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Dr. Andrew Rynne

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Is 4th generation HIV test done 12 weeks post exposure conclusive?

Answered by
Dr.
Dr. Sanjay Kumar Kanodia

Dermatologist

Practicing since :2002

Answered : 4165 Questions

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Posted on Thu, 22 Sep 2016 in Sexually Transmitted Diseases
Question: Exposure : April 28, 2016 - Unprotected anal receptive sex with positive person (later found out) while I have had grade 3 internal hemorrhoids. I have received prostate massage from massage therapist in previous 2 ocassion.

All the TEXTBOOK ARS symptoms within 2-4 weeks. Please understand that I'm not writing all but I have experienced all of them severely.

Tests:
12 week - HIV 4G Ab/AG -ve,
17 week - 2nd generation HIV-1 antibody test
15 week - cononoscopy is clear (as I'm having loose stool from 1 1/2 months)
15 week - loose stool test is negative (as I'm having loose stool from 1 1/2 months)

The problem is I'm feeling so much tired, fatigued, lethargic after exposure. My gums has been turned white and I feel like I'm going through lipostrophy.

The worst problems are:
1) Loose stool from last 1 1/2 month. Loose means not waterly and not smooth.
2) My gums has been turned white
3) I do have tinnitus problem which started 2 months ago.

I don't see any other reason then HIV 1 or 2 but tests outside of window period are coming as negative... What it could be ?
doctor
Answered by Dr. Sanjay Kumar Kanodia 3 hours later
Brief Answer:
Various suggestions for present condition.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I have gone through your complete query and noted your concern for HIV.

After diligently analyzing the complete details let me reassure you first that your chances of HIV positivity is negligible. The most important proof for the same is fourth generation test dine at 12 weeks.

I quite often counsel your kind cases where one experiences ARS symptoms after the exposure. But on testing the results for hiv cones negative. On long term follow up the results remains positive. In such kind of cases a full assurance for negative status is very much required because patients asks the query of late serconversion possibility.

In all such cases I suggest my patients to get a RNA PCR along with 4th generation antibody test for HIV. RNA PCR detects the viruses so a direct evidence can be elaborated for positive or negative status.

In your case I suggest you the same to get complete assurance. In my opinion these should come negative.

For the part of ARS symptoms : there are innumerable conditions which mimics ARS like presentation. So thinking of only Hiv as sole cause is not justifiable. I understand your part of concern and therefore reassure you that your symptoms are not direct evidence of HIV.

I hope this helps.

With regards,

Dr Sanjay Kanodia
MD Dermatology & Sexually transmitted diseases

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sanjay Kumar Kanodia 6 hours later
Ty for your answer. I've got that done at:

1) 35 days - hiv rna tma Qualitative -ve
2) 57 days - hiv rna qualitative and quantitive -ve

The issue is even i hope that its not hiv but my body does not. I have had fever, rashes as part of ars.

the loose stool is persistent even though stool test and colonoscopy are negative. I feel tired and aches. My gums has been turned almost white as well...

At 18 weeks, is there any tests that you suggest ?
Am i converting it slowly?


doctor
Answered by Dr. Sanjay Kumar Kanodia 5 hours later
Brief Answer:
Condition not related to HIV. Meet a physician.

Detailed Answer:
Hello,

Welcome back and thanks for your further follow up.

As you have already done with RNA PCR which is negative so in my opinion you don't require any further tests.

As per best of my experience and correlating with your test results I reassure you that your body doesn't have HIV infection.

In your kind of situation RNA PCR is the ultimate answer to every question.

There are so many of conditions which actually mimic HIV infection. I suggest you to allay all your fears especially for HIV. Meet a proper physician and get yourself examined for line of management think in conditions other than HIV.

I sob many times counsel your kind of cases where on long term follow up we get simple other infections or in many cases the sole cause comes out to be anxiety state only.

So I reassure you fully and guide you to meet a physician to get yourself examined properly for conditions other than HIV.

With regards,

Dr Sanjay Kanodia
MD Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sanjay Kumar Kanodia 17 hours later
TY Dr.

It was RNA TMA at 35 days and HIV RNA PCR qualitative and quantitative at 57 days.

The thing is I've lost almost all body muscle mass and became skinny after that incident. Something like when you see person who have aids. I feel so much tired, fatigue, lethargy on top of white gums, loose stool, and stomach growling. Rash comes and goes on my body parts which are not itchy at all.

Do you recommend any specific tests that I should get done ?
doctor
Answered by Dr. Sanjay Kumar Kanodia 8 hours later
Brief Answer:
Various suggestions for your concern.

Detailed Answer:
Hello,

Welcome back and thanks for your further follow up.

Comparing your symptoms with ARS : the symptoms of ARS never precedes beyond 3 to weeks of initial appearance. In your case firstly these are not related to ARS and then are prolonged than mutiple weeks.

I suggest you to meet a physician and get proper examination done. In your kind of cases I generally go for complete blood counts and ESR with serum biochemistry for blood sugar, liver function and kidney function tests. C reactive protein tells us the any chronic problem going on in the body. A simple X ray chest and ultrasonography of abdomen could be done simultaneously.

These are the basic of the tests which can indicate some kind of problem present if any. If these are abnormal then we can proceed as per the guiding test.

I can understand your concern for HIV but based on all the results you have enumerated I reassure you that HIV is not the cause for any of your symptoms.

I hope this helps.

With regards,

Dr Sanjay Kanodia
MD Dermatology & Sexually transmitted diseases.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Sanjay Kumar Kanodia 2 hours later
Ty. DR.

I will try to get those tests done too as my GP is out on vacation and it's hard to start from scratch from anyone else. I'll try to get HIV related tests as well.

Overall, all ARS symptoms (Flu like fever, rashes throughout the body, night sweats were few) and once those went away it damaged my immune system so much that now I have:

FAT loss from my entire body
loose stool from last 2 months
fatigue

I think the only thing is I'll just need to wait.

even though colonoscopy and stool tests are very normal.
doctor
Answered by Dr. Sanjay Kumar Kanodia 11 hours later
Brief Answer:
Allay all your fears and relax.

Detailed Answer:
Hello,

Welcome and thanks for posting your further concern.

I quite often see your kind of symptoms related to anxiety states also. Stress related symptoms are so pronounced tha it even mimics so many medical conditions. I have many times observed many a symptoms related to HIV but on long term follow up Hiv was no detected.

So I suggest you to allay all your fears regarding specific to HIV. Let you first go ahead with all the routine investigations and then think of any further thing.

Till that time do not think of anything serious.

My best wishes for your healthy life.

With regards,

Dr Sanjay Kanodia
MD Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Sanjay Kumar Kanodia 14 hours later
One last question,

Which Tests that I can get it done that would give me complete picture of my status on HIV ? This would be at 18 weeks.

I'm thinking to visit Metropolis lab and get the blood work done.
doctor
Answered by Dr. Sanjay Kumar Kanodia 3 hours later
Brief Answer:
ELISA for HIV 1 and 2 is more than enough.

Detailed Answer:
Hello,

Welcome back and thanks for posting your further concern.

Though in general you don't require any test. But even just for your own satisfaction you can go for ELISA for HIV 1 and 2.

This would be more than suffice to rule out rarest of possibility of HIV.

I hope this help.

With regards,

Dr Sanjay Kanodia
MD Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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