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Can Uncomfortable Feeling In Throat And Anal Itching After Unprotected Anal Intercourse Be Indications Of HIV?

Posted on Wed, 8 Jan 2014

Question: Hello doctor I am 23 year old guy and worried about wether I am infected with hiv or not. Below are my details I had a high risk exposure of unprotected anal intercourse with a random guy on 2nd sept 2013. I didnt had any feeling after that but after around 7 weeks I somehow started panicing about hiv infection and I did HIV 1&2 antibody p24 antigen test after 53 days of my exposure which came negative. I was relaxed but around 10 th week after exposure I started feeling fatigued and around 12th week I had uncomfotrable feeling in throat and anal itching. I went to doctor and she told as I am stressed these things are happening and I had bad tonsil. She gave me azithral for tonsil which was cured but still I can feel heavy throat. I repeated the same HIV elisa test at 12th week(86 days after exposure) which was also negative. Again I went to doctor around 13th week for anal itching about which the doctor told is fungal infection which can be due to sweating and moisture in that area. She also told I have few ulcers on the back of tongue and prescribed me regular gargle and antifungal cream to apply around anal opening and told me to joingym for improving immunity. My questions are 1. Can I consider my 7th week and 12th week 4th gen hiv elisa test conclusive? 2. Or I was tested negative because my body was unable to produce antibodies till 12th week as my symptoms started around 11th week. 3. Are these symptoms hiv related? My doctor told not to worry about hiv and as I was very much stressed I think noticing the symptoms she told me this just to alleviate my stress otherwise why did she told me to join gym to improve immunity? 4. I think I have weak immune system beacause this was told to me during my childhood days as I used to fell sick frequently during that time. Can this be the reason that my body didnt produced antibodies till 12th week?? 5. Doctor told that usually ppl get positive result by 12th week if infected but still I am scared seeing my symptoms of throat and fungal anal infection.Should I go for retesting it is going to be 15 weeks now and I am scared of getting this positive seeing my recent symptoms. Am I hiv infected?? Please reply

Answered by Dr. Sankaranantham Murugan (6 hours later)

Brief Answer: HIVfree.Tests confirmed.Symptoms notrelated to HIV Detailed Answer: Hi XXXX, Welcome to XXXXXXX Thanks for posting your query. All the exposures are not necessarily infectious. 30-40% of Spouses of HIV positive individuals remain HIV negative in spite of their regular intercourse for years together, especially before the diagnosis of HIV and they are called as Sero-discordant couple. Similarly you had not been infected with HIV in spite of your unprotected anal exposure (partner would be HIV free or due to less infectious for various reasons). So feel happy about it. 1. Your negative HIV Combo/duo HIV1&2 Antibody and P24 Antigen test done after 53 days of your high risk activity itself clearly ruled out the possibility of HIV in you. Once again it is confirmed with doubly sure by the ELISA test done after 86 days of your exposure. Just forget about that as a nightmare. 2. If you are on certain drugs like steroids or anti-cancer drugs the antibody production might be delayed. Even the P24 Antigen test would not have been affected. 3.Symptoms of throat infection is a common problem for anybody else without HIV. you already had a bad Tonsil. 4.Weak immune system did not delay antibody formation. 5.You need no further testing and get treated for the fungal infection of anus and the throat infection which were not at all related to HIV. You are HIV free and stick to protected exposure in future to avoid unnecessary tension. I hope that my answers would be sufficient to clear your doubts. If you have more queries feel free to ask. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (38 hours later)

