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Can someone who is non-reactive have an HIV infection?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At August 22, 2022
Reviewed AtDecember 18, 2023

Patient's Query

Hi doctor,

I have queries related to my human immunodeficiency virus (HIV) test and sexually transmitted diseases (STD).

Hi,

Welcome to icliniq.com.

I understand your concern. Can you please elaborate on your query? I will try to help you.

Patient's Query

Thank you doctor for the reply,

I had protected sex a month ago with a clinical social worker. I did not have any symptoms other than mouth burning. I went for the test to pathology after 28 days of my exposure. I got myself tested through four generation human immunodeficiency virus (HIV) duo from two different pathologies. Both test reports were non-reactive. I got myself tested for sexually transmitted diseases too. My herpes simplex virus (HSV) 1+2 immunoglobulin M is positive with 1.11 just above equivocal 1.10. My rapid plasma reagin (RPR) and treponema pallidum haemagglutination (TPHA) test is also negative. Two reports are yet to be released by the laboratory. I have two queries: Is my human immunodeficiency virus (HIV) test reliable, and can I relax as far as human immunodeficiency virus HIV is concerned? What about the herpes simplex virus (HSV)?

Welcome back to icliniq.com.

I read your query and can understand your concern. It is good that the human immunodeficiency virus (HIV) duo test is negative after 28 days of exposure. The chances of human immunodeficiency virus (HIV) tests coming positive later are almost nil. But it is better to go for an human immunodeficiency virus (HIV) antibodies test after three months of exposure to have conclusive results and relieve anxiety. Herpes simplex virus (HSV) one or two is transmitted by skin-to-skin contact, kissing, or sexually transmitted diseases (STDs). If immunoglobulin M (IgM) is positive, it indicates a recent infection. If you have lesions, then consult your doctor for antiviral medication. You can again go for herpes simplex virus (HSV) one and two, immunoglobulin M (IgM), and immunoglobulin G (IgG) after three months of exposure. Herpes simplex virus (HSV) is not a severe disease like human immunodeficiency virus (HIV).

Patient's Query

Thank you doctor for the reply,

What does equivocal means? My range is 1.11, just above equivocal 1.10. I do not have any genital lesions. Regarding human immunodeficiency virus (HIV), what are the chances of me seroconverting after 28 days? As per the guidelines, 42 days are required for a conclusive fourth-generation test. Is it applicable to the testing system in our country too? Kindly clear my cobwebs and assure me. I am mentally stressed. I need to take care of my family. Is protein 24 (P24) detected within 28 days? I am experiencing tingling sensation in my hands and fingers. Also, a few dry eruptions keep erupting on the backside of the palm. There is numbness in the hands and fingers too occasionally. I also have a pinching sensation on my fingers and palm. Before the exposure to the incident, I had severe allergies on my neck, behind the ears, and face, with red patches. I showed it to a dermatologist. He said my skin is photosensitive, and prescribed me the Tablet Momate XL. There is no sensation whenever I apply on red patches other than the back of my palm. Only the backside of the palm has a burning sensation after using it.

Welcome back to icliniq.com.

I read your query and can understand your concern.

The symptoms are non-specific and need not be related to human immunodeficiency virus (HIV). Consult your doctor for examination and management if it persists. Human immunodeficiency virus (HIV) duo is a very sensitive test after one month. Some consider it conclusive. The chances of human immunodeficiency virus (HIV) tests coming positive later are almost nil. But it is better to go for an human immunodeficiency virus (HIV) antibodies test after three months of exposure to be relieved of anxiety totally and conclusive results. Forget episode for now till three months. Get involved in activities of your interest. Do yoga, meditation, and exercises. If too anxious, consult your psychiatrist for counseling and management.

Patient's Query

Thank you doctor for the reply,

Is there any test that can confirm human immunodeficiency virus (HIV), however costly it is? I am on one month of exposure and want to put my mind to rest.

Welcome back to icliniq.com.

I read your query and can understand your concern.

Do not worry. These tests are enough and are almost conclusive. Wait for three months with patience.

Patient's Query

Thank you doctor for the reply,

Are these dry eruptions due to herpes simplex virus (HSV) positive? I feel dryness in my palm.

Welcome back to icliniq.com.

I read your query and can understand your concern. Form the attached reports (attachments removed to protect patient's identity), it does not look like herpes lesions. It may be due to dryness or irritation, or any allergies. I suggest you continue your consultation with your treating doctor.

Patient's Query

Thank you doctor for the reply,

Kindly look at my report.

  1. Is anything wrong with the report?
  2. Do I need to take any anti-viral?
  3. Why do we need to test after three months when the reports are accurate on the 28th day of exposure?
  4. When you say after 28 days, it is almost nil. What percentage of surety would you give at 28 days?

Welcome back to icliniq.com.

Do not worry too much. There is not much benefit of anti-human immnunodeficiency virus (anti-HIV) medications for you. Antibodies can be formed from two to six weeks post-exposure up to three months. So it is better to go for an human immnunodeficiency virus (HIV) antibodies test after three months of exposure. This is not mathematics to give a percentage surely. Many factors play a determining role.

Patient's Query

Thank you doctor for the reply,

I request you to suggest some antiviral medicines for positive herpes simplex virus (HSV).

Welcome back to icliniq.com.

If you do not have lesions, no medicines are usually required for herpes simplex virus (HSV).

Patient's Query

Thank you for the reply.

I am sorry for asking so many questions.

Will herpes simplex virus (HSV) immunoglobulin M (IgM) test reports change human immunodeficiency virus (HIV) status to positive in the coming days? I never had any lesions or blisters during the exposure, nor do I have any now. Kindly advise on the role my herpes simplex virus (HSV) immunoglobulin M (IgM) in the human immunodeficiency virus (HIV) in the coming days. Secondly, if immunoglobulin M (IgM) positive indicates recent infection, how long ago could i have been exposed?

Welcome back to icliniq.com.

I can understand your concern.

Herpes simplex virus (HSV) will not affect human immunodeficiency virus (HIV) test results. It will not change human immunodeficiency virus (HIV) status or test results. Immunoglobulin M (IgM) herpes simplex virus (HSV) indicates you recently had an infection for a few days. It will fade away within a month or so.

Warm regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basti Bharatesh Devendra
Dr. Basti Bharatesh Devendra

Dermatology

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