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Dr. Andrew Rynne

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Is HIV RNA test done 2 weeks post exposure conclusive?

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Dr. Monika Dede

Infectious Diseases Specialist

Practicing since :2003

Answered : 793 Questions

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Posted on Fri, 17 Mar 2017 in HIV and AIDS
Question: Hello Doctor,
I need very important advice on my one night incident on 22 dec 2016 and any chance of acquiring HIV or any other STD.
1- Nude bath with prostitute i kissed her cheeks , sucked her breast and nipples.
2- She pulled my penis skin from her hand and peehole was completely out ( i am uncircumcised).I Removed her hand with in a second and covered the peehole from the outer skin.
3- Naked laying on bed , kissed her neck and cheeks and sucked her breast.
4- During foreplay my penis was not protected with condom and rubbed to her stomach , legs but surely not vagina and later on rubbed very hard on bedsheet and penetrated.I am sure uthera was contacted and touched to her leg , thigh and bedsheet.
5- the girl has white patch on her chest but as i remember i haven't touched or kissed that place( or may be if touched or kissed by mistake then is it any risk)

I had one HIV Elisa 1-2 & Hep test at 14 days - Negative
I had my Pre-Visa and employment medical test done (Covering HIV & Hep B at 51 day - Negative ( Considering UAE , the health authority might be using the latest generation test here)
After my 51 days medical test , I started feeling relaxed and dropped all anxiety but it looks like happiness is not constant in my life.

From yesterday on wards and technically speaking at 8.5 weeks after now I am experiencing very strange and abnormal signs in my body
- Feeling very hot ( all over the body) temp 37.2 to 37.8 XXXXXXX
- Feeling Constant gas in my stomach
- Very Strange neck sensation and mild pain ( feels like lymph node coming & going or like someone pressing my neck from both hands)
- Throat irritations & dryness.
I know HIV window period is 90 days , but first I don't have penetrated sex nor unprotected oral ( except sucking breast) and my test at 7.3 week is negative.
Than whu so much body trouble....Am I still in risk window , Do i need to retest again at 90 days?
If not than why so much strange symptoms , how confidently i should move on in my life.

Please please please suggest for god sake for the last time.
doctor
Answered by Dr. Monika Dede 1 hour later
Brief Answer:
please see below

Detailed Answer:
Hello XXXX! Ι have been through your question.

Regarding your concerns, I think based on your lab data and sexual history without vaginal intercourse (but only kissing cheeks, neck and breast, rubbing bed sheets, contact with her skin and nude bath) there's almost no risk that you're having any HIV-related concerns for the moment.

You should know that if you test negative on an HIV RNA test after two weeks of possibly being exposed, you are very likely HIV-negative.

If you test negative on a 4th generation rapid test or lab assay that detects HIV antigens in addition to antibodies after three or four weeks after possibly being infected as you have done, you are very likely HIV-negative.

And if you test negative on an antibody test taken 3 months or longer after your last possible risk of possible exposure to HIV, you are likely HIV-negative.

Having not vaginal intercourse, and not contact with bleeding and sores but only kissing cheeks, neck and breast, rubbing bed sheets, contact with her skin and nude bath not exist any risk of getting HIV but only some STD (syphilis, herpes or genital warts) but for the moment you have no signs related.

As per your recent symptoms (for only 2 days) I think that this is an acute viral situation (flu or common cold) and no relation with HIV. F this symptoms last more than 4-5 days you should meet a doctor to see for complication.

What I suggest for you, based that your are so anxious and just to remove definitely from your mind this idea, is to do another antibody test after 90 days of exposure (although I am quite sure this will be negative too).