Hello Doctor Thank you for your reply, It relieved me a lot. I always try to think that everything is fine and for 1 or 2 day I feel good but then suddenly every time new problem comes and I start getting tensed. 1) My throat problem is still not cured, its more than 10 days. My doctor advised me only gargles and nothing else, she told it will take 10-15 days. In my life before I never had this type of sore throat. I am getting excessive saliva also and few ulcers at the end of the tongue. Again I have started feeling weakness, fatigue and slight pain in joints. These symptoms are killing me thinking of HIV infection. I can feel something is going wrong with my body. If possible can u tell what is all this I am feeling? 2) One more question I would like to ask regarding the 4th generation combo Antibody/P24 antigen tests which I took. I know these tests are reliable but can there be a possibility that when I took the test (7th and 12th week) my body might not have produced detectable amount of antibodies by that time? Might be they are developing now? I know these tests look for p24 antigens also. Does that means if antibodies are not produced, antigens can still be detected irrespective of the delay in production of antibodies? I mean to ask is there any phase in an infected person that neither p24 antigens or antibodies present in the body? Should I do retest? Please reply Thanks in advance

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer: Antibiotics for sore throat. No further test need Detailed Answer: Hi XXXX. Welcome back. Nothing serious as you imagine. 1. As your surgeon advised only gargles and your problem of sore throat is still persisting, you can get an another opinion from another E.N.T. specialist. He will treat your problem in a better way and you will be alright. Weakness, fatigue,joint pain and even the ulcers of tongue are all consequences of an ordinary throat infection and nothing to do with HIV. 2. Drugs can delay the antibody production, but will not mask the identification of the antigen, otherwise particles of HIV virus itself. There is no such stage that both antigen and antibodies are absent except that of the first week of the infection. Retest is not necessary for you and you are HIV free as the p24 antigen test on 53rd day and the ELISA on 86 day are negative for HIV and it is a conclusive one. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (45 hours later)

Thanks again for your reply I went to an ENT specialist today and he told my throat is fine and there is no infection and also told what I am feeling (throat discomfort and salivation) is mainly due to stress. He also asked me the reason of my stress so I had to tell him, he told me to be stress free so that everything would be fine. But he also suggested 6 months retesting for complete surety. Sorry to ask you one more question,but why do some doctors say 3 months conclusive and some others 6 months?? I heard that 1% can get positive at 6 months. Is that true? I am sorry again to trouble you but please answer this. Thanks Also I did my Elisa test in Dr. Lal Pathlabs. I learnt from somewhere that they donot look for particular arm (45 or something.. not sure) of HiV which otherwise is looked by IRT centers by Govt. of India. Is this true? Is there any difference in testing by IRT centers and Dr LalPathlabs?? Is testing at IRT center required by me?

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer: No further test is necessary. You are HIV free. Detailed Answer: Hi, Welcome once again. Follow your ENT surgeon's advice with regards to your throat disturbance. All the doctors can not be expert and experienced in all the fields. Those who handle HIV patients in their day today practice for years together and those who have in touch with latest development in the field only can tell anything authoritatively. With the experience of handling HIV positive individuals for the past 25 years, I can tell boldly that you need no further tests as far as HIV is concerned.Those who are on certain drugs like steroids or cancer drugs or other immuno-suppressible drugs would likely to develop antibodies against HIV in presence of an infection and the test may be delayed to show a positive result up to 6 months and not in normal immuno-competent individuals. ICTC centers are testing with two to three different rapid tests before giving a result to avoid any false positive or false negative test. In other private labs only on request it will be repeated with other test. That is the difference. You need not go to ICTC for further confirmation as almost all the tests are more than 98% specific and when repeated with more than once the specificity is almost 100%. SO THERE IS NOTHING TO WORRY and YOU ARE FREE FROM HIV. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (20 minutes later)

Thank you Doctor I totally respect you and will stick to your advice. Once again thanks for answering all my queries.

Answered by Dr. Sankaranantham Murugan (7 hours later)

Brief Answer: Most welcome. Stick to safe sex in future. Detailed Answer: Hi XXXX, You are most welcome. So far you are safe. But in future try to stick to safe sex. This will save you from STD/HIV and also you need not develop unnecessary tension over the same. If you have more questions, feel free to ask. Have a great day. Dr S.Murugan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar