Your website advice indicates that P24 antigen becomes detectable around 10 days post-exposure and peaks at circa 16 days. I had an HIV Duo test at 16 days post-exposure which came back negative for antibodies and antigens. Entrusting the fact that your website advice can be relied upon, can I therefore be re-assured that I don't have HIV? I am now circa 3.5 weeks post-exposure.
I have had enlarged lymph nodes under my right arm and under my jaw, a sore throat (but not severe) and have lost about 12lb in weight since the exposure. The lymph node and throat pain has been there for about 2 weeks now and the weight loss seemed to start about 1 week after the possible exposure. Due to anxiety it is fair to say I have not been eating much at all.
You are right in your statements regarding the HIV p24 antigen. I'm afraid though that you cannot rely on an HIV DUO test at 16 days to conclusively rule out HIV.
The fact that you had a negative test is reassuring, but only that at that point. The HIV DUO test is desgined for use on or about the 28th day post exposure at the earliest - or later than that. We often find it performs better than that and will often successfully identify new HIV positives much earlier. However, a negative at 16 days can not be relied on as accurate.
You don't give any information as to the detail of the exposure so I can't comment further on that.
12lbs is a lot of weight to lose in 3.5 weeks. I think you should see a doctor to discuss and have a proper HIV DUO at the 28 day mark which sounds to be soon.
In terms of the exposure event, I had protected oral sex with a female street sex worker of african origin in Belfast. I know that the risk is estimated to be very small for receptive oral but I have some concerns about the exposure event. She seemed to get the condom out very early and seemed to be fiddling around with it. Before reaching the spot where I received oral sex, she went over to a parked vehicle with someone sat in it. I think this may have been her pimp. Presumably she was just alerting him to the fact of what was about to happen should she get in to trouble. However, the mind runs riot and you begin to worry about 'deliberate infection'etc.
Following on from your response on P24, I understand after further reading that P24 antigen is only relevant to HIV-1 and is not produced in association with HIV-2. I recognise that HIV-2 is far less common in the UK (circa 1% of infections) but she was of african origin where the relative prevalence is much higher. Am I correct in my inference on the irrelevance of P24 to HIV-2?
Just one additional piece of information - I had a UTI which went on for a couple of weeks almost immediately after the event. This didn't respond to 2 courses of standard antibiotics. However, the screening tests at the gum clinic didn't reveal an STI (5 days and 16 days post-exposure). In desperation, I went to a private clinic and got antibiotics that would treat chlamydia and gonorrhea. Whether co-indicental or down to psyscho-sematic reasons, the symptoms cleared within 1.5 days? If it was an STI then my conclusion was that this is suggestive of a route of infection.
On the basis of the above, can I still be 're-assured' of the 16 day test outcome. FYI my symptoms are still persisting.
I've quoted your further post beneath just to make it easier to answer. I hope thats ok.
Quote:
In terms of the exposure event, I had protected oral sex with a female street sex worker of african origin in Belfast. I know that the risk is estimated to be very small for receptive oral but I have some concerns about the exposure event. She seemed to get the condom out very early and seemed to be fiddling around with it. Before reaching the spot where I received oral sex, she went over to a parked vehicle with someone sat in it. I think this may have been her pimp. Presumably she was just alerting him to the fact of what was about to happen should she get in to trouble. However, the mind runs riot and you begin to worry about 'deliberate infection'etc.I cant answer that but what I can say is that "protected oral sex" is zero risk - no risk whatever
Following on from your response on P24, I understand after further reading that P24 antigen is only relevant to HIV-1 and is not produced in association with HIV-2. I recognise that HIV-2 is far less common in the UK (circa 1% of infections) but she was of african origin where the relative prevalence is much higher. Am I correct in my inference on the irrelevance of P24 to HIV-2? HIV 2 is hugely less common than HIV 1 - even and this is really important, in the areas where HIV 2 is at its most prevalent. HIV 1 is vastly more common. You had a zero risk in sexual terms and I do not believe that it is likely that you were exposed to HIV 2.
Just one additional piece of information - I had a UTI which went on for a couple of weeks almost immediately after the event. This didn't respond to 2 courses of standard antibiotics. However, the screening tests at the gum clinic didn't reveal an STI (5 days and 16 days post-exposure). In desperation, I went to a private clinic and got antibiotics that would treat chlamydia and gonorrhea. Whether co-indicental or down to psyscho-sematic reasons, the symptoms cleared within 1.5 days? If it was an STI then my conclusion was that this is suggestive of a route of infection. You had protected sex - your UTI is coincidental or psychosomatic
On the basis of the above, can I still be 're-assured' of the 16 day test outcome. FYI my symptoms are still persisting.My belief is that you were not exposed in the first place and did not need an HIV test. The test you had though was inadequate as I have said earlier. You need to decide on whether you will test again or accept that you didn't need this test.
In my anxiety for a further test (after sending my 1st email to you), I had a repeat DUO test on Day 26 post-exposure (so 2 days short of the 28 day mark). This again came back negative for antibodies and antigens. This obviously gives me more reassurance than my 16 day DUO negative, but unfortunately doesn't meet the 28 day threshold.
I note from the BASHH website that a statement was issued by them on the 15 March 2010 which states that they now view the 28 day test as conclusive now (and disregarding reference to the 'legacy' 3-month window period). I assume you already know of this communication from BASHH.
FYI, my lymph nodes are still tender (particularly under the arms / around the chest) and the sore throat is simply flat lining with little or no improvement or deterioration. Taking onboard your advice about the HIV exposure risk and the ongoing nature of my symptoms, I have made an appointment with my GP to investigate my problems down a different route.
Your advice has been excellent, to the point and timely.
Hiv P24 Antigen
Linear Mode
