Can HIV Be Contracted Through Protected Oral Sex?

Posted on Sat, 30 Jul 2016

Question: Hello doctor I m a 27 year male from XXXXXXX One month before I had protected oral sex with a csw girl in malaysia. During oral sex she licked my scrotum several times. After my exposure I am very much worried about hiv. 7 days from exposure a small red painless dot appeared on my inner thigh and abdomen area. I consulted a dermatologist and explained him about my exposure. He advised me that the rashes look like scabies. He advised me to take a hiv test to relieve from my anxiety. I took a hiv pcr rna real time test on 12 days from exposure and the result came as target not detected. After 10 days from exposure the rashes in thigh and abdomen disappeared and pimples like dots started coming in shoulder and chest area. It started growing in numbers and again I consulted a dermatologist and he advised Me to take vdrl test, hepatitis test and hiv test to relieve from my stress. I took hiv pcr rna real time test on 21 days from exposure and the result came as target not detected. I also took the vdrl and hepatitis test and all the result came as negative. I again took a hiv cmia duo test on 25 th day from exposure and the result came as non reactive. After 25 days from my exposure I started to take Isotretinoin tablet for acne as suggested by dermatologist and I took a hiv rapid tridot test in 35 th day from exposure and the result came as negative and again I took a hiv combo test at 37 days from exposure and the result came as non reactive. I took Isotretinoin tablet while taking the last two tests at 35 and 37 day. Will taking Isotretinoin tablet affects the hiv test result took on 35 and 37 day from exposure? How far are my test results reliable? I m very much stressed and worried about my exposure. Please advice me doctor

Answered by Dr. Sankaranantham Murugan (7 hours later)

Brief Answer:
You are free from HIV 1 infection 100% and symptoms not related to HIV.

Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.
Oral sex carries a low risk for HIV. That too, with protected oral sex, your risk is almost nil for HIV/STD. Licking over scrotum has negligible risk for HIV/STD.
Your repeated HIV tests also confirmed that you are free from HIV 1 infection. Regarding your HIV tests, HIV DNA PCR on 21st day after the exposure, HIV CMIA DUO test on 25th day, once again on 35th day are conclusive that you are free from HIV 1 infection as in all these tests, the antigen detected was HIV 1 which is more common among the HIV infections to the extent of 99.5% throughout the world except in certain parts of XXXXXXX
HIV 2 antibodies with DUO test can be able to be detected only after the completion of window period (6-8 weeks, may be up to 12 weeks after the exposure). But in your case the possibility of HIV 2 is quite unlikely or remote. Tridot test on 35 days has of no value as it is an Antibody detecting test and will become reliable after 12 weeks of exposure. Your symptoms are not related to HIV infection.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Sankaranantham Murugan (1 hour later)

Thanks doctor for your convincing reply. I m having few queries please answer my questions to relieve me from my fear.
1. Will isotretinoin i10 mg tablets affects the hiv test result I took on 37th day ?
2. Will isotretinoin tablet delay sero conversion and extends the window period for hiv test?
3. Is there any possibility of hiv2 from my exposure?
4. Will hiv2 symptoms show late than hiv1 in body?
5. Is hiv2 spread in malaysia or cambodia because I had my oral sex in malaysia and the girl is from cambodia?
Please answer my questions doctor.

Answered by Dr. Sankaranantham Murugan (1 hour later)

Brief Answer:
HIV 2 possibility is very much unlikely.

Detailed Answer:
Hi,
Welcome back.
Isotretin tablets in no way affect your test reports and will not delay the seroconversion.
Protected oral exposure has almost nil risk for both HIV 1 and 2 infection. Manifestations of the HIV 2 infection are not different from HIV 1 infection, also the timing of the appearance. HIV 2 infection is less virulent and has less transmission risk.
HIV 2 infection is very rare in far east countries like Malaysia and Indonesia also (less than 0.5%).
Forget about the incident and relax.
Dr S Murugan

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Sankaranantham Murugan (48 hours later)

Thanks doctor for your valuable reply. Now I am feeling confident. I took a wbc test after the exposure at various days 10,21,35 days from my exposure. The wbc count was 12.6 @ 10 days, 10.6 @ 21 days, 8.6 @ 35 th day. What's the reason for high wbc in 10 days and it started decreasing . Is my body fighting any std infection? Is the high wbc and decreasing wbc indicates hiv or any std? Please clarify doctor.

