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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Exp 50 years

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Do internal hemorrhoids and loose stool post unprotected anal sex suggest HIV infection?

Answered by
Dr.
Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2855 Questions

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Posted on Wed, 7 Sep 2016 in HIV and AIDS
Question: ONLY HIV Specialist please.

Exposure : Unprotected anal receptive sex with positive person (later found out) while I have had grade 3 internal hemorrhoids.

All the TEXTBOOK ARS symptoms. Please understand that I'm not writing all but I have experienced all of them severely.

Last 3 months have been a hell of a journey. Following symptoms still persist: Gums has been turned white, loose stool from 1 1/2 month and so much growling sound in stomach throughout the day. Rashes come and go.

Tests:
6 weeks - 4G Ab/AG -ve, RNA TMA -ve
8 weeks - 4G Ab/AG -ve, PCR RNA qualitative/quantitive
10 weeks - 4G Ab/AG -ve,
12 week - 4G Ab/AG -ve,

I think actual symptoms were between 2-4 weeks , right now I'm just recovering from ARS.

1) Am I converting slowly and will be in 1% who shows up at +ve at 6 MONTHS ?
2) I'll be OO country and while I'm there planning to get NAAT, HIV RNA qualitative and quantitative, viral load , CD4 count and HIV Combo test.
3) Would it be possible to get all above test done in 1-2 days (results can come in later) while I'm in XXXXXXX (lalpathlab or metropolis? Would Dr. prescription required ?
4) What can I do to preserve my immune system ?



doctor
Answered by Dr. S. Murugan 57 minutes later
Brief Answer:
Your symptoms are unlikely to be due to HIV.

Detailed Answer:
Hi,
Welcome to HCM.
All your symptoms can occur to anybody without HIV. They are unlikely to be due to HIV as your tests after 12 weeks were nonreactive for HIV. Persons who are on immuno-suppressive drugs or steroids or ART as PEP only can have a delayed antibody formation up to six months. In that situation also your RNA PCR Qualitative test will reveal the presence of the disease by 1-2 weeks in the presence of an infection and as well as the P24 Antigen part of the HIV 4th generation test even if you were on immunosuppressive drugs. So there is no possibility of HIV with you. Nearly 30-40% of the spouses of HIV positive people remain HIV negative for years together in spite of their regular sex contact. So there is every chance for you also escaped from the HIV risk. Look for some other causes for the loose stools.
Consult your physician. Forget about HIV. No further test for HIV is necessary for you. Most of these tests are being done in labs without doctor's prescription also. These can be done within a single needle prick and you will get the results not later than 5 days. Rich protein and vitamins in the diet will boost your immunity.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. S. Murugan 13 hours later
Thank you doctor for your information. When I got the RNA qualitative and quantitative test done in XXXXXXX while I was there, Dr. took just blood in plastic test tubes and sent it to labs. When I had the test done in Bangkok, they had very professional test tubes and they refrigerated the blood right away for lab to be accurate. So I'm not sure if the test that was done right way or wrong... But What's gone is gone.

I'll definitely consult but I've already had my colonoscopy done and nothing coming out from that and still having loose stool from 1 1/2 Month. My health was never like this in last 20 years... and messed up after this sex act.

1) Can I get all the test done at Metropolis, XXXXXXX without any Dr. prescription ?
2) How accurate those labs are ?

I've read numerous stories about people converting to sero positive status after 3 month specially with high risk situation like mine. I feel like my Body has been changed totally internally, mentally and physically.
doctor
Answered by Dr. S. Murugan 1 hour later
Brief Answer:
HIV tests have to be undertaken by the guidance of an medical expert

Detailed Answer:
Hi,
Welcome back.
Most of the big labs like SRL Ranbaxy, LAL PATH, PATH CARE, VIMTA, Metropolis are reliable and the kits used by them are same or from good manufacturers. So you can have your test from Metropolis lab. But always have the tests through the guidance of an medical expert about what test to do, at what time to do and regarding the interpretations of the results. Discrepancies can occur rarely with all labs. We can not say that this is superior than the other one.
All molecular test are reliable up to the level of 99% or above.
Have you undertaken any motion tests so far regarding your loose motion problem? 3 consecutive test have value with regards to motion tests in the diagnosis of loose motion problem.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. S. Murugan 1 hour later
Regrading loose stool from 1 1/2 month, I had stool test and colonoscopy done and so far those are normal. However, All the symptoms are pointing to ARS.

After exposure, I've had flu-like symptoms with fever, tiredness, rash, night sweats, joint pains, oral ulcer, body fat loss, sores on anus, sore throat, and others as well. These these went away slowly.... leaving my body so much damaged at first place.

Now, From that point, I had GI problems, stomach rumbling sound, loose stool, my gums has turned in white color, I've lost most of the good body fat, I do have severe tinnitus.