I hope my answer helps you.
I wish you a quick recovery.
Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Monika Dede 20 hours later
Hi XXXXXXX
When i was with Girl , i was completely aware of what I was doing and not ready to have sexual incitement. Just what i have described earlier , but while sucking her breast and kissing my penis was rubbed very hard on bed sheet and towel. No body fluid exchanged at all.
I am really scared to this body heating with temp of 37.5 degree. I heard Mild fever is sign of ARS etc even started getting very low headache as well ( Which is again ARS symptom).
I am very logical person and hence not able to understand the logic that , if m not risk of STD's considering my exposures . Then why I am keep on getting such body discomforts ( which are so close to ARS symptoms).
Pls suggest me with your up-most experience ,
1.Do i need to go for retest( keeping aside of psychological factors)?.
2.Am i safe for my family and can go unprotected with my wife with confidence and consider these body problems are due to anxiety not STD's?
3. Have u every seen 7.5 weeks negative test turn positive ( with no exposure events like mine).
4. Considering the devils view , if she was lactating and hiv positive and i had some milk sucked than would it cause hiv infections to adults.?
5. I am planning for my another child and want to go with confidence to plan for new life.

Please suggest.
doctor
Answered by Dr. Monika Dede 1 hour later
Brief Answer:
follow-up consultation

Detailed Answer:
Hello again! Thanks writing back.

First of all, please let me know, "rubbed very hard" does that mean having some sores there ?

Regarding the new fact (sucked milk) you should know that according to the theory, breast milk can carry the HIV virus. However, the risk is really only present between mother and child, as a baby's immune system is yet to be fully developed and babies also drink plenty of of breast milk for a long time during growth phase.

Lastly, there are protective enzymes in your saliva that protects you, so drinking a few milliliters of breast milk is not a high risk situation because your immune system is fully developed (adults do not depend on breast milk for growth and development).

Yes of course, an ARS could have symptoms like you, but based on your sexual history (and two HIV negative tests after 51 days), I'd insist that they are not related to ARS. Furthermore, it has been emphasized as well that ARS is NOT a chronic condition, and if you are having symptoms week after week, you probably do not have ARS.

According to my logic you shouldn't test again and can go with your wife unprotected but if you don't accept this logic, you should retest for HIV after 90 days and after that only should be planing for another child.

No, in my experience I haven't seen a person that to be negative after 7.5 weeks and become positive afterwards (if during this time, has not exposed to any risky encounter).

I hope my answer helps you.
I wish you a quick recovery.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Monika Dede 1 hour later
Hi doctor,

Just to clarify on ur question.
Rubbed hard means ..... my penis had hard contact with friction to bed sheet and on the leg or thighs of lady ( pee hole may have touched to her legs and thighs ( but 100 sure not even near to vagina).
I have no sores at my penis. So only exposure of uthera contact is with bed sheet , to her leg skin and than penetrated on bed sheet.
The burning sensation in body is like hotflashes ... its coming and remain for sometime and went away during the burning sensation when i am
Checking my temp it has varying in between 37 to 37.6 degree.
Since i have read some much in google about hiv and symptoms in past and now such symptoms are pulling me back and shaking my confidence that i am no risk situvation.
Is all such discomfort are attributed to anxiety.
I had couple of unprotected sex with my wife 6 weeks back and she has cough from last 3-4 weeks.
I am not able to understand if this is becoz of seasonal flu or i put her on risk too.
She is going for her visa medical test next week and hope nothing wrong with her too.
Is dry cough 4-5 weeks is anything related to std's or just a manifestation of flu or viral?
Pls sugges
XXXX
doctor
Answered by Dr. Monika Dede 16 hours later
Brief Answer:
Seems viral

Detailed Answer:
Hello again! Thanks writing me back.

Related your recent symptoms (low grade fever, sore throat) I emphasize again, I think that are related to a viral situation and burning sensation (and other discomfort) due to the anxiety.
Furthermore, please don't worry, there not exist any risk get infected from HIV just rubbing your penis (and pee hole) in the leg or thighs of lady, bed sheet and without any sores at your penis.
Regarding your wife I think she has the cough because of a viral situation as well and not related to HIV or std.
I think is a good thing that she is going to do a medical test, to finally convince you that has any risk get infected by HIV and STD. (please could inform me for the result)
I hope my answer helps you.

