Aa
HIV-2
Hi,
i had a possible exposure on 6-Apr with CSW (African) and unfortunatly my condom failed but i pulled out immediatly within 2 seconds.
On day 10, i started to have HIV like symptoms which are still present now at week 4
i have done the following tests:
Day 12: HIV-1 RNA (sensitivty<20 copies) - Negative
Day 15: HIV-1&2 DNA - both not detectable
Day 27: HIV-1&2 ab / p24 ag (DUO) - Normal, non reactive
What is your opnion? and how to rule out HIV-2 before waiting for 3 months? can HIV-2 DNA @ 28 days be conclusive?
Thanks
i had a possible exposure on 6-Apr with CSW (African) and unfortunatly my condom failed but i pulled out immediatly within 2 seconds.
On day 10, i started to have HIV like symptoms which are still present now at week 4
i have done the following tests:
Day 12: HIV-1 RNA (sensitivty<20 copies) - Negative
Day 15: HIV-1&2 DNA - both not detectable
Day 27: HIV-1&2 ab / p24 ag (DUO) - Normal, non reactive
What is your opnion? and how to rule out HIV-2 before waiting for 3 months? can HIV-2 DNA @ 28 days be conclusive?
Thanks
MEDICAL PROFESSIONAL
Hello
I have answered this - as I said earlier, you can choose to accept the answer or not. A personal decision for you.
I've repeated my answer below:-
"""Hello again
I can see obviously that you remain worried but I'm not.
I have answered your further questions already and will repeat my answer beneath for you again:-
"""Even in the areas where HIV 2 is most prevalent HIV 1 is by far the most likely form you would acquire if you were to be infected.
There is some crossover in the testing between HIV 1 and HIV 2.
The HIV 1 and 2 DNA at day 15 establish that you do not have either.
The HIV DUO you had at 27 days is good and you do not have HIV 1 or 2.
You do not need to wait further. You are not infected with HIV""
I dont actually suggest any further testing. I don't agree with your statements about the unreliability of HIV DUO testing and HIV2 so we have a bit of an impasse there.
You can choose to either be reassured or to worry further. Personally, being an optimist and also being a now middle aged doctor with plenty of experience re these scenarios under my belt, I would choose the former for you.
Its up to you my friend. However you play it though you are still HIV negative.
best regards, Sean """
I wont be returning to this post.
best regards, Sean
I have answered this - as I said earlier, you can choose to accept the answer or not. A personal decision for you.
I've repeated my answer below:-
"""Hello again
I can see obviously that you remain worried but I'm not.
I have answered your further questions already and will repeat my answer beneath for you again:-
"""Even in the areas where HIV 2 is most prevalent HIV 1 is by far the most likely form you would acquire if you were to be infected.
There is some crossover in the testing between HIV 1 and HIV 2.
The HIV 1 and 2 DNA at day 15 establish that you do not have either.
The HIV DUO you had at 27 days is good and you do not have HIV 1 or 2.
You do not need to wait further. You are not infected with HIV""
I dont actually suggest any further testing. I don't agree with your statements about the unreliability of HIV DUO testing and HIV2 so we have a bit of an impasse there.
You can choose to either be reassured or to worry further. Personally, being an optimist and also being a now middle aged doctor with plenty of experience re these scenarios under my belt, I would choose the former for you.
Its up to you my friend. However you play it though you are still HIV negative.
best regards, Sean """
I wont be returning to this post.
best regards, Sean
Dear Dr. Sean,
This is my last post under this question, but since it is last just let me explain why your friend is worried
Am not that type of person who would panic when he gets a flu, am 33 years old and during my life i have visited a doctor only twice, one of them was to stich a 5 cm wound on my leg. I had rarely taken any medicine ( twice Antibiotics in my whole life) and so far i dont have any physical issues except this one.