Despite negative antibody tests, my body is not feeling good about it and I personally feel that I'm seroconverting slowly.

I know that initially viral load increased drastically then reduces to set point and remains in mostly asymptomatic state for some years. But your CD4 count goes does meanwhile and your immune system looses it's capability to fight infections...

I feel like that's what's happening with me as I sneeze a lot, bruises does not heal quickly, i get all allergies, etc.. all in last 3 months, despite my negative results.

And that's why i was thinking to get all detailed tests including cd4 count, etc....
I forgot to add additional information so adding it. My knowledge says that XXXXXXX has large HIV population.

1) Have you seen anyone's 3 month negative results turn out to be positive by 6 month ? considering they are NOT on the conditions that you mention earlier...

2) Can I simply walk-in to Metroplis and request to get my blood drawn for test ? I exactly know what tests to get as my dr. earlier prescribed those...

3) Would HIV-2 antibody production would be same window period ? as I read it that HIV-2 is slow progressing and may take longer to get detected...

In my recent (1 month ago) CBC following shows up as problems

Lymphs (Absolute) 3.3 HIGH (Normal range 0.7-3.1)
BUN/Creatinine Ratio 20 HIGH (Normal range 8-19)
Alkaline Phosphatase, 118 HIGH (Normal range 39-117)
Urin Specific Gravity <=1.005 ABNORMAL (range 1.005-1.030)
doctor
Answered by Dr. S. Murugan 6 hours later
Brief Answer:
Borderline variations are not considered as abnormal.

Detailed Answer:
Hi,
Welcome back.
Borderline variations of your investigations are not indicating any abnormality. It is acceptable and with some other labs it might even within normal limits or becomes normal within a day or two. Urine specific gravity is within normal limits. Nothing to worry. This sort of variations can occur with anybody. Medicine is not mathematics to have a constant answer.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. S. Murugan 1 hour later
Ty. DR. I also have few earlier posts...can you help me with that?
Do i have hiv based on results?
Do i need more testing?
If i can get complete hiv profile including cd4,viral load, 4th gen ab/ag and rna qualitative and quantative...would that help?
doctor
Answered by Dr. S. Murugan 13 minutes later
Brief Answer:
You are free from HIV 1 and 2 infection. Need no further testing.

Detailed Answer:
Hi,
Welcome back.
Your non reactive HIV RNA PCR,6 weeks and 8 weeks along with a negative 4th generation DUO/COMBO tests ensure that you are free from HIV. All these tests are highly reliable to the extent of more than 99% and put together nonreactive results amounts to 100%. So you need no further testing for HIV.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. S. Murugan 5 hours later
Hi,

Have you seen anyone turning positive after window period of 3 month?

I've tested negative but had "worst flu ever" symptoms...

doctor
Answered by Dr. S. Murugan 38 minutes later
Brief Answer:
I had not come across such an incident so far.

Detailed Answer:
Hi,
Welcome back.
I had not come across any patient became positive after a 12 weeks non reactive HIV test in my practice of HIV medicine since 28 years. Your symptoms of fever could be from the source you had been exposed and prevalent in your area which is not related to HIV.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. S. Murugan 15 minutes later
Ty Dr. CDC had revised the window period to 3 month in recent 10 years. I'm sure that means even in early years ppl were seroconverting within 3 months even though window period was 6 month.

Whats your recommendation for my further test? 100% conclusive based tests or needs more based on symptoms?
doctor
Answered by Dr. S. Murugan 16 minutes later
Brief Answer:
No need for further test for HIV infection for you.

Detailed Answer:
Hi,
Welcome back.
My personal opinion is that you don't need any further test for HIV.
If you want to have one more test after 6 months, then you can take up 4th generation DUO test. That will be most reliable.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. S. Murugan 31 minutes later
Ok. I personally does not WANT to get any test further but do i NEED to? If medical science proves that everyone with infection converts within 3 months then i guess i dont...but i have seen numerous stories online that ppl tested positive after 3 months those who does not have those specific condition..

I'm worried. If i dont need to then i wont. My only fear is that what if i get converted at 5 month and in few years find out that i have aids because i did not get tested at 6 months...
doctor
Answered by Dr. S. Murugan 23 minutes later
Brief Answer:
Window period will not be delayed beyond 12 weeks in normal individuals

Detailed Answer:
Hi,
Welcome back.
Window period for HIV is 6-8 weeks after the exposure, in some individuals it may be delayed up to 12 weeks. Rarely if the individuals are on immunosuppressive drugs like steroids, anti cancer drugs or ART drugs for prophylaxis, then the window period will likely to be extended up to 6 months and never after that. Normal persons will not have the seroconversion after 3 months.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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