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Dr. Andrew Rynne

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Is HIV RNA test report 19 days post exposure indicate?

Answered by
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Dr. Roopa Hiremath

Infectious Diseases Specialist

Practicing since :2002

Answered : 877 Questions

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Posted on Thu, 10 Sep 2015 in General Health
Question:
Hi Doctor,
Here is the timeline for the events:
25 Saturday August - deep open mouth kissing for a minute. And then, for less than a minute the girl performed oral on my penis (it was short and brief).
27 Monday August - I felt burning in my bottom lips inside my mouth. I was not able to eat for next 4 days. My bottom lip was red - felt like cold sores. No medication taken for 4 days.
28 Friday August - I go see a nurse practitioner. She gave me 4 tablets of valacylovir and I felt good after 3 days and cold sore were gone.
On 4 August - on 10th day after exposure, I ordered a Std test. Hiv, hep b/c, hsv2, chlymadia, honored all came back negative. Only hsv1 came positive.
On the 13 August - I ordered a HIV rna test after 19 days of exposure and It came back negative.

I did go see a doctor and she said, it looks like canker sore. It has been 3 weeks and I'm still having cold sores( not sure what is) inside my mouth. Currently, I'm taking 3 tabs of acyclovir a day.
Questions
1. How accurate will be hiv rna test?
2. In beginning, cold sores appeared very red and wet. Not sure are these cold sores or canker sores?
3. What tests would you recommend me again?
4. Any other suggestions?
Can you please me out?
Thanks for your time.
doctor
Answered by Dr. Roopa Hiremath 14 hours later
Brief Answer:
HIV RNA test is relaible in early exposure, Suspicion of canker sores

Detailed Answer:
Hi Mr.XXXX,

Welcome to health care magic.

Apologies for late reply.

I appreciate the detailed query you have sent and I understand your concern regarding authenticity of tests you have undergone and their results.

HIV RNA test is a reliable test done during early exposure.
HIV once enters the body it takes about 4-11 days to reach the blood circulation.

If the person is infected with HIV, blood sample will test positive for HIV RNA after 10 days of exposure.

HIV RNA is an accurate test, and you are definitely negative for HIV.

Coming to your next query,cold sores are caused by herpes simplex virus type 1 which has the unique property of staying dormant in the nerve ganglia in the body and reappear whenever the immunity of the individual goes down.

Treatment is given to prevent reactivation of these sores. These heal within 7-10 days without scarring. If involves the mucous membranes it may take a little longer to heal.

Based on the details mentioned in your query, I am suspecting canker sores.
Unlike cold sores, canker sores don't occur on the surface of lips and they aren't contagious. They can be painful and can make eating and talking difficult.

Minor canker sores heal within two weeks.But large ones need regular rinsing and application of mouth gel to reduce pain and hasten healing.

I suggest Dentogel application over the sores thrice a day.

You can also take vitamin supplements for two weeks.

Few more tips:
1. Avoid spicy foods
2. Follow strict oral hygiene
3. Try to reduce your stress levels by meditation and exercise.

No further testing is required.

I hope I have answered all your queries.

Please get back if any more queries.

Thanks.


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Roopa Hiremath 8 hours later
Thanks doctor for your reply.
I'm still trying to figure out?
1. Started with cold sore on 27 August. Valacylovir 4 tabs worked good on me. Then again, repetitive cold sores? Or canker sores. Not sure what are these?
2. Still not sure, how can there be a transition from cold sores to canker sores?
3. Hiv tests - on 10th day after exposure, I got tested for hiv1/2 antigen/antibody with reflexes, result - negative. Then, on 19th day after exposure got tested for hiv rna - result negative (discussed above). I'm still worried about HIV, why? Because during deep open mouth kissing there is exchange in body fluids. Not sure, should I be worried so much about HIV?
4. Based on my research canker sores occur in people with HIV. Please clarify this for me. This HIV is driving me crazy.
5. As I got tested on 10th day after exposure, results came back negative for hep b, hep c, hsv 2, syphills, chlymadia, gonorrhea. Is there any other possibility I have got another STD from deep open mouth kissing and oral? Only + for hsv 1 - and I do have cold sores (not sure what it is).
6. While going through all this from last 3 weeks. I did see an eye specialist MD because according to her I had pink eye/conjunctivitis. I'm on ofloxacin eye drops and they are working very good from last 1 week. Good eye improvement.

Please help me out doctor. Thanks!
doctor
Answered by Dr. Roopa Hiremath 5 hours later
Brief Answer:
Canker sores not caused by herpes virus,HIV test results reliable

Detailed Answer:
Hi Mr.XXXX,

Welcome back,

I want to explain few points about canker sores to make you understand better.

Canker sores do not occur on the outer surface of lips but inside the mouth.
They are not caused by herpes simplex virus.

They are stress related and commonly occur during very stressful conditions and during vitamin deficiencies.

As I explained in my previous reply, cold sores are caused by herpes and they heal within two weeks.

In your case, you suffered from cold sores which responded well to valacyclovir.

Now you have developed canker sores due to increased stress levels caused by worries about HIV testing and STDs.

I suggest you follow instructions which I gave in my previous answer and your oral sores will heal soon.

You need not worry about your HIV status, you are definitely negative for HIV.

Moreover, the commonest mode of infection for HIV is sexual intercourse.
The semen and the vaginal secretions are rich with HIV particles in HIV infected individuals.

Coming to deep kissing, saliva is not likely vehicle of HIV transmission as the saliva in adult contains non specific inhibitory substances like fibronectin which can prevent cell to cell transfer of virus.

