Dr. Sushil Kakkar
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Last year I had protected sex with a new condom with a sex worker. The intercourse lasted for ten minutes. The condom did not break after I finished. After this incident, I got worried about getting HIV (Human Immunodeficiency Virus) and did several tests. Nearly eight tests in total. These tests were HIV 1 and 2 antibodies and p24 antigen test both ECLIA (Electro chemiluminescence Immunoassay) and ELFA (Enzyme Linked Fluorescent Assay) methods. All the tests came negative. My latest report is from the last month. I did both 4th generation HIV 1 and HIV 2 antibody and p24 antigen tests. Both the test came out non-reactive. Below are my queries. Are these tests conclusive? No further testing is required? Am I HIV-negative? I am finding it difficult to cope with the fear of contracting HIV. Even if I get a cold or cough, I get worried about whether these are HIV symptoms? Since that sexual incident, I fell ill frequently, which would be cold and throat pain; I used to get worried about that as well. Has my immune system weakened, and does this have to do with Hiv? Please help me.
Thank you.
Hello,
Welcome to icliniq.com.
I have noted your concern. First of all, protected sex is safe. Secondly, your screening tests have convincingly ruled out HIV. So, you do not need to worry.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply—I just have a few more questions. I am just unable to get out of the fear. Last week I heard someone got diagnosed with HIV near my home, and I got scared. How to gain the confidence of being HIV (Human Immunodeficiency Virus) negative and move on with life? Can I donate blood and donate my organs if I would like to in the future?
Hello,
Welcome back to icliniq.com.
Your tests are negative on multiple occasions. So that proves beyond doubt that you are HIV negative. So yes, you can donate blood and organs in the future.
Thank you.
Patient's Query
Hello doctor,
I need a quick clarification. I have heard rumors that people have got infected with HIV through street food or by consuming fruits cut with HIV-contaminated knives. Is this true?? What is the risk of having fruits which are cut by vendors who themselves are HIV positive??
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
HIV is only transmitted through unprotected sex with the exchange of infectious fluids like blood, semen, vaginal fluids, etc., or through contact between infectious genital mucosal surfaces. HIV does not survive outside the body, and therefore there is no risk of HIV from eating or consuming foods with possible contamination with blood or other infected fluids. Moreover, the intact gastrointestinal mucosa does not provide access to the virus. So you do not need to worry about HIV contraction through food.
Thank you.
Patient's Query
Hello doctor, Thank you for the clarification.
Few more queries I have. As I had mentioned, I had been to massage spas several times last year, where I had been more intimate with massage girls' breasts and nipple areas. My tongue and mouth had been in contact with these places during the sessions. Are there any risk factors for contracting hepatitis A, B, or C? I have had on and off stomach issues, indigestion, stomach bloating, and yellow stool issues over the past several months. I am worried if these might be symptoms of any hepatitis? Does hepatitis symptoms show up after a long period of time? Should I get tested for hepatitis? Does hepatitis spread through breast milk?
Thank you.
Hello,
Welcome back to icliniq.com.
Hepatitis A usually spreads through contaminated food or water, whereas hepatitis B occurs through unprotected sex or sharing injection needles with drug abusers. Hepatitis C spreads through sharing needles like injection drug abuse or blood transfusions. Hepatitis C does not even spread through unprotected sex.
Thank you.
Patient's Query
Hello doctor,
It has been one year since that incident, and all my eight tests are negative. Since the beginning of this month, I have had constant gastric issues and did an endoscopy that diagnosed me with gastritis. I have been on medication since then. You have assisted and also given assurance that I am totally alright. I have a few more questions. Does my gastritis issue has to do something with HIV? Does HIV shows up after one year of infection? Should I mention my sexual encounter issue and tests I took up for HIV to the gastroenterologist?
Hello, Welcome back to icliniq.com.
Thank you for your follow-up question. Your HIV status is conclusive. A negative 4th generation HIV screening test at three months (and beyond) after sexual contact is 100% conclusive. So your gastritis has nothing to do with HIV. Your status is final, and it will not change even after one year. You may mention your sexual history to the gastroenterologist. I am sure he will reassure you of your negative HIV status.
Take care.
Patient's Query
Hello doctor,
I just have a few clarifications to be made. The tests used are 100% accurate and certified by a medical board, correct? In my case, there cannot be a case of a false negative? Any health issues from now on should be looked at outside the view of HIV?
Please answer.
Hello,
Welcome back to icliniq.com.
Yes, these recommendations and guidelines are accepted worldwide. Center for Disease Control (CDC), World Health Organisation (WHO), and National AIDS Control Organisation (NACO) (India) accept and approve these guidelines for screening tests. To reiterate, a negative HIV screening test at three months is 100% reliable and conclusive. At three months, an HIV screening test is 100% sensitive, and therefore there is no chance of it being a false negative. So, yes, I agree that any health issue should be looked at separately from HIV.
