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can pregnancy (immunosuppression) delay HIV antibody production?
Oct 7, 2009

Dr. Bob I respect you very much and trust your opinion...PLEASE HELP...I had an exposure 5 1/2 months ago in healthcare where a droplet of blood went in to my eye. The dentist I worked for was laughed at me for being nervous and said that you cant get HIV that way. So I called the PEP HCW hotline and spoke with about 6-7 Drs. all telling me that due to the low chance and me being pregnant they wouldnt recommend PEP because chance of transmission is low. Anyways, we asked the patient of his status about 4 times and he stated he was healthy but refused to take a HIV test. None the less the Docs felt that even if the pt had HIV such an inoculation was low risk. However, after the PEP window passed I literally lost it my mind, I was convinced that the patient lied and I was doomed. And sure enough about 8 days later ARS started...I got loose stools for 2 days, Night sweats for about 2 weeks, Thrush on my tongue (confirmed), white patches on the tip of tongue, hariy looking papilla and fissures on the tip of my tongue, Burning sensation in my esophagus and lips...And still over 5 months later my symptoms persist and more have come about such as numbness in my thighs (femerol nerve) not sciatica, sores on my body that are healing slowly, shortness of breath, insomnia/ fatigue and all I can think about is that I am dying of HIV. Despite all my symptoms all of my tests have been negative thus far. Oral Swab at 3 weeks- NEG I had a PCR-RNA test at 35 days- NEG; no virus detected at less than 48 copies/1.7 ml Oral swab at 6 weeks- NEG Antibody blood test for HIV 1/2, HEP C, Syphillis at 8 weeks- NEG Antibody blood test for HIV 1/2, HEP C, Syphillis at 12 weeks- NEG Antibody test at for HIV 1/2, HEP C, Syphillis at 5 months and 1 week- NEG My questions are: 1) Could pregnancy and extreme stress delay seroconversion? 2) What about coinfection with Hep C? 3) Can having Latent TB delay seroconversion? 4) I know a 3 month test is conclusive but I cannot let go...that said are the antibody tests better now than a couple years ago? 5) And what of my symptoms? they are very strange and more like HIV than pregnancy-related... 6) Is testing out to 1 yr a thing of the past? The CDC states 6 mths as the last test? is that 100% accurate. 7) what would you suggest for me (additional testing etc.)...I need to have be done with this before my baby is due in 1 month. PLEASE HELP ME Worried Well and Vow to donate to HIV foundations maybe even become a counsler after what I have been though...

Response from Dr. Frascino

Hello,

1. No. Neither pregnancy nor stress delays HIV seroconversion.

2. You've had negative hepatitis C screening at 8 weeks, 12 weeks and 5 months. Just what part of "hepatitis C negative" are you having difficulty understanding?

3. No.

4. Yes, your three-month negative test is conclusive and yes, your problem is that you "cannot let go." Your problem is irrational fear, not HIV! Yes, the more recent 3rd and 4th generation tests are better than the earlier versions.

5. Your symptoms are most consistent with anxiety.

6. I concur with the CDC.

7. Testing out to one year is not warranted or recommended Your six-month test is definitive and conclusive. HIV is not your problem. No way. No how. No additional HIV-related tests are warranted.

Thank you for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. Stop worrying and start WOO-HOO-ing, OK? If my strong reassurance is not sufficient for you to shake your worries, consider getting some counseling to help you accept the truly wonderful news that you have dodged the HIV bullet and are definitively HIV negative!

Be well. Stay well. (Yes, you are indeed well!)

Dr. Bob



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