Can immune issues at age 23 delay the HIV antibody response?

Question

Hello doctor,

I am a 23-year-old guy and worried about whether I am infected with HIV (human immunodeficiency virus) or not. Below are my details. I had a high-risk exposure of unprotected anal intercourse with a random guy. After around seven weeks, I somehow started panicking about HIV infection. I did the HIV 1 and 2 antibody p24 antigen test after 53 days of my exposure, which came negative.

I was relaxed, but around the tenth week after exposure, I started feeling fatigued, and around the 12th week, I had an uncomfortable feeling in the throat and anal itching. I went to the doctor, and she told me that because I am stressed, these things are happening, and I have a bad tonsil. She gave me Azithral (Azithromycin) for tonsillitis, it got cured, but I can still feel a massive sore throat. I repeated the same HIV ELISA (enzyme-linked immunosorbent assay) test at the 12th week (86 days after exposure), which was also negative.

Again, I went to the doctor around the 13th week for anal itching, about which the doctor told me is a fungal infection, which can be due to sweating and moisture in that area. She also suggested I have a few ulcers on the back of the tongue and prescribed me regular gargling and antifungal cream to apply around the anal opening, and said to me to join the gym to improve immunity.

My questions are, can I consider my seventh week and the 12th week fourth-generation HIV ELISA test conclusive? Or I was tested negative because my body was unable to produce antibodies till the 12th week, as my symptoms started around the 11th week. Are these symptoms HIV-related? My doctor told me not to worry about HIV, and as I was very much stressed, I think noticing the signs; she told me this to alleviate my stress; otherwise, why did she tell me to join the gym to improve immunity?

I think I have a weak immune system because this was told to me during my childhood days, as I frequently fell sick during that time. Can this be the reason that my body did not produce antibodies till the 12th week? The doctor told me that people usually get a positive result by the 12th week if infected, but I am still scared of seeing my symptoms of throat and fungal anal infection. Should I go for retesting?

It will be the 15th week now, and I am afraid of getting this positive, seeing my recent symptoms. I am still feeling slight joint pains and weakness. Can these be due to early HIV infection? I am anxious. Am I HIV infected?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Initially, it takes three to 12 weeks for the antibodies against HIV to develop in any person, irrespective of the person's immunity and the duration of onset of symptoms. Next, suppose your ELISA (enzyme-linked immunosorbent assay) is negative in the 12th week. In that case, it is doubtful that you are infected with HIV, but to be completely sure, get an HIV PCR (polymerase chain reaction) test now and repeat the ELISA after one month from now and after six months of exposure.

If these come back negative, then HIV is ruled out. The symptoms you are having are very nonspecific and are also seen in early HIV syndrome, but since your ELISA at the 12th week is negative, the chances are less. The anal itching and fungal infection can be part of an STD (sexually transmitted disease), which you may have contracted during intercourse.

If your doctor has prescribed medicines for the same, then continue the same. Finally, my advice, in general, is not to worry a lot; what is done is done. In the future, always use protection. Everything will be fine.

I hope this helps.

Thank you.