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HomeAnswersCosmetologyhsvI have a positive HSV test after sex. Will I get HIV?

Does HSV positivity indicate risk of HIV?

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

Dr. K. Shobana

Published At October 22, 2017
Reviewed AtJanuary 29, 2024

Patient's Query

Hello doctor,

I am a 28 year old male. I had an exposure with a CSW and precaution broke during the act. I do not know the HIV status of the girl. Four weeks later, I got a light fever which subsided in a week. I got a blood test that showed 11500 WBC with a bacterial infection. But, I have leg pain and stuffy nose from the last 30 days. I went with the following test. 28 days after exposure: HIV antibody 1 and 2 and p24 antigen test nonreactive. 37 days after exposure: HIV antibody 1 and 2 and p24 antigen test nonreactive. HIV RNA PCR (quantitative test) undetectable. 42 days after exposure: HIV antibody 1 and 2 and p24 antigen test nonreactive. 49 days after exposure: HIV antibody 1 and 2 and p24 antigen test nonreactive. Serological test for syphilis nonreactive. Herpes simplex 1 and 2 IgM reactive. Herpes simplex 1 and 2 IgG reactive. What are my chances of being infected with HIV? Since herpes simplex is reactive, does it mean that I am infected with HIV?

Thank you.

Hello,

Welcome to icliniq.com.

First of all, do not panic. Your results till now are highly suggestive (but not 100 % confirmatory) of you being HIV (human immunodeficiency virus) negative. Please note. Getting triple ELISA (enzyme-linked immunosorbent assay) with p24 Ag test every few days will not help. You just need to get it done once, and if negative, it should be repeated at the fourth month and then sixth month only. Your positive IgG and IgM for herpes simplex virus (HSV) are only indicative of the fact that you have been exposed to HSV virus in the past and may have an active herpes progenitalis, characterized by superficial erosions over the glans or penile shaft. Having HSV infection increases the chance of acquiring HIV. But, a positive Ig test for HSV does not in any way have any indication of HIV positivity. So, please do not get unduly concerned about that. If you want to be really sure about a remote possibility of HIV infection, get a western blot test. The possibility of HIV positivity, however, is almost negligible due to negative (undetectable) HIV RNA levels. So as of now, just do the following. Relax and do not panic. Get a western blot test for HIV confirmation. If it is negative, you are surely HIV negative. Get the following additional tests - HBsAg and Anti-hepatitis C antibodies. If you are married, get HIV ELISA with p24 done for your spouse. And, until both your results are available, strictly avoid any sexual contact. In the future, stick to your spouse or partner. Always use barrier protection such as a condom during any act of intercourse. Get back to me with the reports as suggested. Also tell me in your response, if you have any genital ulcer, swollen glands in the inguinal (groin) region, burning sensation on the passing of urine, pus discharge from the urethral opening. Also, if you are married, then inform me about any genital symptoms that your spouse is suffering from. Awaiting your answers to the queries. Follow up with reports. Best regards.

Patient's Query

Hi doctor,

No, I do not have any of those symptoms that you asked about. But, I do have a regular pain in my foot and a tingling sensation. I also got tested for vitamin D and the result was 7.67. I have a vitamin B12 deficiency as well. I also tested for allergy and got the result as high dust allergy. As I have a stuffy nose from a long time, immunoglobulin E level is 657 (high). What is the right time to get the western blot test done? Is 60 days after exposure reliable enough? What are my chances of being infected with HIV?

Thank you.

Hello,

Welcome back to icliniq.com.

May I suggest you have a telephonic consultation with me? I need to counsel you and discuss some issues that cannot really be written elaborately. There is nothing to worry at all. But a telephonic discussion would definitely help you much more.

Thank you.

Patient's Query

Hi doctor,

I tested eight weeks after the exposure. Western blot test is negative. All std panels and herpes simplex are nonreactive.

After 10 weeks of exposure

HIV 1 proviral DNA -is not detectable.

HIV 1/2ab +p24 ag - Non reactive

1 . Does the 10 weeks negative turn positive after 12 or more weeks?

2 . Is there any chance of HIV 2 infection?

3 . Should I go for an HIV 2 RNA PCR test?

Thank you.

Hi,

Welcome back to icliniq.com.

Answers to your queries:

1 . Does the 10 weeks negative turn positive after 12 or more weeks?

Western Blot is a confirmatory test for HIV-1 and 2 and does not need repetition.

2 . Is there any chance of HIV 2 infection?

After all these test reports - No

3 . Should I go for an HIV 2 RNA PCR test - You do not need to, but for your peace of mind, I would not stop you from getting it done. Do not worry from an HIV point of view. But a few things got left out:

1) HBsAg.

2) Anti-HCV antibodies.

3) Please mention the levels of Vitamin D and Vitamin B-12 so that I can suggest you the supplements accordingly.

Thank you.

Treatment plan

Based on the final investigation results.

Preventive measures

Barrier contraception to reduce the possibility of any sexually transmitted disease transmission in the future, and sticking to a single partner.

Regarding follow up

Follow-up one last time with the reports asked for.

Patient's Query

Hi doctor,

I had tested 12 weeks after exposer

  1. HIV RNA PCR and HIV 2 were undetectable.
  2. Hbsag was non-reactive.
  3. Hepatitis C non-reactive.
  4. Hiv ab + p24 non-reactive.
  5. Western blot was negative.

My questions

1. Are 12 weeks result conclusive, or do I have to test again at 24 weeks?

2. I have high IgE levels of 657. May this take HIV antibodies to develop later?

3. Does high IgE levels indicate immunodeficiency, as my WBC count is 11500?

4. My vitamin D level is 7.67.

Thank you.

Hi,

Welcome back to icliniq.com.

Please find below the brief responses to your queries;

  1. The total of all your results is conclusively negative. You do not have an HIV infection. So no more worry, anxiety, or apprehension. Stay happy but safe.
  2. High IgE levels only indicate a tendency of allergic issues like dust allergy and spontaneous hives. It has no relation with HIV.
  3. High IgE levels do not indicate immunodeficiency.
  4. For low vitamin D levels, start taking a capsule of Uprise-D3, Eco-D3, or Bonshine, either of these brands, of 60K units - one capsule to be taken empty stomach with little milk every Sunday (or any particular day of the week) - that means once-a-week for 12 weeks.

All the very best.

Thank you

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

Dr. Sidharth Sonthalia
Dr. Sidharth Sonthalia

Dermatology

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