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What Are The Chances Of HIV Transmission Through Protected Sex?
Question: Hi Dr. ,
I am a 31 year old male.I had protected sex with a sex worker on 15th of August, 2013. As far as I could see, there was no visible breakage in condoms (I used 2) .
I removed the condom with my right hand.Some vaginal fluid or lubrication (I don't know exactly) stuck to my fingers. I cleaned my penis with the same hand. I am circumcised. All this happened barely seconds after pulling out from the female's vagina.
Then I took some water in my hand and repeatedly gargled.
Do these activities put me at a risk of HIV?
1. I tested for HIV with a Retroquick test at 57 days after exposure. It was negative
2. I took my cd4 counts 25 and 57 days after exposure. On the 25th day it was 847 (43.2%). On t he 55th day it was 454 (42.7%)
3.I tested for Hepatitis c at 45 days after exposure. It was positive. RNA PCR count put it viral loda at 4.19 millions. Genotype 3
4. I had a blood transfusion done when I was an infant
5. My Liver Function Tests were normal on 25th day after exposure but SGOT,SGOT and Bilrubin were elevated at 55th day after exposure.
6. After being diagnosed with HCV, I was eating not more than 1 meal for a period of 8-10 days. I also did not sleep for more than 2-3 hours on an average after diagnosis. I had taken the second cd4 count 8-10 days after being diagnosed with HCV.
I have researched extensively about c4 counts, HIV and HCV. Based on the sharp drop in cd4 counts and the sharp rise in SGOT,SGPT and Bilrubin, I have convinced myself that I probably I have also contracted HIV. I know that an HIV acclerates HCV.
7. I had taken peg interfferon ribavarin treatment from 31st december 2013 to 17th XXXXXXX 2014.
I have tested for hiv one year after the exposure (August 2014) with a rapid test at lal path labs and it was negative. I also took my cd4 count 1 year after the exposure and it was only 421 (33%).
I am worried about this. I took a cbc count and my lymphocytes were only at 19%, (lower than normal) Throughout my treatment my wbc was below normal. But one and a half months after treatment my neutrophils have returned to normal while my lmphocyte percentage which used to be around 35 to 40 is only 19%. The last lymphocyte count was 1.33. wbc was 7.1. I have read that lymphocyte count is reduced in hiv infected people.
8. I have read that in a number of cases where an individual is exposed to both hiv and hcv the production of hiv antibodies may be delayed significantly. Please find the link here http://www.healthsystem XXXXXXX edu/pub/safetycenter/internetsafetycenterwebpages/trainingeducationalresources/co-infection-with-hiv-and-hcv.pdf
10. I have also read a documented report published by a hospital wherein a man who had receptive anal sex tested positive for hcv affter 3 months and positive for hiv antibodies 7 months after infection
11. I have read on medhelp and thebody.com that chemotherapy can also delay production of hiv antibodies significantly and my hcv treatment was a form of chemo, right?
12. I am scared beyond imagination. Do my low cd4 counts and hep c infection tell something. Or can I rely on my negative HIV reports and proceed with life. I am looking to get married soon. Please advise.
13. I have also read that in hcv infected females with hiv, vaginal fluid can have hepatitis c virus as well, which is otherwise only present in significant amount in blood. This is why I am worried that I might have acquired hcv from her.
14. I had blood transfusion done when I was 6 months old. I had jaundice around 7 years back. However, I do not remember if the dr tested for hcv then. I assume he would have being a gastroenterologist.
15. To sum up, my low cd4 counts, hcv treatment and low lyphocyte percentage have made me worried. Can I be sure that I do not have HIV or do I need to test further. I have completely lost my peace of mind. Please advise.
I am a 31 year old male.I had protected sex with a sex worker on 15th of August, 2013. As far as I could see, there was no visible breakage in condoms (I used 2) .
I removed the condom with my right hand.Some vaginal fluid or lubrication (I don't know exactly) stuck to my fingers. I cleaned my penis with the same hand. I am circumcised. All this happened barely seconds after pulling out from the female's vagina.
Then I took some water in my hand and repeatedly gargled.
Do these activities put me at a risk of HIV?
1. I tested for HIV with a Retroquick test at 57 days after exposure. It was negative
2. I took my cd4 counts 25 and 57 days after exposure. On the 25th day it was 847 (43.2%). On t he 55th day it was 454 (42.7%)
3.I tested for Hepatitis c at 45 days after exposure. It was positive. RNA PCR count put it viral loda at 4.19 millions. Genotype 3
4. I had a blood transfusion done when I was an infant
5. My Liver Function Tests were normal on 25th day after exposure but SGOT,SGOT and Bilrubin were elevated at 55th day after exposure.
