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hi doc pediatric resident here
Feb 4, 2012

i have low risk exposure 18 months back through oral sex( girl performed oral sex on me-blow job). i followed up every three months untill 18 months for HIV antibody tests. and on one occassion at 18 months i did HCV antibody test.all came to be negative only. i can make my mind at rest if i expand my knowledge

some textbooks saying about delayed seroconversion and all(possible upto 24-36 months or so..it is mentioned briefly under current medical diagnosis and treatment 2011 edition) what is the longest possible seroconversion happened in terms of HIV according to available literature..i mean detectable to antibody tests? (i read about that 1997 new england journal of medicine health worker case where it took 8-9 months..is that the maximum one happened) i am almost convinced that i am negative but some rare things are bothering me much(what if this happens to me? ) i am going to get married thats why, this element of doubt is flaring up very frequently. if i can share issues with you and expand my knowledge i can learn good medicine and can serve my patients better

Response from Dr. Wohl

Some basic facts:

With current HIV tests, the vast majority of people will have antibodies detected to the virus within a month or so of the exposure. By 12 weeks almost all who are infected will be detected. Are there rare cases of longer time to seroconversion, I am sure there are but the tests used today in the US are better than ever and that means more accurate and able to detect infection earlier. See the CDC website, which is pretty conservative, at: http://www.cdc.gov/hiv/topics/testing/resources/qa/index.htm. Note, they mention HIV viral load which can be done for the most worried of the worried well but at a cost.

Re oral sex, see my standard answer below- DW

You have asked a question that many writing to this site have asked. Therefore, this is a standard reply I have prepared.

Oral sex is a very inefficient way to acquire HIV. The mouth does not contain the type of cells that HIV likes to infect. One study from Europe that followed couples where one person was HIV+ and the other HIV- failed to find a case of HIV transmission despite unprotected oral sex.

If you remain worried, due to some circumstance, you can certainly get tested for HIV. By 4 weeks after the encounter, antibodies to HIV are detected by standard HIV tests in almost all cases.

Please be aware that syphilis, herpes simplex virus, and gonorrhea can certainly be transmitted by oral sex.



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