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Is A 5 Months Post Exposure HIV Test Conclusive?

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Posted on Mon, 15 Sep 2014
Question: Sir, I am 25 years male from XXXXXXX 5 months back I had an protected vaginal sexual intercourse with csw in XXXXXXX i wore 2 condoms.I didnt do oral and anal. The intercourse lasts for 2 minutes.I think condom was not ripped. Because I saw the semen that was collected at the tip of condom. But I have also seen semen in the middle upper part of penis. I don't know how did it come back.but I didn't see semen leaking out. My condom covered 80 percent of penis. After 3 days of sexual exposure I started feeling too much sleepy.after one week I got cold and it lasted for 2 weeks. After that sore throat, painful lympnodes in armpit, groin and dry mouth.After one month loose stools started.stools were like paste. And I suffered for one month from the loose stools.I also got white tounge .it is burning when I eat food.it is also giving bad taste. I went for HIV Elisa test at 3 months 15 days after the exposure and the result was negative. Hepb,hepc,herpes,chlamydia,_trepenoma palladium.all are negative. I also went for 5 month HIV test .result negative. I got cmv igg positive.but cmv igm negative.rubella igg positive and Igm negative.my cmv igg is high .it is 3.26. I also went for complement4 which is normal. But my anti Ds DNA antibodies were positive. Now at 5 month mark I am suffering from severe fatigue and oral trush like symptoms.my mind is filled with full of doubts.
Am I infected with HIV?
Do I have lupus?
Do I have cancer?
These symtoms are due to stress?
Should I have to go for any other tests?
These symptoms will be there forever?
doctor
Answered by Dr. Dr. Prasad J (8 hours later)
Brief Answer:
Current symptoms not related to last intercourse.

Detailed Answer:
Hi,

I went through your symptoms and investigation report with diligence. Before I answer your questions specifically, my comments are as follows:

1. The intercourse that you described seems very well protected. There is no suspicion about contact with your partner's body fluid. Hence I doubt you will get an infection from that event.
2. Subsequent symptoms that happened is most likely incidental and doesn't seem to be related to that sexual activity.
3. Presence of IgG antibody against CMV and Rubella indicates past infection and that you have good immunity against it now.
4. Various HIV tests at 3rd month and 5th month are more than enough to rule out HIV infections.
5. Anti Dys DNA positive needs further evaluation by Rheumatologist.

With these comments answers to your specific query are:
a) In my opinion you are not infected by HIV. The chances that you will turn up HIV positive in future are exceedingly low. Late seroconversion from HIV negative to HIV positive beyond 3 months is something that is found in literature, but clinically it is such uncommon occurrence all HIV experts consider 3rd month results conclusive.

b) Anti Dys DNA positive is highly specific to SLE (autoimmune condition). However before I arrive at this conclusion, I will recommend you visit a rheumatologist who will re-examine you and repeat this test.

c) If the lymph nodes are persistently swollen, I will suggest that we get one of the node biopsied and studied under microscope. Lymph node biopsy will rule out doubts about cancers.

d) Anxiety and stress have some role. It can explain bowel changes you described. But we should consider it at last when all evaluation is complete.

e) Definitely you need more tests. I will begin with reference to rheumatologist.

f) Prognosis looks healthy at this point of time. But do complete full evaluation. Start with Rheumatologist visit as explained above.

Hope I have answered all your questions to your satisfaction. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (5 days later)
Sir, I went for auto immune tests and for ebv tests. I have attached the files .please go through them and give reply.
doctor
Answered by Dr. Dr. Prasad J (1 hour later)
Brief Answer:
Test reports not alarming, however you need evalua

Detailed Answer:
Hi,

I went through the reports and the only significant finding I could find is positive ebstein barr virus. However what I see is only IgG positive report, it would be better if you can also have IgM test too (Ebstein barr viral capsid antigen IgM).

1. The current report indicate you have chronic infection. IgM test will suggest if this infection is active. Active and acute EBV infection will explain the sorethroat and painful lymph node. That being said, this infection is unlikely to have spread from the described exposure.

2. Your reports clearly indicate HIV negativity. I would not add any more tests to test HIV here, so you need not be worried.

3. EB virus infection can explain anti dys DNA positivity. However a rheumatological consultation is required before we safely rule out lupus.

In short, the summary of these tests are:
a) You don't have HIV infection.
b) Current symptoms may be related to viral infection (EB virus). However you need more tests on this front. EBV capsid antigen IgM is one test that I suggest. You should talk with your primary physician about it.
c) A rheumatology consult may be needed to rule out other causes of anti dys DNA, including lupus.

