviral syndrome symptoms,HIV-1,HIV-2 all tests negative 5 hours later

Thank you for your answer on the reliability of my DNA tests part.

Actually my Dr. following my case concurr with you that its very unlikely i would be HIV+, but for confirmation he is following the British guildlines which consider a DUO on 28 days as conclusive unless the patient suffer ARS symptoms which in that case he suggests to perform another DUO on 6 weeks for which the result will be conclusive.

I suggested to him the WB, but he said it should not be used unless I have a positive Elisa or DUO, as it is a confirmty test not a stand alone, he told me alot of his patients got intermediate WB or even positive when their Elisa at 1,2, 3 & 6 months was negative.

One last question though, what other viral STDs i should check for if my symptoms were not caused by HIV?

Answered by Dr. Tulasi Raman.P 9 hours later
Hi Hussun,

Thanks for getting back to me.

If your doctors feels to repeat DUO on 6 weeks by all means do get it done. But I believe the results will definitely be negative.

Your doctor is right in telling that Western Blot should be done only when you have a positive Elisa or DUO. Because Western Blot doesn't have a higher positive predictive value. It is mainly used to rule out HIV (Negative predictive value). So Western Blot should always be interpreted in light of Elisa or Duo test.

Other common STD's are:
1. Chlamydia
2. Genital herpes
3. Genital warts
4. Gonorrhea
5. Hepatitis A, hepatitis B, hepatitis C
6. Syphilis

These are not very serious disease and also they can be treated.

But if you insist you can do the test for Hepatitis B and Syphilis. For other diseases no specific test is required.

Wish you Good Health and Take Care.
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