Dr. Penchilaprasad Kandikattu
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
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Patient's Query
Hi doctor,
I had unprotected vaginal sex ten weeks ago. But I suffer from premature ejaculation, so I finished within two minutes. Following that, I got her to do a 4th generation HIV test the next day as I was freaking out from the exposure as I was not sure about her status. She did it, and it was non-reactive. I can attach a report if needed. One month back, as I was still afraid of exposure, I went to a sexual health clinic and did a rapid test on HIV, syphilis, hepatitis B, and C. The rapid tests used were HIV screening test, rapid lateral flow test for HBsAg and rapid test for HCV antibody. Everything was non-reactive. One week after that, I ran basic health testing for major components like FBC, LFT, renal function and diabetic screening, and infectious disease HIV Ag/Ab (CMIA) (non-reactive), Treponema Pallidum Ab (non-reactive), HBsAg CMIA (non-reactive) and HbSAb CMIA (non-reactive).
Hello,
Welcome to icliniq.com.
Do not worry. You do not have any retroviral disease at present. I have gone through your investigation reports (attachments removed to protect the patient's identity). Still, if you have queries, please feel free to ask. Serum cholesterol is on a little higher side, so exercise regularly and avoid cholesterol-rich foods.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
Does that mean no retroviral disease at present and I can get it later down the line? Can I take the HIV tests to be conclusive?
1) Alere HIV Combo (non-reactive) - 7 weeks post exposure.
2) HIV Ag/Ab (CMIA) (non-reactive) - 8 weeks post exposure.
Can I take the Hepatitis B test to be conclusive?
1) Determine HbSAg2 (Abbott) (non-reactive) - 7 weeks post exposure.
2) Hepatitis B surface Antigen (CMIA) (non-reactive) - 8 weeks post exposure.
3) Hepatitis B surface antibody (non-reactive).
Hello,
Welcome back to icliniq.com.
I read your query and can conclude there is no chance of getting HIV (human immunodeficiency virus) infection later. The test may detect p24 antigen within two weeks, which was negative. CMIA (chemiluminescent magnetic microparticle immunoassay) is nonreactive, so do not worry. HBsAg is also negative. It is conclusive, mostly 99%, so do not worry.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply,
I have a question regarding hepatitis B panel test. My hepatitis B antigen was non reactive and hepatitis B antibody was negative. Please help.
Hi,
Welcome back to icliniq.com.
From the reports attached (attachments removed to protect the patient's identity), there are reports of liver function test, rheumatoid factor, and lipid profile. But I did not receive hepatitis panel of investigation. Please send it.
Patient's Query
Hello doctor,
Thank you for the reply.
I did not take the complete hepatitis panel test. I have attached the reports.
Hi,
Welcome back to icliniq.com.
From the reports attached (attachments removed to protect the patient's identity), you are normal.
Patient's Query
Hello doctor,
Thank you for the reply.
My report shows negative for both HBsAg and HbsAb, which means I am not infected and not immune to Hepatitis B. Should I be concerned about it as I am joining the medical school this year? I have been vaccinated thrice during my childhood. Why does my body unable to produce antibodies? Is it related to the COVID vaccine? Should I vaccinate with a single booster or in three doses? Please help.
Hi,
Welcome back to icliniq.com.
From the reports attached (attachments removed to protect the patient's identity), antibody levels reduces over a period of 10 to 15 years after vaccination but cellular memory is long-term. So, single booster dose is enough to induce immunoglobulin production. Even though if you took vaccine at first six months of life the antibodies level may reduce over a period of 10-15 years but cellular memory will be there for life long. So do not worry and you can take a single dose of booster dose of hepatitis b vaccine to induce immunoglobulin production. Repeat it every ten years if possible.
Patient's Query
Hello doctor,
Thank you for the reply.
What is a cellular memory? Does that mean I am immune to hepatitis B even though my antibody level is low?
Hi,
Welcome back to icliniq.com.
Memory cells are present in the bone marrow for the whole life. They will produce antibodies if you are infected or vaccinated.
Patient's Query
Hello doctor,
Thank you for the reply.
Since I am negative to HbsAg since my last exposure was before three months and that I do not have HbsAb, I will need to be vaccinated once again. Do you think booster vaccination will be sufficient or should I go for another complete three cycles? Should I be concerned about my results? I would humbly seek your assurance in this as your final response so that I can move on with my life once again.
Hi,
Welcome back to icliniq.com.
Single dose is sufficient. You will produce required antibodies after the vaccination. You are completely normal since you were negative.
Patient's Query
Hello doctor,
Thank you for the reply.
Should I be concerned about the exposure after negative results?
Hi,
Welcome back to icliniq.com.
The test has 92 % sensitivity and 99 % specificity. The chance of turning positive is nil unless you are exposed during sex or needle sharing. Even vaccine is considered as a exposure.
Patient's Query
Hello doctor,
Thank you for the reply.
I have already exposed during sex. My partner took a test for HIV. But she was in her window period. After 49 days, I took fourth generation test. After 58 days, I took STD screening tests. All my tests showed non-reactive. Last week, I did confirmatory diagnosis for HIV. The result was non-reactive. Can it be used as confirmatory diagnosis? I have red spots on tongue. Should I be concerned about HIV?
Hi,
Welcome back to icliniq.com.
From the reports attached (attachments removed to protect the patient's identity), the test taken after 50 days of exposure is 99.5 to 99.7 % accurate. Do not worry. The red spots on tongue occurs due to the inflammation of fungiform papillae seen in common cold or riboflavin deficiency. I suggest (consult with a specialist doctor, talk with him or her and take medicines with their consent) Vitamin B complex tablets. Avoid oily or spicy foods.
Patient's Query
Hello doctor,
Thank you for the reply.
Should I repeat the test after 90 days? I will follow your instructions.
Hi,
Welcome back to icliniq.com.
Your red spots will subside after three to five days. Do not worry, your results are already negative.
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Internal Medicine
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