Dr your thoughts

[Brian1112]

Hello dr.  I'll get rigt to my question so I can put this to rest.  I had a lot of unprotected sex with a female of unknown status over the coarse of 1.5 months.  About 3-4 weeks after final encounter I experienced fatigue vomitting diahrea.  The diarrhea and vomitting laste about 2 days.  Fatigue has been on going for over a month with some body aches and pains.  I had negative rapid tests at 6 and 8 weeks with mouth swab.  I went one last time at 11 weeks with a rapid test with blood out of my finger all negative.  I also was screened for everything else including hcv at 9 weeks.

My questions are 1. Is my HIV results conclusive?  2. If I had hcv would thy delay seroconversion?  3.  Is vomitting an ars symptom?  4.would an 8 or 11 week negative test change to positive if I had hcv?

Thanks

[H. Hunter Handsfield, M.D.]

From my main reply above:  "...contrary to common perceptions, HCV is not an STD except in HIV-positive gay men who participate in traumatic rectal sexual practices."  People rarely if ever catch HCV from heterosexual intercourse -- and sex during menstruation obviously occurs millions of times each year in the US alone.

Syphilis blood tests are conidered conclusive 6 weeks after exposure.

[Brian1112]

I understand not increasing chance of HIV...but what about hcv? And I had a syphilis test at 7 weeks post...is that conclusive?

[H. Hunter Handsfield, M.D.]

The answer to this is obvious, since I have stated rather strongly that the test results overrule all other considerations.  Your test PROVES you did not catch HIV -- so there is no point in further worry about whether or not the exposure was risky.  Even it it did, though, it would make no difference.  Sex during menstruation does not significantly increase the risk of HIV compared with sex at other times in a woman's cycle.

Since the sex was unprotected, you might consider testing for other STDs (gonorrhea, chlamydia, syphilis) if this hasn't been done.  But I urge you to stop worrying about HIV.

[Brian1112]

Thanks doctor...and this includes her being on her period and having unprotected sex?

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.  I'll try to help, but you won't hear anything you haven't already seen in the responses to your questions on the HIV community forum.

There are 3 issues that concern you with regard to HIV risk:  your sexual exposure; your symptoms; and your HIV test results.  Of these, the first two are irrelevant.  You could have had the highest imaginable risk for HIV (actually, it was very low) or typical symptoms of ARS (they were not); your test result proves you didn't catch HIV.

HIV test results always overrule exposure and symptoms, as long as testing is done sufficiently long after the last exposure.  With the modern HIV antibody tests in standard use, that interval is 6-8 weeks.  Below I have provided the link to a thread that explains why the tests are officially approved and claimed by their manufacturers to only be valid after 3 months, even though 6-8 weeks would be sufficient.  As you will see, it has nothing to do with science, but with regulatory issues about marketing diagnostic tests.

As for HCV, it would not interfere with HIV test reliability.  The HIV tests were designed to be very robust, and they are not affected by any known medical conditions.  (There are theoretical concerns about potent chemotherapy and certain terminal illnesses, but even these actually cause problems rarely if ever.)  In any case, contrary to common perceptions, HCV is not an STD except in HIV-positive gay men who participate in traumatic rectal sexual practices.

Those comments answer your numbered questions, but just so there is no potential for misunderstanding:

1) Your negative HIV test results are 100% reliable.

2) If you had HCV, it would have no effect on your HIV test results.

3) Additional testing at 12 weeks or later is not necessary.  However, given the official advice about testing at 3 months (of 13 weeks), you might decide to do it for its additional reassurance value.  The result will not change.

Here is the thread that discusses the timing of reliable HIV antibody tests.  Read it all; the important information is in the follow-up comments.

http://www.medhelp.org/posts/HIV-Prevention/-A-Question-on-Testing/show/1347755

I hope these comments help you get beyond your concerns about HIV (and HCV).  You're home free on both.

Regards--  HHH, MD

[H. Hunter Handsfield, M.D.]

Sharing razors is one of those potential risk factors for HCV and other blood-borne viruses that is universally listed as a concern, but for which there are very few if any actual documented transmissions.  If your partner was not an injection drug users, it is unlikely she has HCV; and even if she does, your risk of infection either sexually or by shared razors is very low.  This isn't something to be worried about.

[Brian1112]

And to be clear the reason I am worried about hcv is that she was on hr period 2 of the times and she had used my razor to shave and I used it a day or 2 later with out knowing. Thanks.