Dear Dr. Dezube

My possible expsoure was at the end of June 2000, vaginal sex with a message parlor girl from Asia. No condom, we used latex grove instead. Blood was found on the "condom" after I pulled it out. She explained she was having her period.

1 month later, I was diagnosed with HPV. Saw a dermatologist who gave me Aldara, I found that Aldara was effective in getting rid of warts.

2 months later after exposure, had a very bad cold that lasted over 3 weeks, symptoms:

1. Sore throat (lasted 2 days) 2. itchy rash under both armpits (lasted 3 weeks). 3. fatique (1 day). 4. Nasal congestion

I also noticed swollen glands on the neck.I started to use Aldara again. I found it much less effective, less skin reaction than before.

Nasal congestion, mild night sweats, dry mouth, malaise and muscle pain still linger. ELISA negative at 3rd and 6th months. PCR RNA (first generation at Quest lab) at 7th month also negative.

My questions for HPV and HIV:

1) Since Aldara becomes less effective for me, is it because my immune system are being damaged by HIV? 2) what are the HIV strains in Asia? 3) Can ELISA or PCR tests in USA detect Asian strains? 4) Should I get tested again at 9th or 12th month?

thanks Dan

Dear Dan,

Given that you have genital warts, you most likely did indeed pick up an HPV infection. Many patients infected with HPV will clear the infection completely, thanks to their own immune system. If your HIV tests are negative at 7 months, then you are most probably not HIV positive. You do not necessarily need to be tested at 9th and 12th months unless you have more unprotected sex. I doubt you are "falsely negative" because of some Asian strain.

Aldara is reasonably effective for external warts. If the warts continue to be problematic, then consult your health care provider/dermatologist about alternative treatments for them.

Lastly, I want to point out that although condoms, when used properly, are quite effective in terms of preventing HIV transmission, they are less effective at preventing HPV transmission, which can occur from skin-to-skin contact.