Dr. Basti Bharatesh Devendra
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,
I had sexual intercourse four and a half months back. I had taken the HIV Combo test after 46, 70, 124, and 138 days and the results came negative, respectively. I have a previous history of asthma and have been taking Prednisolone 5 mg daily for the past year. Can Prednisolone delay the antibodies? Are these results conclusive, or do they need to be repeated at six months? Kindly help.
Hello,
Welcome to icliniq.com.
It is good that the fourth-generation HIV (human immunodeficiency virus) antibodies test is negative repeatedly even after 138 days of risk exposure. Prednisolone (a steroid medication) can alter the antibodies to some extent. In my opinion, the test can be considered conclusive as the test also detects HIV antigens. The chances of HIV tests coming positive later are almost nil. If you are anxious, you can go for an HIV antibodies test after six months of exposure to relieve anxiety. Kindly revert for more queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
I want to add that I did not take Prednisolone for 70 days before the last test. In this case, my previous antibodies test is conclusive or still need to be repeated? Kindly help.
Hi,
Welcome back to icliniq.com.
Prednisolone, to some extent, can alter antibodies. In my opinion, the test can be considered conclusive as the test also detects HIV antigens. The chances of HIV tests coming positive later are almost nil. As said previously, you can go for an HIV antibodies test after six months of exposure to be relieved of anxiety. Kindly revert for more queries.
Thank you.
Patient's Query
Thank you for your reply doctor.
I have had sores on my tongue for the last three months. So I consulted a doctor, who advised me to gargle one teaspoon of Prednisolone with one glass of water two times a day. Can this cause a delay in showing antibodies? Can this have the same effect on immune systems as Prednisolone tablets orally? Kindly advise.
Hi,
Welcome back to icliniq.com.
The ulcers may be due to aphthous ulcers. Prednisolone may alter antibodies to some extent as it is a steroid. The chances of HIV tests coming positive later are almost nil, as HIV tests repeatedly came negative. You can get the HIV tests after six months of exposure to be relieved of anxiety. Kindly revert for more queries.
Thank you.
Patient's Query
Thank you for your reply doctor,
Can gargling with Prednisolone syrup and water affect antibodies as well? Kindly help.
Hi,
Welcome back to icliniq.com.
Some absorption can occur, and there are minimal chances of antibodies getting affected. However, to be safer and relieve anxiety, you can take the test after six months of exposure. Kindly revert for more queries.
Patient's Query
Hello doctor,
As I had sex with an African sex worker, so I am concerned about HIV-2. Can a combo test detect p24 antigen for HIV-2 as well? Or does it detect p24 antigen for only HIV-1? Kindly help.
Hi,
Welcome back to icliniq.com.
Yes, many of the HIV combo tests detect HIV-1 antigen and HIV-1/2 antibodies. You can check in your reports regarding the same. You need not worry as the tests are already negative repeatedly and even at 138 days post-exposure. As mentioned earlier, go for HIV tests again after six months to relieve your anxiety.
Thank you.
Patient's Query
Hello doctor,
Kindly go through my combo test reports and advise me. Do these tests detect antigen for HIV-2 or is it only for HIV-1? Kindly help.
Hi,
Welcome back to icliniq.com.
I have gone through your reports (attachment removed to protect patient's identity). It is more likely to detect p24 ag of HIV 1. It is not mentioned clearly. It does not matter in your scenario as antigen usually is transient for the initial few weeks, and later antibodies only will be detected. As 138 days have lapsed, antibody detection is more critical and conclusive. The chances of HIV tests coming positive later are almost nil in your scenario. Just because intake of prednisolone is there, you may have to go for an HIV antibodies test after six months of exposure to relieve anxiety.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I got the result of the PCR test for HIV-2, which is negative. The sample was taken on 155 days after the exposure. PCR for HIV-1 was also negative after 138 days of exposure. I have attached those reports herein. Is antibodies test after six months still required? Kindly help.
Hi,
Welcome back icliniq.com.
