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I am male 40 yrs at India . I had protected sex but unprotected insertive fellatio ( 2 mins ) from a call girl . On the 11th day and 17th day after exposure went for both DNA PCR test and P24 antigen test and all the 4 tests turned out to be negative. Please appraise me about my current status and shud I consider the results to be conclusive . Please let me know wether I shud go for any more tests . If yes , which test and at what time frame . I somehow managed to avoid any sexual contacts with my wife. Looking forward to your kind reply and I am under lot of stress and guilt

PAST HISTORY : Never has any sexual contacts earlier besides my wife , physically fit and dont have any sexual desease

3 Answers

Dr. Puneet Madan answered : 12 years ago

Hi,

The most common HIV test, the enzyme-linked immunosorbent assay, or ELISA (also called EIA), is used to detect HIV antibodies in a sample of the blood.
Although HIV tests are very sensitive, they can produce false-positive results.So ELISA HIV tests must be confirmed with another HIV test, such as a Western blot or indirect immunofluorescence assay (IFA).
Antibodies won't show up in the blood or body fluid immediately after you've been infected. There is a "window period" of six to 12 weeks, and sometimes several months, before the body starts producing antibodies to the virus and the virus is transmissible during this period.
So the test should be performed again at 3 and 6 months.
The first test to come positive is p-24 antigen and amongst the tests elisa is the most confirmatory test.
However there have been less known cases because of oral sex,it is more because of unprotected anal or vaginal sex.
You have done enough tests but they will have to be repeated again at 3 and 6 months.

Patient asked followup Question: 12 years ago

I have also taken DNA PCR TEST . Have learned that DNA PCR test is highly reliable between 2 -3 weeks and may be conclusive . Besides the same its a noble prize winning technology Besides the same what chances do i have of getting HIV transmitted taking into consideration that i had protected sex but unprotected oral sex insertive fellatio - assuming the call girl was HIV carrier or recently infected with HIV Please advise

Dr. Puneet Madan answered : 12 years ago

Hi,

The chances are very less of getting hiv through oral sex,compared to anal and vaginal sex,however still there are some chances(but very less).
The conclusive test test report for above test(dna-pcr test) is also said to be after 28 days only,however your test result might be accepted but company giving details about this test says the test to be of high value and conclusively after 28 days only.
You may also go for antibody tests like elisa just for confirmation(after 3months).

Patient asked followup Question: 12 years ago

Hi Doc , Thanx for your advise Today is the 32nd day of exposure . Would u advise to gest tested today . If Yes shud i go gor HIV 1 / 2 and P24 antigen test or please suggest specifically as ito which test shud i opt for have to tell the diagonistic centre correctly. Is a 42nd day good time frame for conclusive testing Is there no option fror conclusive test before 84 days . I am under lot of stress which is effecting my work and personal life . I have a aspiring career and at any cost i would not let that go for toss . Nights have become sleepless . This 1st time extramarital sexual contact happened all of a sudden in a message parloue and I dont know how i comitted this mistake inpite of being so scared about STD's and HIV . God save me please and i will never indulge in such hopeless activities . As already informed , i have refrained from any sexual contacts with my wife , but now she is getting suspicious . As advised by SRL Religare manager , the P24 combined with DNA PCR at 2 -3 weeks gives a conlusive reasults Please help and advise ........................i feel like having a nervous breakdown

Dr. Puneet Madan answered : 12 years ago

Hi,

That is true that it gives a conclusive result as told by the company,however since i have not seen many results by myself so i am not very confident since the test is not very old.
You may get your test repeated now,just to get it confirmed and you may visit an internal medicine specialist and if you are so anxious you may also have hiv prophylaxis (if the doctor md medicine thinks it right for you).
Don't worry as much as i have read about the test it is conclusive but since the test is new,and i have not used it, so i am a little unsure and want you to take second opinion which would be better for you.

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