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What Does Negative HIV Test Result Post Unprotected Sex Indicate?

Posted on Fri, 24 Oct 2014

Question: hello
I have to start with my sex history; i am male, I went to my home place far away from my work place vacation for 20 days. I have unprotected vaginal sex for 3 days with my fiance and a week after i went to my village i did 1 day unprotected sex with a girl in village,where my head of penis has cut due to rough sex, I forgot that incident and back mt home next day sex with my fience with condom but condom has teared.
I finished my vacation i came back to work and i started think about sex everyday i have met a girl internet and went to her place for 1 day there i have engaged in unrotected oral and protected vaginal sex; After comeback from that incident after 2 days my head of penis have started sore, and itching genital area for 3 days. After9 days after recent exposure i have slight fever, mild pain in testicles, complete dry tongue i thought something i have got from he lady and rushed to urologist where he did complete STD panel including hiv ab, eveything showed up negative. in first after exposure fever(98.4-99.3 f), chills, white tongue, excessive gas, muscle pains, mild liver pain, muscle twitching, hand and leg feet buruning, i can say almost all typical HIV symptoms has been persisted for 3 months, I rush to ID doctor she has tested for HIV PCR RNA quant (not detected, 5 weeeks), hiv ab negative 8 week, generalized lymphnodes has been started after 3 months after exposure which still(i m in 9 month now) persisting continious low grade fever (97.9-99.2f), thrush(oral hairy l) muscle wasting (buttocks, upper chest, hands, legs), shingles around collar bone. I can say all typical symptoms of HIV are persisting still i m in at 9 months;
In this 9 months of i have been to so many hiv and std tests all came back negative
HIV PCR RNA Quant 5,15 weekds not detected (low 20 copies/ml)
HIV ab 2,8,15,18,32,40 weeks negative
all std include hepb,c negative,
ANA, TB blood test negative.
TB skin test positive 10mm, chest x ray normal
CBC with differential normal
CMV IGG psotive, IGM negative
EBV VCA IGG postive, EBNA IGG postive, IGM negative

Can you please help me i have enagaged sex with 3 different partners(2 known hiv negative
(fiance, friend), 1 unknown hiv status) all this happen in 2 months duration and my body low grade fever hurting a lot, muscle lost from all over body, lymph nodes everywhere, on off sore throat

Did i contracted HIv from the above exposure still lab tests showing hiv negative at 9 month duration?

Or did I get tb and showing all these symptoms??

I have checked skin test it came positive 10 mm, and the area has pain for 2 weeks

but Chest x rays were normal
Tb blood tests were also negative

Am I suffering with tb?? or HIV??

Your assistance will be so appreciated.

Answered by Dr. Dr. Kakkar (17 minutes later)

Brief Answer:
HIV is ruled out, Need to be further Investigated

Detailed Answer:
Hello and thanks for writing to us at healthcaremagic

Your HIV test results certainly rule out HIV since the later ones were performed well past the window period of detection(3 months for an antibody based test and 2 weeks for RNA PCR), so there is no chance that you are Falsely Negative. You don't need to repeat it any further.

The significant finding in your investigation list is positive skin test (actually it was hyper reactive) so that strongly suggests that you need to be thoroughly investigated for underlying Tuberculosis.

A word of caution: Always practice safe sex with a condom and preferably sex with a single trustworthy partner

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Kakkar (23 minutes later)

I will promise to you and god, I will not sex with anybody except with my wife;

Can you please guide what should I do now.. How can I investigate my sysmptoms??

I went so skinny, lost buttocks, shoulder muscles

Nails also have (horizontal ridges chronic infection)

Sharp pains also at legs and hands.

Mouth ulcer sides to tongue

Please please help me

Answered by Dr. Dr. Kakkar (7 hours later)

Brief Answer:
Needs to be thoroughly investigated

Detailed Answer:
Hi.

Since your blood counts are normal as mentioned in your query. The next logical step would be to go for FNAC (Fine Needle Aspiration Cytology) from lymph nodes and lymph node biopsy. Though TB needs to be thoroughly investigated but we have to keep other possibilities too.

-What was the blood test for TB performed?
-Is the ESR raised?

I would also want to rule out Secondary Syphilis. Apart from syphilis, I won't keep a possibility of any other STD. Syphilis can present with generalized lymphadenopathy along with mouth ulcers. Fever is also a symptom in secondary syphilis.

Were you tested for VDRL and TPHA? Let me know. VDRL may be falsely negative because of a pro-zone phenonmena. Therefore, you must test for both VDRL as well as TPHA.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Kakkar (12 hours later)

As per i know ID doctor tested for Tspot.Tb (negative) post 5week exposure of sex

i went XXXXXXX there internal dr tested for TB skin test 10 weeks post exposure came postive 8-10mm, and milld elvation and pain for 2 weeks in PPD area.

Also ESR tested for couple of times int this 9 month duration, it always normal.