6. After being diagnosed with HCV, I was eating not more than 1 meal for a period of 8-10 days. I also did not sleep for more than 2-3 hours on an average after diagnosis. I had taken the second cd4 count 8-10 days after being diagnosed with HCV.
I have researched extensively about c4 counts, HIV and HCV. Based on the sharp drop in cd4 counts and the sharp rise in SGOT,SGPT and Bilrubin, I have convinced myself that I probably I have also contracted HIV. I know that an HIV acclerates HCV.
7. I had taken peg interfferon ribavarin treatment from 31st december 2013 to 17th XXXXXXX 2014.
I have tested for hiv one year after the exposure (August 2014) with a rapid test at lal path labs and it was negative. I also took my cd4 count 1 year after the exposure and it was only 421 (33%).
I am worried about this. I took a cbc count and my lymphocytes were only at 19%, (lower than normal) Throughout my treatment my wbc was below normal. But one and a half months after treatment my neutrophils have returned to normal while my lmphocyte percentage which used to be around 35 to 40 is only 19%. The last lymphocyte count was 1.33. wbc was 7.1. I have read that lymphocyte count is reduced in hiv infected people.
8. I have read that in a number of cases where an individual is exposed to both hiv and hcv the production of hiv antibodies may be delayed significantly. Please find the link here http://www.healthsystem XXXXXXX edu/pub/safetycenter/internetsafetycenterwebpages/trainingeducationalresources/co-infection-with-hiv-and-hcv.pdf
10. I have also read a documented report published by a hospital wherein a man who had receptive anal sex tested positive for hcv affter 3 months and positive for hiv antibodies 7 months after infection
11. I have read on medhelp and thebody.com that chemotherapy can also delay production of hiv antibodies significantly and my hcv treatment was a form of chemo, right?
12. I am scared beyond imagination. Do my low cd4 counts and hep c infection tell something. Or can I rely on my negative HIV reports and proceed with life. I am looking to get married soon. Please advise.
13. I have also read that in hcv infected females with hiv, vaginal fluid can have hepatitis c virus as well, which is otherwise only present in significant amount in blood. This is why I am worried that I might have acquired hcv from her.
14. I had blood transfusion done when I was 6 months old. I had jaundice around 7 years back. However, I do not remember if the dr tested for hcv then. I assume he would have being a gastroenterologist.
15. To sum up, my low cd4 counts, hcv treatment and low lyphocyte percentage have made me worried. Can I be sure that I do not have HIV or do I need to test further. I have completely lost my peace of mind. Please advise.
Brief Answer:
Kindly upload all your reports done previously
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for HIV, HCV and then related issue of fall in CD4 counts.
I have gone though your complete query and read all the points. After analyzing the complete query let me give you my suggestions regarding all your issues:
@ Academically saying in my opinion you are free from HIV infection. A HIV infection can be diagnosed within maximum of 3 months of period. So, on this basis you appear to be HIV negative.
You got tested at various times and last one was almost a year period after the intercourse which was probably rapid test. I am not able to see whether you have gone for RNA PCR for HIV. I suggest you to go for RNA PCR for HIV and tell me the reports.
@For the concern of Hepatitis C: We consider its incubation period to be around 60 days to 180 days on average. As you tested in 45 days is bit lower than what it should be. So in my opinion your sexual intercourse was not the main cause of Hepatitis C.
@In my opinion your jaundice 7 years back could be the factor indicating a direction towards contracting hepatitis C.
As your intercourse was protected one so the chances of both HIV and HCV are negligible through this mode. Your HIV report itself tells us repeatedly as negative status and therefore I consider that this episode was not the main cause of any of the problem you are experiencing.
@ Directly saying CD4 count is not related to HCV infection. But as HIV is negative so we can correlate a low CD4 count can be because of Hepatitis C infection. As your viral load is higher so it can itself be the cause of low CD4 count. Don’t just think of HIV as a sole cause low CD4 count.
@Regarding your marriage part: Kindly get tested for the Hepatitis C viral load and revert back to me so that I can guide you accordingly.
I request you to kindly upload all your reports done previously and get RNA PCR done for both HIV and HCV and upload the same too.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Kindly upload all your reports done previously
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for HIV, HCV and then related issue of fall in CD4 counts.
I have gone though your complete query and read all the points. After analyzing the complete query let me give you my suggestions regarding all your issues:
@ Academically saying in my opinion you are free from HIV infection. A HIV infection can be diagnosed within maximum of 3 months of period. So, on this basis you appear to be HIV negative.