Take care.
Patient's Query
Hello doctor,
I just did a liver function test as advised by my gastroenterologist. I see a few parameters are high. So I just want to check with you if these are not due to any of the hepatitises just to rule out hepatitis infections in my case.
Could you please check my reports and advise.
Hello, Welcome back to icliniq.com.
From the attached reports (attachments have been removed to protect the patient's privacy), serum bilirubin is raised slightly above the normal range, but I could not find any report for viral markers, i.e., hepatitis B or C. This could be due to some drug intake or alcohol intake? Do you take alcohol? Are there any drugs that you are taking?
Take care.
Patient's Query
Hello doctor,
I am not on any medication. Does hepatitis B spread only from blood to blood contact? Or can it spread through the blood to the mouth or other means? Does hepatitis show symptoms immediately or after a few months? Is hepatitis curable by vaccination?
Please answer.
Hello,
Welcome back to icliniq.com.
Hepatitis B spreads only through blood-to-blood contact such as blood transfusion, sharing needles, or direct sexual contact and not from kissing or saliva. The infection may be silent, or it may show symptoms within days to weeks. Vaccination prevents the infection but does not cure it.
Take care.
Patient's Query
Hello doctor,
We had a family gathering tonight, and one of my relatives fell off during dancing and got injured on his knee and had minor bruises, and blood started coming out. So after nearly 15 minutes, as a first-aid, I applied turmeric powder on his bare injured knee by using my bare palm, and in the process little bit of blood was touched by my palm. My palm did not have any open wounds or scratches, and I washed my palm with soap after this.
Please advise if this is risky behavior for HIV contraction?
Anything to be concerned about?
Hello,
Welcome back to icliniq.com.
Ideally, one should never touch infectious fluids like blood with bare hands, but since intact skin is an efficient barrier, so there is no risk of acquiring HIV through this particular incident.
Take care.
Patient's Query
Hello doctor,
Just to confirm, this is not a risky behavior for HIV, correct? I am a bit worried. I did not think of this due to the intensity of the incident.
Please advise.
Hello,
Welcome back to icliniq.com.
I can understand. Do not worry. There is no risk of HIV from this particular incident.
Take care.
Patient's Query
Hello doctor,
Thank you for your advise. After that incident, I experienced a lot of stress. I did not sleep that entire night, and now I feel feverish. I am not sure what might be causing it. I hope these symptoms are not related to that night's incident? Is it due to stress and overthinking, which I am doing? Are there any cases where people have been infected with HIV in this way? I hope there is no need for a screening test due to the incident? Am I safe from any other infection which gets transferred via blood contact?
Please advise.
Hello,
Welcome back to icliniq.com.
The intact skin of hands is a tough enough barrier to prevent any blood-borne infectious microbial pathogen from passing through unless the skin barrier is compromised. A feverish feeling could be due to stress and lack of sleep. So relax.
Take care.
Patient's Query
Hello doctor,
Could you explain when the skin barrier is being compromised? Is it deep cuts that are bleeding or even minor cuts? Please advise on the above. Doctor, thanks for your expert advise on this issue and also other ones over the course of time. I will try to relax and calm down. You have been very helpful in all my worries and issues.
Thank you very much.
Hello,
Welcome back to icliniq.com.
Minor cuts or scratches do not compromise the skin. It has to be a fresh deep cut or laceration that is actively bleeding.
Thank you for your appreciation. You are always welcome.
Take care.
Let me know if you need any more assistance.
Patient's Query
Hello doctor,
Do you advise me to take another rapid card test or ELISA test due to that night's incident? Do you think this is required? My negative HIV status still holds good, correct? I had no high-risk behavior for 1.5 years.
Thank you.
Hello,
Welcome back to icliniq.com.
There is no need for a card test, given that exposure was not risky.
Take care.
Patient's Query
Hello doctor,
What happens if the viral load was less during exposure? What will be the upper limit or window period for a conclusive result, or what will be the duration of generating antibodies? Would it still be three months? Or is it more than that? And also, are the 4th generation antibodies test sensitive to detect antibiotics when the viral load was less during exposure? I just want to rule out even the "less viral load" situation in my case.
Please advise.
Hello,
Welcome back to icliniq.com.
A less viral load would mean less chances of passing on HIV infection, but if infected, it would have no bearing on the window period of the 4th generation HIV screening test. The window period would remain the same, i.e., 4 to 12 weeks in a newly infected partner, irrespective of the infected partner's viral load. Let me know if you need any more assistance.
Take care.
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