Am worried for a reason, its not simple anixety, i had ALL the ARS/HIV-early symptoms and i mean ALL OF THEM starting from day 10 (White tongue, night sweats, headache, Fatigue, red veins in my eyes, loss pf appetit, rapid loss of weight i lost 8 kgs in 3 weeks, blurry vision and recently numbness in my right hand last finger), and all as you can see are in the proper time frame after a risky exposure. Am not asking what are my chances to get HIV after having a protected oral.
I fully respect you experience and this is why i have posted a question on your forum. It seems you and my doctor agree that chances to be HIV-2 + are minute. Thats great, am not challenging your experience in anyway, but what i needed to learn from you, based on what we are coming to that conclusion !
I fully agree with you that my DUO test was good, for HIV-1, however for HIV-2 my concern is i might not have developped antibodies yet and P24 is not detected as it is associated with HIV-1, and HIV-2 DNA might not be sensetive enough to detect any at 15 days.
So what i wanted is an answer from an experienced doctor like you to kill my fears rationally not emotionally. I thank you for your emotional support but this is not what i need now with the developping symptoms.
I cannot just rely on a simple answer, go sleep with somone else get her infected. I dont want my case to be missunderstood as another guy who is panicing from HIV infection after 0% exposure with anixety symptoms.
i need to be convinced.Am not spamming in anyway, i just want to put my brain to rest, and i promise you i will not ask any further questions on this post.
Thanks alot,
Sam
This is my last post under this question, but since it is last just let me explain why your friend is worried
Am not that type of person who would panic when he gets a flu, am 33 years old and during my life i have visited a doctor only twice, one of them was to stich a 5 cm wound on my leg. I had rarely taken any medicine ( twice Antibiotics in my whole life) and so far i dont have any physical issues except this one.
Am worried for a reason, its not simple anixety, i had ALL the ARS/HIV-early symptoms and i mean ALL OF THEM starting from day 10 (White tongue, night sweats, headache, Fatigue, red veins in my eyes, loss pf appetit, rapid loss of weight i lost 8 kgs in 3 weeks, blurry vision and recently numbness in my right hand last finger), and all as you can see are in the proper time frame after a risky exposure. Am not asking what are my chances to get HIV after having a protected oral.
I fully respect you experience and this is why i have posted a question on your forum. It seems you and my doctor agree that chances to be HIV-2 + are minute. Thats great, am not challenging your experience in anyway, but what i needed to learn from you, based on what we are coming to that conclusion !
I fully agree with you that my DUO test was good, for HIV-1, however for HIV-2 my concern is i might not have developped antibodies yet and P24 is not detected as it is associated with HIV-1, and HIV-2 DNA might not be sensetive enough to detect any at 15 days.
So what i wanted is an answer from an experienced doctor like you to kill my fears rationally not emotionally. I thank you for your emotional support but this is not what i need now with the developping symptoms.
I cannot just rely on a simple answer, go sleep with somone else get her infected. I dont want my case to be missunderstood as another guy who is panicing from HIV infection after 0% exposure with anixety symptoms.
i need to be convinced.Am not spamming in anyway, i just want to put my brain to rest, and i promise you i will not ask any further questions on this post.
Thanks alot,
Sam
MEDICAL PROFESSIONAL
Hello again
I can see obviously that you remain worried but I'm not.
I have answered your further questions already and will repeat my answer beneath for you again:-
"""Even in the areas where HIV 2 is most prevalent HIV 1 is by far the most likely form you would acquire if you were to be infected.
There is some crossover in the testing between HIV 1 and HIV 2.
The HIV 1 and 2 DNA at day 15 establish that you do not have either.
The HIV DUO you had at 27 days is good and you do not have HIV 1 or 2.
You do not need to wait further. You are not infected with HIV""
I dont actually suggest any further testing. I don't agree with your statements about the unreliability of HIV DUO testing and HIV2 so we have a bit of an impasse there.
You can choose to either be reassured or to worry further. Personally, being an optimist and also being a now middle aged doctor with plenty of experience re these scenarios under my belt, I would choose the former for you.
