I am 28, HSV positive after sex. Am I at risk of HIV?

Question

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.

Answer 1

Hello,

Welcome to icliniq.com.

First of all, do not panic. Your results till now are highly suggestive (but not 100 percent 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.

I hope this has helped you. Please feel free to reach me again, in case of further queries.

Thank you.

Answer 2

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.

Answer 3

Hi,

Welcome back to icliniq.com.

Answers to your queries:

Western Blot is a confirmatory test for HIV-1 and 2 and does not need repetition.
After all these test reports - No
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:

Investigations to be done include:

1. HBsAg.
2. Anti-HCV antibodies.
3. Please mention the levels of Vitamin D and Vitamin B-12 so that I can suggest the supplements accordingly.

The treatment plan will be done based on the final investigation report.

Meanwhile, you can use barrier contraception to reduce the possibility of any sexually transmitted disease transmission in the future, and stick to a single partner as preventive measure. And follow up with the reports.

I hope this has helped you. Please feel free to reach me again in case of further queries.

Thank you.

Answer 4

Hi,

Welcome back to icliniq.com.

Please find below the brief responses to your queries;

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.
High IgE levels only indicate a tendency of allergic issues like dust allergy and spontaneous hives. It has no relation with HIV.
High IgE levels do not indicate immunodeficiency.
For low vitamin D levels, start taking a capsule 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.

Hope I have solved your query. I will be happy to help you further.

Thank you.