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Suffering From Body Pain And Sore Throat. HIV 1/2 P24 Combo Revealed Hepatitis B Infection. Suggest

Posted on Tue, 10 Dec 2013

Question: I had once only insertive vaiginal sex with CSW. I am circumscized man. i wore condom but it had slipped off during the course and when finished I found the condom inside her vaigina. I examined and found that semen are attached outside of the condom. 3 days after this incident I got mild fever which is contuing till now , groin pain, body ache sometimes headache. I was depressed to have HIV infection. Thought of killing myself. I used to take lots of acetaminophen for fever. I took Azithromycin 1 g in single dose thinking of UTI. Even with mild throat irritation used to take Augmentin 675mg for two or three days. Evertime i went to measure my temperature came back as 36.5 to 37.4 till now. At the day 17 of this exposure, I got HIV 1/2 P24 combo testing. It came back as negative with 0.23 index. But the test informed about Hepatitis B infection. Now at day 22 after infection, I am feeling some sore throat. Body ache was there. I took betadine gurgle and applied Volini (diclofenac) tropical cream and the pain subsided a bit. Does it seems to be of HIV infection or Hepatitis Infection. Can HIV 1/2 p24 combo test miss on day day 17 of the infection and what is the chance of missing it altogether. I want to know from your experience is there any chance of mine HIV free..... I am really worried. I can manage with hepatitis b infection but if its HIV then mine living in this world would be less, I will simply die. I will dedicate myself to the needy people if God give me a second chance to live. Please advice me, please......

Answered by Dr. Sankaranantham Murugan (4 hours later)

Brief Answer: Symptoms are not due to HIV Repeat the test 4 week Detailed Answer: Hi, Welcome to XXXXXXX Thanks for posting your query. I can understand your feelings.First off all get rid off your feeling of finishing your life. HIV is no longer a killer disease. It is like any other disease and well manageable. People are living normal life like any other without HIV. It doesn't mean that you are having HIV. There are 30-40% of spouses of HIV positive individuals remain HIV free in spite of their regular and prolonged sex contact before recognizing their problem. They are called as Sero-discordant couple. So even if that CSW is a HIV positive woman there are many chances that you are unlikely to have HIV. Earliest manifestations of HIV can occur only after 4 weeks that too only with 40-50% of the infected people. You symptoms started 3 days after the high risk activity could not be due to HIV. Moreover throat infection is such a common problem for anybody without HIV. Regarding the test, your test will become more conclusive after 4 weeks rather than 17 days. Combo test antibodies can be detected only after 8 weeks not earlier than that. HIV 2 cannot be usually detected with P24 antigen test. So my suggestion is to repeat the test after 4 weeks to be sure that you are free from HIV1 and have one more rapid antibody test to rule out HIV2 infection. But your risk is low only as you had protected exposure with a slipped condom. Dr S XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (25 minutes later)

Dear Doctor, Thank you so much for your reply. I was just hoping that i can have consult you. I found urs answers are really appreciable.in the forum. What should i do now to test both HIV 1 and 2. I have planned to go for again HIV Combo.1/2 with p24 screening at the end of 4th week. Should i continue with that or anything you would like to suggest? When i penetrated was wearing condom. But when.i finshed the act , found that its not with me. I personally examined and found that semen is outside of the condom and not inside. This is only one exposure. Do you think still i having low risk? Further, although.my fever back pain and sore throat started after 3 days of exposure but they are still.continuing. Its been two weeks now. Yesterday (day 22), i had cough also. Do you think its because of HIV or Hepstitis B infection. I am Hepatitis B positive. Thank you so much doctor in advance. You people are real XXXXXXX for millions of us. May God bless u and me also,

Answered by Dr. Sankaranantham Murugan (37 minutes later)

Brief Answer: Change of antibiotic need.COMBO test after 12weeks Detailed Answer: Hi, Welcome back Hepatitis B would not manifest with sore throat. It will have symptoms of mild abdomen pain, loss of appetite, high colored urine and yellowish eyes etc. For your present symptoms of throat infection a change antibiotic other than Augmentin and Azithromycin may be necessary. Your physician will help in this regard. P24 Antigen Negative at 17 days after the high risk exposure is also highly reliable as it might detect the antigen as early as 1 week, but considered more conclusive after 4 weeks as far as HIV1 infection is concerned. HIV 1 infection is common all over the world except sub saharan and western Africa almost more than 99%. Combo test will also be able to detect the antibodies against both HIV1&2. But the antibodies against HIV infection will appear only after 8-12 weeks of infection.(window period) So if you are going to take the test after 12 weeks, the same COMBO test is enough and more reliable and conclusive to rule out both HIV 1&2. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (47 minutes later)

Dear Dr. XXXXXXX thank you so much for your reply. Really appreciate. Lastly do you think still low risk exposure considering condom slipped inside vagina and ejaculated semen is just outside of condom. But at the time of penetration i had weared condom. Can only groin have pain in HIV infection. From the 3rd day after exposure i have some groin pain. Sometime less but some times more. Thank you so much Sir in advance, With best regards,

Answered by Dr. Sankaranantham Murugan (6 hours later)

Brief Answer: Groin pain not HIV symptom.HIV risk low Detailed Answer: Hi, Welcome Once again. Groin pain is not at all a symptom for HIV. As you were having a history of slip of condom, we might not able to assess the extent of contact of vaginal fluid with your organ. It is not the extent of time, but whether the woman is HIV positive, whether she is having high viral load or under control and the quantity of exposure that matters. Anyhow the risk is very low only. Even with a vaginal penetrative sex the risk for HIV is just 5/10000 exposures as per CDC,Atlanta, whereas the risk is further low as far as your case is concerned. So there is nothing much to worry. The test is to confirm your HIV free status only. Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (5 hours later)

Dear Dr. XXXXXXX Thank you so much for your reply. Can sore throat leads to caugh. Just a passing final question HIV 1/2 p24 combo screening at 17 day is a positive indication or not? Thank you so much for your efforts. Just bless me With best regards and respect.

Answered by Dr. Sankaranantham Murugan (8 minutes later)

Brief Answer: Cough occur with throat infection,almost HIV1 free Detailed Answer: Hi, Welcome back. Sore throat definitely leads to cough due to pharyngitis or laryngitis. HIV Combo test at 17th day conveys that you are free from HIV1 almost 75% surety. Get well soon and you will unlikely to have HIV. Dr S.Murugan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar