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What is my risk of HIV and HCV after blood exposure?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

Unfortunately, I am a bicurious male who encountered a possible exposure to blood (environmental exposure). Being my first male-to-male exposure, I was not very sure how to engage in anal sex, and I just tried inserting, and I am sure even I was not hard enough to penetrate when I tried to.

So, I removed the condom and just ejaculated. Before that, I had unprotected oral sex. Once I was about to leave the place, I found a tinge of blood on the top of the used condom. It happened over three months ago. I tested the partner on the same day for the HIV fourth-generation Ab/Ag test, and he tested negative.

From then, I am panicked about being contracted with HCV and HIV. In due course, I got a small sore on my penis, which was examined by a dermatologist, and he was very sure that it was not a syphilis sore (I explained all that happened). Eight weeks later, I wanted the person who had all other STD tests, including syphilis, HCV, and HIV. He tested positive for syphilis, and only now is he on treatment.

My VDRL and TPHA results were negative until the last test, 90 days after the exposure. Further, I underwent anti-HIV Combo ab/ag, Anti-HCV, VDRL, TPHA, and HIV RNA PCR qualitatively several times in the last three months and got the results as non-reactive and non-detected. Now it has been 13 weeks and three days since the possible exposure. All the above tests were taken in a reputed lab. Apart from the above, HIV RNA qualitative and Western blot tests were also done in a different lab twice (eight and 10 weeks post exposure) and were negative.

My fear is:

  1. If there was any exposure by touching the blood while I pulled off my condom and that had contact with my penile gland when I ejaculated (though I did not have any open cut or sore, did not see any bleeding or blood tinge on my penis when I washed my penis after the mishap), will I be at a greater risk of contracting HIV or HCV (though the partner was tested negative for HIV and HCV two months post this mishap)?
  2. With the above tests done now, after three months, what is the chance that I contracted HIV or HCV? Articles on the internet talking about HIV and HCV co-infection, which delays HIV seroconversion, make me go mad. With the tests done, can I allay my fears of HIV at least?
  3. As my partner is positive for syphilis, are my three months of negative VDRL conclusive for me?
  4. Is there any other test I can do to put my mind at peace?

It has been three months since I slept, and now I feel that my liver is bulging and my ribs are aching. I know I am paranoid, but an assurance from you as a doctor would give me more confidence.

Please help.

Thanks.

Answered by Dr. Kakkar

Hello,

Welcome to icliniq.com.

I understand your concern.

Since the blood was on the outside of the condom, it was almost certainly not in direct contact with your penis. Your screening tests are negative on multiple occasions, and they are conclusive. A negative combo test (anti-HIV antibody test and P24Ag test) is considered conclusive at six weeks by most HIV (human immunodeficiency virus) specialists.

Similarly, anti-HCV (hepatitis C) and HBsAg (hepatitis B) are reliable from six weeks onwards in those with possible exposure. VDRL (venereal disease research laboratory) usually becomes positive three weeks after infection, but because of the variable incubation period of syphilis of nine to 90 days, it is certainly conclusive if it is negative at three months. So a negative at three months in your case is conclusive.

I hope this information will help you.

Thanks.

Patient's Query

Hello doctor,

Thank you for the reply.

After three months, what is the chance that I had contracted HIV or HCV?

With articles on the internet talking about HIV and HCV co-infection, which delays HIV seroconversion, makes me go mad. Do you agree with it?

If no, with the tests done, can I allay my fears of HIV, HCV, and syphilis?

Thanks.

Answered by Dr. Kakkar

Hello,

Welcome back to icliniq.com.

I understand your concern.

Yes, there can be delayed seroconversion in HIV-infected individuals infected with HCV. However, PCR (polymerase chain reaction) for HCV (hepatitis C virus) is a sensitive test and is the investigation of choice in suspected cases of delayed seroconversion. Your PCR for HCV is negative. So, that rules out this possibility.

I hope this information will help you.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

If HCV RNA qualitative non-detected rules out the possibility of HCV in me, do the above tests for HIV done so far rule out HIV in me as well?

I may sound stupid. But I do not know science.

Thank you.

Answered by Dr. Kakkar

Hello,

Welcome back to icliniq.com.

I understand your concern.

Yes certainly, a negative HIV Combo test at six weeks and beyond from risky exposure is considered to be conclusive. So, all your negative HIV Combo tests at 8, 9, 10, 11 and 12 weeks respectively are conclusive.

I hope this information will help you.

Thanks.

Patient's Query

Hello doctor,

Thanks for your reply.

Further, is there any other test I can do to allay my fear of HIV or HCV or co-infection? What is done will suffice to put my mind at rest?

Thanks in advance.

Answered by Dr. Kakkar

Hi,

Welcome back to icliniq.com.

I understand your concern.

As far as HIV and HCV infection is concerned, they have both been ruled out convincingly by the battery of tests that you have gone through. However, unprotected oral sex does carry a risk of transmission of HSV (herpes simplex virus) infection, and you have not been screened for that. Therefore, you may take a screening test for HSV types 1 and 2, ELISA, IgG, and IgM.

I hope this information will help you.

Thank you.

Answered byDr. Kakkar

Medically reviewed byiCliniq medical review team

Published At May 4, 2018
Reviewed AtJune 2, 2026

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