You got tested at various times and last one was almost a year period after the intercourse which was probably rapid test. I am not able to see whether you have gone for RNA PCR for HIV. I suggest you to go for RNA PCR for HIV and tell me the reports.
@For the concern of Hepatitis C: We consider its incubation period to be around 60 days to 180 days on average. As you tested in 45 days is bit lower than what it should be. So in my opinion your sexual intercourse was not the main cause of Hepatitis C.
@In my opinion your jaundice 7 years back could be the factor indicating a direction towards contracting hepatitis C.
As your intercourse was protected one so the chances of both HIV and HCV are negligible through this mode. Your HIV report itself tells us repeatedly as negative status and therefore I consider that this episode was not the main cause of any of the problem you are experiencing.
@ Directly saying CD4 count is not related to HCV infection. But as HIV is negative so we can correlate a low CD4 count can be because of Hepatitis C infection. As your viral load is higher so it can itself be the cause of low CD4 count. Don’t just think of HIV as a sole cause low CD4 count.
@Regarding your marriage part: Kindly get tested for the Hepatitis C viral load and revert back to me so that I can guide you accordingly.
I request you to kindly upload all your reports done previously and get RNA PCR done for both HIV and HCV and upload the same too.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Yes all four tests for HIV were rapid tests.
I really do not have the courage to take another HIV test (PCR RNA). Have you ever encountered a situation where an individual tested negative with an antibody test at 3 months and then tested positive later. I have taken my family into confidence and put them in a lot of stress in the last one year. I can not take the test alone and my family members are fed up of my obsession with the disease
My Hepatitis C viral load at the end of 24 weeks of treatment was 0.
I will get a HCV viral load done again. But I dont want to take an HIV viral load test. Its too stressfful.
Can I just forget this episode?
Please advise.
Yes all four tests for HIV were rapid tests.
I really do not have the courage to take another HIV test (PCR RNA). Have you ever encountered a situation where an individual tested negative with an antibody test at 3 months and then tested positive later. I have taken my family into confidence and put them in a lot of stress in the last one year. I can not take the test alone and my family members are fed up of my obsession with the disease
My Hepatitis C viral load at the end of 24 weeks of treatment was 0.
I will get a HCV viral load done again. But I dont want to take an HIV viral load test. Its too stressfful.
Can I just forget this episode?
Please advise.
Brief Answer:
Go for the test of RNA PCR for HIV- it shd be -ve
Detailed Answer:
Hello young buddy,
Welcoem again tot he forum and thanks a lot for your follow.
I can very well understand your part of concern and anxiousness related to the episode and afterwards feelings.
I have not seen even a single case in my 10 years of practice who was negative till three months and then becoming positive later on after 3 months. In my experience it has not occurred even for single time.
Though literature do say about very few cases who became positve afterwards but then in those cases the things of exposure were not very much clear.
Overall I say that it is practically impossible to get positive status once you are negative after 3 months of episode. In your case now it si more than a year so it should be negative.
The only part why I want to go for RNA PCR is that it wil give you complete relaxation that you are HIV negative. Just think of yourself and your family who must be in the same great anxiousness and tension as you are.
So take my words and go for the test of RNA PCR for HIV. I assure you as my younger brother that your test would be cent percent negative and therefore you will relieve all your tensions.
I am happy to know that your viral load is non detectable. Do have a continuous follow up with your doctor. In my view getting married is a personal issue and in that case you have to use complete protection with your spouse. A good protection maintains barrier between the spreading of the infection to your spouse.
I again reassure you regarding all your issue which can be solved by a single test.
I hope these informations will help you. I will be glad to guide you any further.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Go for the test of RNA PCR for HIV- it shd be -ve
Detailed Answer:
Hello young buddy,
Welcoem again tot he forum and thanks a lot for your follow.
I can very well understand your part of concern and anxiousness related to the episode and afterwards feelings.
I have not seen even a single case in my 10 years of practice who was negative till three months and then becoming positive later on after 3 months. In my experience it has not occurred even for single time.
Though literature do say about very few cases who became positve afterwards but then in those cases the things of exposure were not very much clear.
Overall I say that it is practically impossible to get positive status once you are negative after 3 months of episode. In your case now it si more than a year so it should be negative.
The only part why I want to go for RNA PCR is that it wil give you complete relaxation that you are HIV negative. Just think of yourself and your family who must be in the same great anxiousness and tension as you are.
So take my words and go for the test of RNA PCR for HIV. I assure you as my younger brother that your test would be cent percent negative and therefore you will relieve all your tensions.
I am happy to know that your viral load is non detectable. Do have a continuous follow up with your doctor. In my view getting married is a personal issue and in that case you have to use complete protection with your spouse. A good protection maintains barrier between the spreading of the infection to your spouse.
