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 twice unprotected oral sex with the same commercial sex worker. First time since ten weeks and the second since six weeks. After the first time, I got a fever and cough. The fever resolved after four days, and I am worried it might be due to HIV (human immunodeficiency virus). But the second time, I got red dots over my chest and shoulders at six weeks. After four weeks, I was highly stressed about HIV. So I did a combo test at four weeks and ten weeks from the first exposure, which was non-reactive. Also, I did a combo test six weeks after the second exposure. It was non-reactive. I did PCR (polymerase chain reaction) HIV 1 RNA (ribonucleic acid) one month after the first exposure, and after one month from the second exposure, both were not detected. Are my results assuring? What are the possibilities the test would change after 12 weeks? Is the combo test p24 antigen test for HIV 1 and 2, or is it specific for HIV 1?
Hello,
Welcome to icliniq.com.
The chances of transmission of HIV (human immunodeficiency virus) by unprotected oral sex are almost nil unless there are bleeding wounds in the oral cavity. The chances of HIV tests coming positive later with given test results is almost nil. But it is better to go for an HIV antibody test after three months of exposure for conclusive results and to relieve anxiety. Yes, a combo HIV test is 4th generation test that detects both the p24 antigen and HIV 1 and 2 antibodies. The rashes and symptoms are non-specific and do not suggest HIV. If it persists, consult your doctor for further examination and management.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Is the p24 antigen an antigen for HIV or both HIV 1 and 2?
Hello,
Welcome back to icliniq.com.
These are tests used to detect the P24 antigen of HIV 1.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
How much time do antibodies need to be detected?
Hi,
Welcome back to icliniq.com.
HIV (human immunodeficiency virus) antibodies will be formed within two to six weeks after exposure. The chances of HIV tests turning positive later are almost nil. However, it is advisable to undergo an HIV antibodies test three months after the last exposure. Tongue whiteness may be due to poor hygiene and is not related to HIV. Consider using tongue cleaners for better hygiene. Blood values are not related to HIV. Consult your doctor for further management.
Hope this helps you. Feel free to ask if you have any further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you again for your time; I greatly appreciate it.
The most recent combo HIV tests are negative. Is this oral candidiasis on my tongue? As you saw in the picture.
Hi,
Welcome back to icliniq.com.
It does not appear to be candidiasis. It may be due to poor oral hygiene. Maintain hygiene and use tongue cleaners. It is good if the combo test is negative, but it is even better to go for an HIV (human immunodeficiency virus) antibodies test after three months of exposure.
I hope this has helped you.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
I did follow-up tests. Can you give me your opinion? I had a PCR HIV-1 RNA test after 42 days from the last exposure, and it was not detected. I also had a PCR HIV-2 RNA test after 58 days from the last exposure, and it was not detected. I also took an HIV combo test after 30, 40, and 60 days from the last exposure. Can I have peace of mind? Can the results change later?
Hi,
Welcome back to icliniq.com.
Thank you for the follow up query.
The chances of HIV (human immunodeficiency virus) tests coming positive later is nil with given test results. But it may be better to undergo an HIV antibodies test after three months from the last exposure to completely relieve anxiety.
Patient's Query
Hello doctor,
Thank you for the reply.
One more question: are the PCR tests for HIV-1 and HIV-2 accurate after this period? Is the combo test after 60 days, which came back negative, also considered conclusive? I am still experiencing itchiness on my body. Could this be related to HIV symptoms?
Hi,
Thank you for the follow up query.
They are almost conclusive on the given dates. The chances of HIV tests yielding positive results later are almost nil. The symptoms are nonspecific and not related to HIV.
Patient's Query
Hi doctor,
Thank you for your prompt reply.
I want to update you on my tests. As I mentioned before, I did an HIV-1 RNA PCR test at 6 weeks, and it was not detected. I also did an HIV-2 PCR DNA RNA test at 6 weeks, and it was not detected. I repeated the HIV-1 RNA PCR test at 10 weeks, and it was still not detected. I also repeated the combo test at 10 weeks, and it was non-reactive. Is it possible for the test to be negative at 70 days and change at 90 days? I still feel itchiness on my skin, hands, and sometimes my back.
Hi,
Welcome back to icliniq.com.
As I mentioned earlier, the chances of HIV tests yielding positive results later, based on the given test results, are almost nil. It is better to undergo an HIV antibodies test after 90 days of exposure to alleviate anxiety completely and obtain conclusive results. The symptoms are nonspecific. Avoid attributing everything to HIV. Consider symptomatic treatment, and if necessary, consult your doctor for symptom management.
I hope this has helped you. Thank you.
Patient's Query
Hi doctor,
Thank you again for your time; I greatly appreciate it.
Okay, one more question, please. I have been reading a lot, and I am confused about whether the result is conclusive after three months. Why do some people say it is conclusive after six months?