Canker sores do occur in HIV infected individuals due to immunodeficiency.

The net has so much information on HIV and AIDS which can be misleading sometimes for the reader.

I suggest you trust your treating doctor to guide you regarding your HIV test results.

You are negative for STDs and no further testing is required.

Your ophthalmologist has prescribed appropriate eye drops for conjunctivitis and please complete the full course of medication.

I suggest you quit worrying unnecessarily about HIV and STDs.

I hope I have answered your queries satisfactorily.

Please follow tips suggested in my previous reply for canker sores and they will heal within 2 weeks.

Wishing you good health,

Thanks.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Roopa Hiremath 1 hour later
Dr XXXXXXX - Your help and time is highly appreciative. I'm actively considering your advice. Please help me with few more questions:
1. I'm worried about genital hsv2. Why? - because girl performed oral on my penis for about 1 min. So far, no symptoms and it has 22 days after exposure. If she had oral hsv2 - what are the chances of acquiring genital hsv2 from here? Then, as discussed, after deep open mouth kissing with her, I got hsv1 oral symptoms. All of my canker or cold sores are inside my mouth - below tongue, cheeks etc.
2. Does these canker sores/cold sores fall under dermatologist? Or infectious disease doctor or ENT or dentist category?
3. What are the chances of syphills? As I got tested on 10thday after exposure?
4. Right now my acyclovir tabs will be finished in 4 days. Is there any substitute of dentogel?
5. Information about Aids/HIV on Internet - yes, there is lot of information and too much. My concern is - if there is blood present during deep kissing ( bleeding gums, broken inside of cheeks)then it is possible for someone to get infected with HIV? Ami I correct? And further, it would require lots of blood to blood contact between both deep kissing parties, right?

Again, thanks for your time. You are very helpful.

doctor
Answered by Dr. Roopa Hiremath 9 hours later
Brief Answer:
Most unlikely to be HSV 2 infection,syphilis,HIV not transmitted by kissing

Detailed Answer:
Hi Mr.XXXX,

Welcome back,

It is most unlikely for you to get HSV 2 through oral contact.
HSV 2 can be transmitted orally but most common route is sexual intercourse.
The incubation period for HSV 2 is around two weeks, so if you had been infected by HSV 2 you should have developed symptoms by now.

Canker sores can be treated by any GP but if you want a specialist opinion, a dermatologist can be consulted.

Syphilis has an incubation period of 10-50 days, and presents with chancre which is painless, avascular, circumscribed, indurated, superficial ulcer covered with thick exudate. You have no symptoms of syphilis, most unlikely you have acquired it.

You can get a prescription for any mouth gel containing a steroid and anesthetic to reduce pain and also hasten healing of the mouth ulcers.Your dermatologist will be able to help you with an appropriate prescription.

As I have explained earlier information about HIV on net can be very misleading and worrisome.

HIV can enter through ulcers and broken mucous membranes of the mouth but as I had mentioned earlier saliva has inhibitory substances which does not allow the virus to multiply. Most unlikely to get HIV by kissing.

I hope I have cleared all your doubts.

Please get back if any more queries.

Thanks.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Roopa Hiremath 32 hours later
Hi Doctor XXXXXXX
Few more questions. I'm just too much worried.
1. So far, it has been 25 days with cold sore/canker sore etc. There size starts with 2 mm then they go up to over an inch in size. For how many more days sores can go for? I still have them in my mouth. I still have 3 days worth of acyclovir left to take.
2. Oral hygiene - From last 25 days, due to these sores, I have to say that my oral hygiene, exercise, and eating habits have not been good at all, basically nil. So, last night I noticed, my tongue is white in color and have white small bumps on the both sides of my tongue. Can you please tell me what is going on with my tongue?
3. These sores again make me think I have got an STD after that deep open mouth kissing encounter because everything started right after that. Please help me?
4. Dr. XXXXXXX you have done a tremendous job helping me out.

Again, you are a great at helping.
doctor
Answered by Dr. Roopa Hiremath 4 hours later
Brief Answer:
Get a prescription for a mouth rinse, steroid gel and vitamin supplements

Detailed Answer:
Hi Mr.XXXX,

Welcome back.

First of all, quit worrying about STDs. Based on the results of your tests you do not have a STD infection.

Coming to your queries, it can take 1 to 3 weeks for a canker sore to completely heal. Large ulcers can take longer to heal.

I suggest you complete the full course of acyclovir prescribed.Get a prescription for a mouth rinse, steroid gel and vitamin supplements.

Rinse your mouth thrice a day, apply steroid gel over the ulcer 3-4 times a day, and get B complex capsules which have to be taken 1 capsule twice a day for 7 days.

Maintenance of oral hygiene is a must. You are getting a white tongue because of overgrowth and swelling of the fingerlike projections (papillae) on the surface of your tongue.

The appearance of a white coating is caused by debris, bacteria and dead cells getting lodged between the enlarged and inflamed papillae.

You have to rinse your mouth at least thrice a day and gently scrape your tongue by a toothbrush or tongue scraper. Drink ample water to avoid dehydration of the mouth.

If the canker sore does not heal after following the above instructions, then you might have to get a biopsy done to rule out other causes of non healing mouth ulcers.

I suggest you stop correlating all your symptoms to the episode of exposure you have had.

For now, follow the suggested instructions and try to reduce your stress levels by doing some relaxation exercises.

I am glad I have been able to clear your doubts.

Please get back if any more queries.

Thanks.





Above answer was peer-reviewed by : Dr. Raju A.T
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