Its up to you my friend. However you play it though you are still HIV negative.
best regards, Sean
I can see obviously that you remain worried but I'm not.
I have answered your further questions already and will repeat my answer beneath for you again:-
"""Even in the areas where HIV 2 is most prevalent HIV 1 is by far the most likely form you would acquire if you were to be infected.
There is some crossover in the testing between HIV 1 and HIV 2.
The HIV 1 and 2 DNA at day 15 establish that you do not have either.
The HIV DUO you had at 27 days is good and you do not have HIV 1 or 2.
You do not need to wait further. You are not infected with HIV""
I dont actually suggest any further testing. I don't agree with your statements about the unreliability of HIV DUO testing and HIV2 so we have a bit of an impasse there.
You can choose to either be reassured or to worry further. Personally, being an optimist and also being a now middle aged doctor with plenty of experience re these scenarios under my belt, I would choose the former for you.
Its up to you my friend. However you play it though you are still HIV negative.
best regards, Sean
Dear Dr. Sean,
You reply is confident and assuring (as always) but not enough to trump my worries
I really doubt the reliability of the DNA test (done by an Indian Lab), and specially as far as the HIV-2 is concerned since no DNA test reliable anyway, am i correct?
As for the DUO test, i believe it is not reliable to rule out HIV-2 as it is for HIV-1 since the p24 protein is not associated with HIV-2 (my test detected an amount of p24 but half way below the reactive threshold 0.49 and threshold is >1)
So the scenario which i have in mind is that DNA is not reliable and i have HIV-2 which my body did not develop antibodies for yet and p24 is irrelevant as far as HIV-2 is concerned.
Unfortunetly HIV-2 RNA is not available where i am
What further tests would u suggest to make me more confident?
am waiting for DNA @ 28 days and planning to go for 6 weeks HIV-2 ab 4th generation
But i want to know if you still feeling confident after what i have just said, its all a matter of probablity, when we discussing Bio, so let me know on a scale of 1 to 10 my chances to be HIV-1 and those to be HIV-2 positive
Thanks alot
You reply is confident and assuring (as always) but not enough to trump my worries
I really doubt the reliability of the DNA test (done by an Indian Lab), and specially as far as the HIV-2 is concerned since no DNA test reliable anyway, am i correct?
As for the DUO test, i believe it is not reliable to rule out HIV-2 as it is for HIV-1 since the p24 protein is not associated with HIV-2 (my test detected an amount of p24 but half way below the reactive threshold 0.49 and threshold is >1)
So the scenario which i have in mind is that DNA is not reliable and i have HIV-2 which my body did not develop antibodies for yet and p24 is irrelevant as far as HIV-2 is concerned.
Unfortunetly HIV-2 RNA is not available where i am
What further tests would u suggest to make me more confident?
am waiting for DNA @ 28 days and planning to go for 6 weeks HIV-2 ab 4th generation
But i want to know if you still feeling confident after what i have just said, its all a matter of probablity, when we discussing Bio, so let me know on a scale of 1 to 10 my chances to be HIV-1 and those to be HIV-2 positive
Thanks alot
MEDICAL PROFESSIONAL
Hello
Even in the areas where HIV 2 is most prevalent HIV 1 is by far the most likely form you would acquire if you were to be infected.
There is some crossover in the testing between HIV 1 and HIV 2.
The HIV 1 and 2 DNA at day 15 establish that you do not have either.
The HIV DUO you had at 27 days is good and you do not have HIV 1 or 2.
You do not need to wait further. You are not infected with HIV.
Best regards, Sean
Even in the areas where HIV 2 is most prevalent HIV 1 is by far the most likely form you would acquire if you were to be infected.
There is some crossover in the testing between HIV 1 and HIV 2.
The HIV 1 and 2 DNA at day 15 establish that you do not have either.
The HIV DUO you had at 27 days is good and you do not have HIV 1 or 2.
You do not need to wait further. You are not infected with HIV.
Best regards, Sean
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