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Asking for the third time: Please answer, I feel like killing myself
Oct 31, 2013

I am a 30 year old male. I had sex with an Indian csw. I had used double condoms.

Seconds after pulling out, I removed the condom using my right hand. Some vaginal fluid stuck to my fingers. I took some amount of water and with the same hand cleaned my penis repeatedly. After this I took some water in the same hand and used it to gargle/ gulp.

A month later, too afraid to take an hiv test, i took a cd4 count test and a liver function test. LFT was normal and cd4 was 843 at 43.2%.

50 days after the incident, I took a cd4 test, an hcv test and a lft test. HCV was positive. liver enzymes were significantly elevated and cd4 count went down to 454 at 42.7%. 57 days after the incident I took a retroquick hiv test. It was negative. A retroquick test is a 2nd gen test.

My cd4 count significantly decreased in a span of 20 days. My liver enzymes became elevated in these 20 days. These are classic symptoms of acute hiv infection (Including increased enzyme levels).

I am afraid that I might have contracted hcv from the sex worker. Also, since prevalence of hiv is very high among indian csws, i am afraid, I might have contracted hiv from her too.

1. I know 12 weeks is when tests are conclusive, but how confident can I be of an 8 week negative

2. Can any infection other than HIV cause such a drastic drop in cd4 in such a short span of time?

3. Does simultaneous exposute to both viruses delay HIV seroconversion?

4. The fact tha liver enzymes were elevated (twice the upper limit), is it an indicator of hiv infection?

Response from Dr. Hightow-Weidman

Hello there An HIV test at 8 weeks would be accurate but not conclusive. Certainly acute hepatitis C infection could cause a drop in your CD4 counts as well as the increase in liver function tests that you have. I would recommend repeat testing for HIV at 90 days but my guess is that you are not infected, especially given the low to no risk exposure you describe. I would get treatment for the hepatitis c as there are many new treatments that have a high cure rate. Take care, LHW



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