Hope I am clear. Let me know if you need clarifications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (2 hours later)
Sir, I have attached ebv igm also . It is negative. I have gone for auto immunity tests 3 days before. All are normal. I have attached those files also.I have tested anti D's DNA in may I got positive(195 IU/ml). Now in august my anti D's DNA is negative(3.5 IU/ml).How is it possible.And my ANA ,ANTI PHOSPHOLIPID(IGM,IGG),COMPLEMENT3,COMPLEMENT4,IMMUNOGLOBULIN M,RHEUMATOID FACTOR are normal.
Only ebv capsid antigen igg is 2.6 positive .
Ebv capsid antigen igm is 0.1negative.
Ebv nuclear antigen igg is 0.2 negative.
What is the conclusion doctor.
doctor
Answered by Dr. Dr. Prasad J (13 hours later)
Brief Answer:
Past EBV infection...

Detailed Answer:
Hi,

1. Anti dys DNA can come positive with some viral infection including EBV infection. Most likely the positivity was secondary to past viral infection. As the infection gets controlled, Dys DNA antibodies can become negativity. This explain the change from positive to negative.
2. Other autoimmune tests negativity makes lupus a very, very unlikely condition.
3. As IgM antibody test is negative, this suggest that you no longer have an acute/active infection. This EBV infection was in the past and you have antibodies to it now. It rarely cause complications in future. So don't be worried.
4. If sorethroat and painful lymph nodes are persisting, I encourage you to see a physician and plan its management.

Hope this answers all your doubts. Let me know if you need any more clarifications.

Regards

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dr. Prasad J (4 hours later)
Sir, should I have to go for further viral tests.if I have to go what tests should I have to look for.
I have gone for HIV pcr test,tb test .may be in 2 days I will get test results.
If I had infected with ebv at 6 months back .is there a possibility of igg positive and igm negative.
doctor
Answered by Dr. Dr. Prasad J (29 minutes later)
Brief Answer:
No more tests from my side.

Detailed Answer:
Hi,

As described earlier,
1. HIV status is clearly been ruled out as the described exposure was completely safe and tests results are in your favour. You don't need further tests to reprove this state.
2. EBV infection is a past and inactive state as proved by postive IgG and negative IgM. We cannot predict the time of previous infection, but may be you are right, 6 month back may have been the time when you received it.
3. No more test from my side. But at this point of time I would suggest you start multivitamin pills such as zincovit once a day for two weeks. If burning mouth and whit tongue coating doesn't improve, you should see a doctor for physical examination.

Hope I have answered all your questions. Let me know if you need clarifications.

Regards
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3708 Questions

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Is A 5 Months Post Exposure HIV Test Conclusive?

Brief Answer: Current symptoms not related to last intercourse. Detailed Answer: Hi, I went through your symptoms and investigation report with diligence. Before I answer your questions specifically, my comments are as follows: 1. The intercourse that you described seems very well protected. There is no suspicion about contact with your partner's body fluid. Hence I doubt you will get an infection from that event. 2. Subsequent symptoms that happened is most likely incidental and doesn't seem to be related to that sexual activity. 3. Presence of IgG antibody against CMV and Rubella indicates past infection and that you have good immunity against it now. 4. Various HIV tests at 3rd month and 5th month are more than enough to rule out HIV infections. 5. Anti Dys DNA positive needs further evaluation by Rheumatologist. With these comments answers to your specific query are: a) In my opinion you are not infected by HIV. The chances that you will turn up HIV positive in future are exceedingly low. Late seroconversion from HIV negative to HIV positive beyond 3 months is something that is found in literature, but clinically it is such uncommon occurrence all HIV experts consider 3rd month results conclusive. b) Anti Dys DNA positive is highly specific to SLE (autoimmune condition). However before I arrive at this conclusion, I will recommend you visit a rheumatologist who will re-examine you and repeat this test. c) If the lymph nodes are persistently swollen, I will suggest that we get one of the node biopsied and studied under microscope. Lymph node biopsy will rule out doubts about cancers. d) Anxiety and stress have some role. It can explain bowel changes you described. But we should consider it at last when all evaluation is complete. e) Definitely you need more tests. I will begin with reference to rheumatologist. f) Prognosis looks healthy at this point of time. But do complete full evaluation. Start with Rheumatologist visit as explained above. Hope I have answered all your questions to your satisfaction. Let me know if you need clarifications. Regards