unprotected oral exposure - please answer - will donate 200$
Dec 18, 2010
Hello Dr.Bob Hope you are doing well.I had an unprotected oral exposure with an escort on Oct 6. This involved sucking the penis for 10 -15 minutes, kissing and hand job as well. I got worried about HIV and did test for the same.
1. Oct 15 (9th day) reactive ELISA and indeterminate WB with reactive P24 2. Oct 21 ( 15th day) Negative ELISA 3. Nov 29 ( 53th day) - reactive ELISA and indeterminate WB with reactive P24
These are my questions:
1. Is my 3rd test a false positive as the 1st one? Can I be assured and convinced and not worry about this? 2. I read in some websites that most or all cases test completely positive around 7th week. Since this is almost close to 8 weeks, please let me know your take on this. 3. Are there reasons for such false positives? 4. During weeks 2 and 3, I had neck stiffness, neck pain, shoulder and chest area pain. I am not sure if this was due to anxiety, but there were no other symptpoms like fever, fatigue, etc during weeks 2 and 3. Neck pain is on and off and I still have it. I hope these are not ARS symptoms. 5. I did not have any major ARS symptoms later though I had diarrhoea after 6.5 weeks and have little fever now. I assume this time frame is too late for ARS. Please confirm.
Based on my Doctors suggestion, I have given a repeat antibody test and DNA PCR test today.
Thanks for your time and help in this regard.
Response from Dr. Frascino
Unprotected insertive oral sex carries only a very low risk of acquiring HIV. Kissing and masturbation are not considered significant HIV-acquisition risks.
It is difficult to evaluate your tests, because HIV-antibody tests taken before the three-month mark are not considered to be definitive.
1. Most likely both your first and third tests are false-positive/indeterminate results. This assumption is based on a very low risk exposure and a negative ELISA between the two indeterminate results. Also, if your first positive/indeterminate test was the result of early seroconversion, complete seroconversion (positive ELISA and WB) would have occurred by day 53.
2. The vast majority (but not all) of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks after primary HIV infection.
3. Yes, there are a number of potential causes of false-positive and/or indeterminate HIV-antibody tests. These include nonspecific cross-reacting antibodies (this can occur during pregnancy, for example), HIV vaccines (clinical trials) and technical or clerical errors. You can read much more about false-positive results in the archives of this forum.
4. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. Your symptoms are not suggestive of or worrisome for HIV acute retroviral syndrome (ARS).
5. Most ARS symptoms manifest two to three weeks after infection.
I would assume you are HIV negative. DNA PCR testing is not FDA approved for HIV-diagnostic testing, but can be helpful in sorting out confusing HIV-antibody test results. I would anticipate the qualitative HIV DNA PCR will be undetectable. I should point out all this confusion and anxiety may have been avoided if you had followed the diagnostic HIV-testing guidelines and waited until the three-month mark for your first HIV-antibody test.
Thank you for your generous tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated during this holiday season of giving. In return I'm sending you my best good-luck/good-health karma that you are now and will forever be HIV free.
Good luck. Happy (and Healthy) Holidays.
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