Answered by Dr. Sankaranantham Murugan (6 hours later)

Brief Answer:
All your WBC counts were within normal limits.

Detailed Answer:
Hi,
Welcome back.
Total WBC count normal value ranging from 4000-11000 cu.mm. Changes of value within the normal limits has not much value. It will support other findings in any health status. By the difference in value we can not come to any conclusion. Sometimes laboratory variations also we used to come across. (two different values it different labs from the sample taken at the same time). So you need not give any importance to these values. Convalescence from ordinary cold also we can have such results.
DR S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (19 hours later)

Thanks doctor for your convincing reply. Sorry to disturb you again doctor. I m very much disturbed by the incident and I don't the reason for my rashes. Please answer my questions doctor.
1. Will hiv2 have a slow sero conversion?
2. What are the std that causes rashes as a symptom?
3. I took a vdrl test at 21 days from exposure is that test conclusive?
4. I also took a hsv1 and hsv2 igm test @ 21 days from exposure is that test result conclusive? Or too soon to test for syphilis?
5. Is it possible to be caught with hiv2 with protected oral and licking scrotum with out any open wounds?
6. Is there any possibility of hpv infection from my exposure ?
7. What are the symptoms of hpv?
Please clarify my doubts doctor.

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer:
Protected oral sex has an almost nil risk for HIV /STD

Detailed Answer:
Hi,
Welcome back.
HIV 2 infection has a slow progress compared to HIV 1 infection. But there will not be delay in seroconversion.
VDRL test will be reliable after 4 weeks following the exposure. HSV result can be reliable from 3 weeks onwards.
Syphilis and HIV can manifest with rashes. The possibility of HIV 2 infection and HPV infection are remote. HPV infection has tiny skin colored or pink color growth from skin or mucosa. Protected oral sex is very safe and unlikely to have HIV /STD
Dr S Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (30 hours later)

Thanks doctor for your patience and reply.
1. Is my hiv 1 negative result conclusive from my various test results?
2.I took a differential blood test on 9th day from my exposure and in that test result the lymph percentage was 32.8 percentage and again I took a differential blood test on 35 th day from my exposure and in that test result the lymph percentage was 45 percentage. What's the reason for this rise in lymph percentage?
3. Is the rise in lymph percentage indicates any viral infection?4. I took a hiv pcr test on 21 day and the result is negative. I took a hiv duo test on 25th and 37th day and both the results are negative with values 0.09 and 0.06. Are these results conclusive that I m 100percent free from hiv1 ?
6. How much percent is my hiv duo test results on 25, 37 days reliable regarding hiv 2 detection?
7. Doctor you advised that hiv 2 is less virulent and not easily transmitted. Will hiv 2 symptoms occur at the same time hiv 1 symptoms occur?
8. If hiv2 is less virulent is it possible to transmit through protected oral sex and body rubbing?
9. Will herpes zoster, syphilis, any other std causes rashes and increase in lymph percentage?
Pls answer my questions doctor. Sorry to disturb you again and again with the same questions. Please help me doctor.

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer:
You are free from HIV 1 infection. Risk for HIV 2 is almost nil.

Detailed Answer:
Hi,
Welcome back.
1.Yes you are free from HIV 1 infection. There is no doubt.
2. Lymphocyte count can vary every day according to various reasons including the temporary infections etc. Lab report may vary to each lab. Not much significance.
3. It is not necessarily indicative of any viral infection.
4. Multiple negative HIV tests after 3 weeks confirmed that you are free from
HIV 1 infection to the extent of 100%.
5.Negative HIV DUO test on 25 and 37 days does not rule out HIV 2 infection as these tests were within the window period. Antibody part of the DUO test will be reliable after the window period.
6. Symptoms of HIV 1 and 2 can not be differentiated.
7. Transmission of HIV 2 through vaginal sex and mother to child transmission are very much less than that of HIV 1 infection. Transmission risk of HIV 2 through protected oral sex and body rubbing is almost nil.
8. Lymphocyte increase during these infections are possible, not mandatory.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sankaranantham Murugan (38 hours later)

Doctor can I take a hiv2 pct test now @ 45 days from exposure? Will that test be reliable now?

Answered by Dr. Sankaranantham Murugan (2 hours later)

Brief Answer:
It will be highly reliable.

Detailed Answer:
Hi,
Welcome back.
HIV2 RNA Qualitative PCR will be reliable from 4 weeks after exposure on wards.
Dr S.Murugan

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar