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Developed oral ulcer and anal fissure. Started medicine for zoster. Qualitative RNA test done. Worrisome

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Practicing since : 2005
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Hi...I went for a haircut on 31/01/2013. After the haircut the barber trimmed my sideburns and neck hair with an electric shaver...Since electric shavers have fixed blades, I asked him whether he had cleaned/sterilized the shaver before using it on me. He replied in the negative and told me that it isn't necessary as it doesn't cut skin (I had no apparent cut or bleeding on my neck/face and did not feel anything as it was over in no time).
Later that evening, I panicked and went for an HIV/HepB/HepC test which was negative (I know it doesnt matter because of the window period).
In a few days, I had forgotten about it but then on day 9 i developed an oral ulcer followed by an anal fissure/ulcer in quick succession. While being treated for the ulcer/s on day 12 I also discovered a weird inflamed spot on my back which was at the time diagnosed as herpes zoster (it was localised and did not spread like zoster usually does). The dermatologist put me on a 5 day course of the indian version of Valtrex (1000mg 3 times a day). I also experienced some nausea/sickly feeling for a few days before and after starting medicine for the zoster.

Since zoster is common in HIV and since i had some sort of an exposure...I went to a local HIV specialist who laughed it off when i told him of my "exposure" but when i mentioned my zoster his face changed and he asked me whether i had any sexual exposure...I said that there was none and that i have been completely monogamous and I havent had ANY sexual encounter (including my wife) for the last 2-3 months. He also checked my mouth and discovered some oral thrush (another sign of immune suppression).
Since the anxiety was killing me, On day 18 I went for a HIV-1 RNA PCR Qualitative test (Cobas Taqman LOD: 20 units) from Metropolis Labs here in Mumbai. The pathologist told me that it was a pooled test and it was conclusive after 15 days. The result was not detected. The HIV doc seems satisfied and does not want me to test again. My family physician thinks i am crazy and told me there was no need to test AT ALL. I must also mention that i have been under tremendous stress for the last 3-4 months (family issues) and i have also been fasting for 3 months (eating once a day - only evenings) which has not gone down well with my body(i have been getting ulcers on/off since november). I continue to experience severe dry mouth as a result of the fasting (even though i have stopped now)

My questions are
1. Is there a realistic chance of catching anything from the exposure i described?
2. Can zoster stay localised and can it be caused by stress/nutritional deficiency? same for oral thrush?
3. Is my Qualitative RNA test conclusive after 18 days of the haircut....and can the active course of Valacyclovir (1000 mg 3 times a day) interfere with the RNA test results??

Pls do reply in detail as i am in tremendous anxiety.


Posted Fri, 15 Mar 2013 in HIV and AIDS
Answered by Dr. Sudarshan 1 hour later
Thanks for writing in.
I would like to agree with your HIV specialist ,as there is no real exposure.Only when there is blood or body fluid exchange ,HIV risk can be considered.As nothing of this sort has happened in your case there is nothing to be worried about.
herpes zoster,oral thrush and oral ulcers are very commonly induced by stress.The fact that herpes is limited to area is against HIV.zoster in HIV is usually extensive ,non healing and disseminated.
RNA PCR is very much dependable test and at 18 days negative test rules out HIV completely.
Valacyclovir cannot interfere with test results anyway.
Your stress is responsible for symptoms rather than anything else.
Hope this calms your mind.
Dr Sudarshan
MD dermatologist
HIV specialist
Above answer was peer-reviewed by
Follow-up: Developed oral ulcer and anal fissure. Started medicine for zoster. Qualitative RNA test done. Worrisome 7 minutes later
Sir in case the shaver squished a few pimples or caused micro-wounds (like most shavers do)...would that change anything???...I would like to reiterate that there was no visible blood on my face neck post the haircut.

Answered by Dr. Sudarshan 7 hours later
hi again,
Even if it made some micro wounds ,it does not make any difference.
It does not constitute any exposure.
Hope this helps.
Above answer was peer-reviewed by
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