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Last question. I promise you!
Aug 13, 2011

Dear Dr. Bob, Im that guy who took PEP by mistake for 28 days after getting semen in the eye and over an eczema/folliculitis on my butts. Do you remember me? I celebrated a lot after my 3-month negative RNA PCR and HIV 1 and 2 ELISA tests, and even moved on with my life for one month. However, after thinking over and over, I started to wonder if you would ever consider an HIV-HCV co-infection after this incidence, and possible delayed seroconversion. I still have a lot of weird symptoms: oral candidiasis (Im a dentist, so I know how to diagnose this), low CD4 (but a CD4/Cd8 ratio of 1.5), mouth ulcers (I did not use to have them before), neurophatic pain, dermographism, anal fistula (never did anal sex) and skin papilomaceous lesions that appear to increase in number. Because of all that, and because I also had 3 eye exposures to blood during my practice after the semen episode, I started fearing the possibility of delayed seroconversion. 1.Would you consider Hep C infection after the semen episode? 2. Would you test for it? 3.Should I test for HIV and HCV after 6 months? 4. Which PCR test is more indicated at 5-6 months post exposure? Please reply! I put a great trust on you! I only calm down when you reply! I appreciate your patience!

Response from Dr. Frascino

Hi.

Your "last question" has four parts. So shouldn't the title of your post more accurately read "Last four Questions. I promise you!"???

Your fears are once again unwarranted. Your negative RNA PCR coupled with your negative ELISA tests rules out any possibility of HIV/hepatitis C coinfection causing delayed HIV seroconversion. Seroconversion refers to developing specific anti-HIV antibodies, and remains the gold standard for HIV-diagnostic testing. HIV RNA PCR tests assay directly for a piece of the virus's genetic material. PCR tests have nothing to do with anti-HIV antibodies or seroconversion.

Responding to your specific questions:

1. No.

2. No.

3. No.

4. Neither. PCR testing is generally not recommended for routine HIV-diagnostic screening.

Dr. Bob



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