I wish you and your wife a quick recovery and happy life.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monika Dede 5 hours later
Hi Doctor,
What does it mean soar at penis? I dont have any soar and i ever noticed any?
Even with soar does just rubbing on body can cause infection? I hope its not possible without mixing body fluids ? Am i right?

Secondly this fever is on and off coming and going, even whenever I feel hot and check the temp and noticed around 37 degree or 37.2 around.
For example at morning today my temp was 36.4 than middle of day it was 37.3 and now at night it was around 36.8.
Does ARS fever sounds like that?coz i heard its very high like between 101-104.
Headache is so mild that its hard to notice even and coming and going as well.
Sorry doctor why i am pushing if and else question, coz my wife pushing me hard to go unprotected and plan for another baby.
I know m not in risk situvation , but want to double sure that i am not treat for anybody else life.
My internal medicine doctor want me to meet psycologist since they beleive its fear of hiv and laughing on me saying just rubing and penetration on bed never causing hiv to anyone and not recommending for test even at 3 months.
But here in healtcaremagic doctors are recommending for 3 month conclusive test.
If my activities are no risk than why recommendation for test?
Just want to understand what i have to address hiv or fear of hiv? But need complete medical insights for next actions. Please suggest doctor
.
doctor
Answered by Dr. Monika Dede 4 hours later
Brief Answer:
Hello again! Thanks writing me back.

Detailed Answer:
Please don't worry.
Of course not, even a sore rubbing on body without contact of body fluids (blood or vaginal discharge) absolutely cannot cause HIV infection.
Body temperature 37-37.2 is not a fever to take in consideration, usually we don't. Usually body temperature could have some little changes during the different part of day from different factors, as you have.This is not a problem.
Furthermore during ARS persons can have either a low-grade fever, a high-grade fever, or no fever at all, varies significantly from person to person but this could be present and in other situation.
In this situation, even I think that not exist absolutely the risk of get infected by HIV, I suggest to do the test after 90 days and as well to see the test result of your wife, in order to convince you that you don't get the HIV infection and to start planing a baby. Please follow the advice of your doctor as well to meet a psychologist.
I hope my answer helps you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Monika Dede 43 hours later
Hi Doctor,

Just last question , i am going to get tested at 90 days marks to kill both medical and psycological standpoints.
At 90 days do i need to go for hiv 1-2 elisa or p24 antigen as well?
Or should i go for hiv PCR RNA test. Which would be the 100% assaurance from all medical standpoint.
Secondly in some cases some sites like CDC and doctors are suggesting 6 months as incubation period?
Is this incubation window is right or wrong or its not updated information?
Can i consider 90 days with hiv 1-2 elisa and P24 test conclusive for my case?
Last point is ARS symptoms attributing at 9 weeks mark time period or its just anxiety which i am experiencing.
The girl which i met in the bar has the white patch or mark on her ribs near neck. No blood though but if by mistake i touched or kissed that point is risk of aquring any std? When i asked her about the mark she said her skin got hurt due to hot air of hair dryer. Dont know if she was right or wrong?
This is my last followup question , pls guide.
doctor
Answered by Dr. Monika Dede 8 hours later
Brief Answer:
Hello again! Thanks writing me back.

Detailed Answer:
Related your concern I think the best test for you is 4 generation test (Ag/Antibody test) test because is more accurate.
Usually PCR RNA HIV Test is not very accurate after 3 months because could be low HIV RNA in this period.
If the test is negative and it has been longer than 3 months since the last time when you may have been exposed to HIV then it means that the test is not seeing antibodies/Ag to HIV and you do not have HIV infection. No further testing is needed.
Repeat testing 3 months following exposure will rule out HIV infection in 99% of cases but 6 months is for PEP therapy, "inability to produce antibodies", organs transplantation.
Related the STD , of course you can take STD from contact skin(like syphilis, moluscum contagious ,HSV) but I think that white patch or marks are not related.
According your recent symptoms I think is just anxiety, don't worry.

I hope this helps address your concerns & that you can find peace and acceptance with your HIV test results and status.

Above answer was peer-reviewed by : Dr. Remy Koshy
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