Jun 3, 2009
Hello, dr Bob. I'm medical student writing from Bulgaria. About 2 weeks after unprotected sex, I experienced low grade fever (about 37.5 degrees Celsius) which lasted for a day-two and few day later - macular rash at the shoulders and brachial part of the arms, lasting 2 days. The first day of the symptoms onset I did a CBC (cause I'm with thalassemia) and it showed: WBC 10.2, NEU about 7000, monocytosis (can't remember the exact number), Lym 1690 and about 17%, ESR 2mm/h. PLT 269 000, MCV 58 fl, RBC 6.7. A week later (few days after the macukar rash disappeared and about 3 weeks after the sexual contact (anal sex with someone with unknown HIV status)) I did a POC rapid Insti test, that was negative.
My question is how reliable is the 3-week rapid test result (I want to tell me from your pratice, not what the guidelines say). Are my symptoms and CBC (no matter how much non-specific it is) suggestive ARS?
| Response from Dr. Frascino
Hello Medical Student from Bulgaria,
HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive. Consequently, guidelines or no guidelines, the best I can offer is that a negative test at three weeks is certainly better than a positive test; however, it is not definitive or conclusive.
CBC results cannot be used to suggest, diagnose, or rule out HIV ARS.
I'm surprised you, as a medical student, placed yourself at risk for STDs, including HIV, by choosing to have unprotected sex. What's up with that? Certainly healthcare workers (and healthcare workers in training) should know better!
My advice is that you get an HIV test at the three-month mark. That's my personal advice and it happens to correspond to the guidelines! I'd also strongly urge you to never put yourself put yourself at risk again.
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