I again reassure you regarding all your issue which can be solved by a single test.
I hope these informations will help you. I will be glad to guide you any further.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor Kanodia,
Thank you for your encouraging words. I had another rapid test at SRL yesterday and it was negative.
Dr, I had blood transfusion done when I was six months old. My mother tells me that my face had swollen immediately post transfusion. Then I had another transfusion in which my father gave me blood. My father does not have Hepatitis C.
I had jaundice twice, once at the age of 3 years and again at the age of 24 years.
What baffles me doctor, that I remember at the age of 24 I had a thorough check up, I was taken to a gastroenterologist.
I dont remember whether he tested me for Hepatitis C or not.
Is it not the norm that doctors ask for Hepatitis, A , B and C tests when a person encounters jaundice?
Because, I came to know that I have Hepatitis C only after this incident.
If he did test me then and I was negative, then very clearly I acquired HCV from this incident.
At the same, time, I see doctors saying that it is very difficult to transmit hepatitis c through sex unless it is unprotected anal sex
I am worried as hell, the last one year has been an absolute nightmare.
I still cannot gather the courage to go for RNA PCR. I think that somehow my body has not made antibodies, because of confection and the Hepatitis C treatment.
I feel so helpless doctor. I just don't know what to do. Every second seems like a night mare.
Thank you for your encouraging words. I had another rapid test at SRL yesterday and it was negative.
Dr, I had blood transfusion done when I was six months old. My mother tells me that my face had swollen immediately post transfusion. Then I had another transfusion in which my father gave me blood. My father does not have Hepatitis C.
I had jaundice twice, once at the age of 3 years and again at the age of 24 years.
What baffles me doctor, that I remember at the age of 24 I had a thorough check up, I was taken to a gastroenterologist.
I dont remember whether he tested me for Hepatitis C or not.
Is it not the norm that doctors ask for Hepatitis, A , B and C tests when a person encounters jaundice?
Because, I came to know that I have Hepatitis C only after this incident.
If he did test me then and I was negative, then very clearly I acquired HCV from this incident.
At the same, time, I see doctors saying that it is very difficult to transmit hepatitis c through sex unless it is unprotected anal sex
I am worried as hell, the last one year has been an absolute nightmare.
I still cannot gather the courage to go for RNA PCR. I think that somehow my body has not made antibodies, because of confection and the Hepatitis C treatment.
I feel so helpless doctor. I just don't know what to do. Every second seems like a night mare.
Brief Answer:
A sinlge test will solve all your issues.
Detailed Answer:
Hello young buddy,
Welcome to the forum again.
I very well understand your part of stress which you are experiencing every second.
In my view your positive HCV status doesn't seems to be from the incidence of 2013 but an older one.
On the part that your present test for HIV is negative is a further confirmation that you are HIV negative and clear from HIV.
You yourself know that presently your HCV viral load is zero. Even if you think that your immunity is not better then on considering this part your immunity must be better after the imperceptible viral load of HCV. Therefore this negative test of HIV si the best sign that your status is clear from the part of HIV.
I suggested you to go for RNA PCR only for the part of your confidence that you are clear from HIV.This is not just my suggestion but also a friendly advise that on seeing a cleat RNA PCR results of HIV you will the complete release of pressure form your mind and your family too.
I again reassure you regarding all your issue which can be solved by a single test. I give you my full confidence that your RNA PCR for HIV would be negative as per my clinical experience, so have tha dare and just get relieved of all your anxiety my dear young buddy.
I hope these informations will help you. I will be glad to guide you any further.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
A sinlge test will solve all your issues.
Detailed Answer:
Hello young buddy,
Welcome to the forum again.
I very well understand your part of stress which you are experiencing every second.
In my view your positive HCV status doesn't seems to be from the incidence of 2013 but an older one.
On the part that your present test for HIV is negative is a further confirmation that you are HIV negative and clear from HIV.
You yourself know that presently your HCV viral load is zero. Even if you think that your immunity is not better then on considering this part your immunity must be better after the imperceptible viral load of HCV. Therefore this negative test of HIV si the best sign that your status is clear from the part of HIV.
I suggested you to go for RNA PCR only for the part of your confidence that you are clear from HIV.This is not just my suggestion but also a friendly advise that on seeing a cleat RNA PCR results of HIV you will the complete release of pressure form your mind and your family too.
I again reassure you regarding all your issue which can be solved by a single test. I give you my full confidence that your RNA PCR for HIV would be negative as per my clinical experience, so have tha dare and just get relieved of all your anxiety my dear young buddy.
I hope these informations will help you. I will be glad to guide you any further.
With regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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