Hi,
Welcome back to icliniq.com.
Relax. Stop searching on the internet. A lot of information can lead to misinterpretation and can do more harm than good. A three-month post-exposure HIV antibodies test is considered conclusive. Antibodies are usually detected between two to six weeks, and a maximum of three months is given for detection. Previously, there was a six month window period.
Patient's Query
Hi doctor,
Thank you for your prompt reply.
Kindly check my test dates and reply if further tests are needed.
Could you please review the dates and confirm if these results are conclusive or not? I am still occasionally experiencing skin itching all over my body. Is this related to HIV? What can I take for it? Is an antibiotic needed? Could it be an infection? Additionally, why do some doctors advise repeating the test at six months? If I am a healthy person and do not take any medications, could HIV antibodies be delayed until now? Please respond regarding whether I can continue my normal life with my wife.
Hi,
Welcome back to icliniq.com.
The HIV tests have consistently shown negative results, including the antibodies test after 90 days of exposure, which is also negative. This result is conclusive. There is no need for further HIV tests. You can lead a normal life without fearing HIV. The symptoms you are experiencing are nonspecific and may not be related to HIV. You can consider taking antihistamines like Cetirizine. If your symptoms persist, it's advisable to consult a dermatologist for a thorough examination and appropriate management.
I hope this has helped you.
Thank you.
Patient's Query
Hi doctor,
Thank you again for your time; I greatly appreciate it.
Could you please check the uploaded photo? This is the type of itchiness I sometimes experience, and it goes away within minutes. Do you have any recommendations or medication suggestions? Can I be confident that my result will not change, assuming there are no more exposures? Regarding the six-month period, which category of people does it apply to?
Hi,
Welcome back to icliniq.com.
It may be due to allergies or dry skin. If you have dry skin, consider using moisturizing creams and soaps of your choice. You can also take antihistamines like Cetirizine. If the condition worsens or does not improve, consult your dermatologist. There is no need for further HIV tests. In cases of severely immunosuppressive diseases, testing may be required after six months of exposure. However, if this were the case, your doctor would have already diagnosed it. So, do not worry about all this. Just forget about this episode.
I hope this has helped you.
Thank you.
Patient's Query
Hello doctor,
Thank you again for your time; I greatly appreciate it.
It has been four months since my last exposure. I repeated the ELISA test after four months, and the result was negative with an index value of 0.06. However, two weeks ago, I contracted COVID-19, and yesterday, I experienced lower backaches. I am stressed about the possibility of the HIV test changing later on. Can the test result turn positive later? I am concerned that these lower muscular pains are signs of HIV. Could you kindly check the attached photo of my tongue to determine if it's normal or if it's considered a white tongue? Your help would be greatly appreciated.
Hi,
Welcome back to icliniq.com.
The negative result of the HIV antibodies test after 4 months of exposure is conclusive. There is no need for further HIV tests. The symptoms are not related to HIV. You can consult your doctor for further examination and management. As for your tongue, maintain hygiene and use an oral rinse.
Patient's Query
Hi doctor,
Thank you for your prompt reply.
But doctor, does my tongue have a normal color? Secondly, I am still experiencing folliculitis sometimes. Is it a skin infection? I took antihistamines, but it did not subside. I am experiencing itching and folliculitis on my hands again. How long could this condition last?
Hi,
Thank you for the follow up query.
It is not related to HIV and is likely due to poor hygiene. Folliculitis is not connected to HIV. You should consult and follow up with your treating doctor or dermatologist for treatment. Please avoid linking it to HIV. Once the HIV tests come back negative on the specified dates and there is no further risk of exposure, you need not worry about HIV.
Patient's Query
Hello doctor,
Thank you again for your time; I greatly appreciate it.
I have a concern, and I hope you can help me. Six months ago, I had unprotected oral sex with a commercial sex worker. After that, I experienced several symptoms, including one episode of diarrhea, loss of appetite, and a weight loss of 6.6 pounds. I later gained 22 pounds and have had chest folliculitis since then. I have undergone the following tests:
My concern is that I also did a CD4/CD8 test, and the result is below 1 (0.89), with CD4 at 513 and CD8 at 574. Could you please review the report and help me understand why it is below 1? Could I have HIV, which is affecting my immunity and preventing my body from producing antibodies? Do I need more HIV tests?
Hi,
Welcome back to icliniq.com.
All the lymphocyte counts and percentages are within the normal recommended ranges, with a slightly lower CD4/CD8 ratio. It is unlikely due to HIV, as both the HIV PCR and combo tests came back negative after four months, and the combo test was negative again at six months. You can repeat the lymphocyte and hemogram tests after a few days or weeks. If there are any abnormalities, you can consult a hematologist for further evaluation.
I hope you are satisfied with my answer. For further queries, you can consult me at icliniq.
Thank you.
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