CBC tested for In january, feb, april, may, aug, sep results follows below

WBC in XXXXXXX 5.8thousand/ul; lymhocytes 1612
WBC in feb 5.8 k/ul; lymhocytes 1600
WBC in april 6.8k/ul; lymhocytes 2100
WBC in may 5.8k/ul; lymhocytes 2105
WBC in aug 5.9k/ul; lymhocytes 1650
WBC in sep5.8k/ul; lymhocytes 2480

chest xray tested for multiple times normal

cmv igg postive; igm negative at 6 month duration
ebv iggVCA postive, igm negative 6 month
ebv igg VCA neg, igm neg, NA igg postive 9 month duration.

i gave lot of blood to lot of tests; whatelse should i do....

after stupid mistake ..wow..i feeling horrible.

Answered by Dr. Dr. Kakkar (10 hours later)

Brief Answer:
Need further investigations

Detailed Answer:
Hi.

I understand your frustration. Please don't feel horrible about it anymore.

These tests are largely normal.

I hope you have already tested for VDRL and TPHA, as I inquired in my previous reply?

Syphilis is the only STD that is to be ruled out because it can present with general symptoms like fever, lymphadenopathy, oral ulcers etc. Any other STD is unlikely. HIV has already been ruled out.

You mentioned that you have generalized lymphadenopathy. If I was the treating doctor, I would have also ordered an FNAC from lymph node and a Lymph node biopsy for histopathology and PCR for TB

If repeated tests for TB reveal nothing then we have to think in other terms like lymphoma.

Regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Kakkar (59 minutes later)

Thanks dr a lot

I m going to see pulmonoligst tomorrow,
Will see what tests he wants to check

Beautiful life has changed to horrible life just with " sex" mistake

Been 10 months lost my valuable life time realations

Answered by Dr. Dr. Kakkar (4 hours later)

Brief Answer:
Keep us informed

Detailed Answer:
Hi.

Keep us informed at healthcaremagic about the progress.

Let me know if I can help you any further.

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Kakkar (8 hours later)

I went to pulmuonogist today morning , he looked at my recent last week blood results and also previous 5 month blood result.
Doctor:you looks healthy and good.
Me:I have lymph nodes why
Doctor: i dont feel any may be small.it ok

Doctor: Tested for some breathe test,said you dont have any TB problem; even he didnt recommend any TB tests. and given appointment for novemeber.. this frustrating.

I know this is ridiculous.. i just pray god.. Nobody helping me.

Last week i asked for blood tests and everything came with normal today and WBD is 6.0 k/ul, lymphocytes 2150

HIV PCR RNA quantitative still pending and i beleive they take 10-12 days. i will get in this week.. Lets hope for this result negative (not detected)

Rash is forming around neck shoulder and leaving scars..why this only at necks nd shoulder targeting??

Febrile illness , dry mouth thrush, lymphnodes.........Dr i m tired mentally geeting weak

I pray god and leave rest to god.

Answered by Dr. Dr. Kakkar (9 hours later)

Brief Answer:
Upload photographs

Detailed Answer:
Hi.

Kindly upload a few clear digital photographs of the rash on neck and shoulders.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Kakkar (9 hours later)

attached rash which has formed at neck or just below shoulders,

On/off febrile(feverish) illness hurting me.Also rash is itchy.....

Dr kakkar, Please advise me.

Answered by Dr. Dr. Kakkar (3 hours later)

Brief Answer:
Acne

Detailed Answer:
Hi.

I have reviewed the photographs.

This is actually acne. Apart from face, acne lesions can involve chest, upper back and shoulders as well, as these areas are rich in sebaceous glands. Itching is subjective in individuals although acne is not usually itchy.

If you were in my clinic, I would recommend you use topical benzoyl peroxide 2.5% gel, twice daily. That should dry them up in about 2 weeks

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Kakkar (10 hours later)

My last question: is that rash is due to hiv?? Or some other problem

I see google about hiv symptoms, there rash also listed symptom

Is my rash due to hiv ??

I have tested for hiv pcr RNA quant last week(9 month period) waiting for results and due this week

How months still I keep on testing for hiv??

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
No more testing is required

Detailed Answer:
Hi.

No, this rash is not due to HIV. This is acne which is very common in the general population.

You actually don't need to test anymore for HIV because HIV PCR RNA test result is taken as conclusive after 2 weeks (window period of detection by this method) of a risky sexual encounter and a negative test rules out HIV. You have already got a negative test result for HIV PCR RNA at 5 weeks and then again at 15 weeks, therefore you don't need to repeat it.

Moreover, antibody based testing for HIV is conclusive after 3 months or 12 weeks (window period for this test is 3 months or 12 weeks) and you already been tested negative at 15, 18, 32 and 42 weeks.

Therefore you have been tested negative by both antibody and HIV RNA PCR test, which is more than enough evidence to prove that you are HIV negative.

Therefore, you require no further testing.

Regards

Above answer was peer-reviewed by : Dr. Prasad