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Wife Tested Positive, I am Negative - Please answer me
Oct 10, 2007

Hi Dr Bob

I have been living out of my home country for 3 years. I did not have any form of sexual contact during these three years. I fully abstained. I asked my wife that we do the routine HIV test. It is a practice that we have been having before we get a child. Unfortunately, she turned out to be HIV positive. I turned out to be negative. However, I had had sex with her at least nine times without protection. After finding out she is positive, we stopped all sexual contact. I did a rapid HIV test and an Elisa test at 8 weeks (22nd July) and (29th July) 9 weeks after the first exposure with her. Both Rapid and ELISA tests came back negative. I went 10 weeks after the first exposure and I re-tested and still negative though still within the window period. The day she got her positive result, the doctor decided to put me on PEP ARV for 28 days because we had had anal sex. All the other encounters were 11 vaginal sex (were between 26th May and 29th July), 1 anal sex (the last exposure was actually on 29th July). Between 20th June and 9th July there was no exposure since I was out of the country. I have the habit of washing after every sexual encounter, after 5 to 10 minutes after each encounter and always use antiseptic soap as standard in the house. I am a circumcised male. I finished Combivir. What are my chances that I shall maintain negative status? In all the encounters, our sex was ten minutes and below and I withdrew immediately and she was extremely wet.

I have a few questions:

Antibodies appear and can be detected in most cases within 4-6 weeks of infection; it is rare for it to take longer, even though CDC and other authorities continue to stick to the historic advice to wait 3 months to be absolutely sure. Is this true? I was tested at 8 and 9 weeks after first exposure but that includes the last exposure which occurred on the 9th week, actually the day I went on PEP.

Many websites claim that sero-conversion occurs within 4-6 weeks and ARS typically has onset at 7-14 days after exposure. In other words, most people seroconvert with a time course similar to that of ARS. Some claim the symptoms of acute HIV infection always start 1-2 weeks after exposure, not 3 months later. Which one is the correct information from your experience?

Is it true that when HIV causes lymph node inflammation, it's all over the body, not just in one localized area. Are there exceptions to this? I have two swollen lymph nodes at the back of my right ear. My doctor has insisted that I wait to get tested at 3 and 6 months to know my status and she is of the idea that I may have dodged the bullet since antibodies show positive result within 35 days (6 weeks). It is now 10 weeks with PEP but 6 weeks post PEP.

I have not experienced any ARS symptoms but for the past 6 weeks I have been having tingling the whole body, generalized muscle twitching, numbness in the hands and my fingernails are darkish almost blue? What could this be? The doctor says it is the Combivir and that peripheral neuropathy can never come at seroconversion time as it is later as progression to AIDS occurs.

Is it true that influenza vaccine can give false positive result? My wife had gotten a flu vaccine 11 days before her positive HIV result.

How long should she wait to get tested again after the flu vaccine? Western Blot is okay for this?

This does not change the fact that we are abstaining till I get to know my status.

Are these websites misleading?

http://www.aliveandwell.org/html/questioning/VaccineCrossReactions.pdf

http://www.aliveandwell.org/html/questioning/questioningrelated.html

I will send a donation, let me know how.

Bush should retire

Response from Dr. Frascino

Hello,

Your post is rather lengthy and poses many questions. Rather than address information found on other Web sites, I'll focus on your current conundrum, OK?

First, your wife. Flu vaccine or not, if she has had only one positive HIV test, this should be confirmed with a repeat ELISA and follow-up Western Blot if reactive. (Please note a Western Blot should not be performed unless the person has a reactive ELISA.)

If your wife is confirmed to be HIV positive, she should seek out the consultation of an HIV specialist for further evaluation and ongoing care.

Turning to your situation, the HIV window period begins with the date of your last potential exposure in your case July 29th.

That you took PEP and have negative HIV-antibody tests out to six weeks post-PEP is indeed extremely encouraging. I agree with your physician: further HIV testing is warranted at the three- and six-month marks. Your recent symptoms are not suggestive of or worrisome for HIV ARS.

Thank you for your donation to The Robert James Frascino AIDS Foundation. In return I'm sending you my good-luck karma that your definitive HIV tests remain negative.

Regarding Dubya, not only should he retire, he should never have been installed (note I did not say elected) in the first place!

Dr. Bob



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