In my opinion, there is no further need for HIV tests. These are conclusive. You can go for an HIV antibodies test after six months of exposure to be relieved of anxiety.
Thank you.
Patient's Query
Hello doctor,
Still, antibodies test is required after six months to be conclusive or are these enough? Kindly suggest.
Hi,
Welcome back to icliniq.com.
Thank you for the query. In my opinion, there is no further need for HIV tests. These are conclusive. You can go for an HIV antibodies test after six months of exposure to be relieved of anxiety.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
I recently learned about groups N and O of HIV. Is it true that these groups cannot be detected in the combo test? Does the PCR test detect these groups? Or else which test can surely detect these groups? Kindly help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
Most of the available antibody tests detect antibodies for all HIV subtypes. PCR detects the genetic material of HIV, not antigen-related. So do not worry. You will get lots of information from internet sources which can misguide you. Antibodies test is conclusive after six months in your scenario. You can do it as suggested earlier. Kindly revert for more queries.
Thank you.
Patient's Query
Hello doctor,
Thanks for your reply.
PCR detects the genetic material of HIV, which means if it is negative, it will be negative for all groups, including N and P? Does ELISA (enzyme-linked immunosorbent assay) test will detect these groups? I plan to go for it in six months as you suggested. However, now 176 days completed after exposure, so can I go for the test, or should I wait till 180 days more? Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
Yes, antibodies test after six months or 180 days exposure is enough and conclusive. PCR (polymerase chain reaction) detects genetic component of HIV (human immunodeficiency virus) 1 or 2. Kindly revert for more queries.
Thank you.
Patient's Query
Hello doctor,
As per your advice, I got tested after six months of exposure, which was non-reactive. After that, I started having unprotected sex with my wife to have a baby. I tested again at nine and a half months because I was worried, and the report came negative. After one month of unprotected sex with my wife, I got my wife tested with HIV combo test with non-reactive and index was 0.18. So during this period, we had sex almost three to four times. Again after one month, she got tested, but the index value was 0.8. I am worried about this change in index value which is a little high. During this period, we again had unprotected sex three to four times. Should I get my wife tested again for HIV? Kindly help.
Hi,
Welcome back to icliniq.com.
These tests are conclusive and do not worry about HIV types and tests. I do not see any need for further HIV tests for you or your wife. Kindly revert for more queries.
Thank you.
Patient's Query
Thank you for your reply docotor.
Why is this variation in index value from 0.18 to 0.80? Why did it get high in only one month? Also, the lady is around nine weeks pregnant now. Kindly help.
Hi,
Welcome back to icliniq.com.
The titers can vary; as long the report is negative, it is negative only. Kindly revert for more queries.
Thank you.
Patient's Query
Thank you for your reply doctor.
Can p24 antigen be detected in someone who is infected and left untreated? Kindly advise.
Hi,
Welcome back to icliniq.com.
P24 antigen need not be detectable after some months of exposure, but the antibody will be detected. The HIV combo or duo test has antigen and antibody detection. So no need to worry about that.
Thank you.
Patient's Query
Thank you for your reply doctor.
Sometimes in a hurry, barbers do not change the blade or razor and use the same razor or blade for other customers. Can this be a cause of infection? Can it be transmitted through small cuts or scratches on the skin from the old blades or razor? Kindly help.
Hi,
Welcome to back icliniq.com.
Yes. It can be transmitted through the reuse of blades in barber shops. Always make sure that the barber changes the blades before use. Kindly revert for more queries.
Thank you.
Patient's Query
Thank you for your reply doctor.
So I need to be tested because I did not notice him change the blades? Kindly help.
Hi,
Welcome back to icliniq.com.
You can confirm with him if he has changed the blade and still if you are anxious then you can get the test done.
Thank you.
Patient's Query
Thank you for your reply doctor.
But as I read on the internet articles and experts' comments, HIV cannot live outside the host body and will die immediately. Is it like that? Kindly advise.
Hi.
Welcome back to icliniq.com.
HIV can survive outside body for few minutes.
Thank you.
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