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Is It Possible To Get HIV After Kissing?
Question: Hi
On 15 dec I was drunk in a strip bar , I ended taking home a female strip. We had deep open mouth kisses and she game me a blow job . I also inserted my finger in her ass with lotion . 2nd day I renumbered that a day or aday and half before this I had an internal cut on my lower lip it was my own lip bit , and that my finger had a cigarette burn almost aday or 2 before this .
I am worried , I am going home after 10 days
My questions are
1- what's my risk here ?
2- if I do p24 test like Elisa 4th generation on 27th dec I.e after 12 days of this how reliable ?
3- if I do PCR on 27th how reliable ?
4- if the tests of 27th come negative is it safe to sleep with my wife without condom ?
Brief Answer:
P24 antigen assay and PCR are Specific tests
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day
Dear XXXX
The amount of viral load present in saliva is unlikely to cause transmission of HIV and is not in known to cause spread of infection.
Coming to second mode of exposure, as you mentioned digital insertion of finger on which burn was sustained into the rectum, it's a significant exposure and the probability of contracting HIV is High. Probability of 40-50%.
There is serological window period of 3-4 months in which time the normally done test for HIV could be negative in spite of having contracted HIV infection.
In this period p24 antigen assay and PCR test are quite confirmatory. If the results of these test are negative it's unlikely you are infected.
Rest be assured everything is alright.
In case you require any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Surgeon
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear dr. Thanks
My finger seemed intact I hope . No blood any way .
When you say p24 and PCR test are quite accurate are they accurate in 13 days of exposure ?
Thanks
Brief Answer:
RT PCR highly specific even on 13 th day
Detailed Answer:
Namasthe
Greetings
That's a good thing there was no contact with blood.
RT PCR is the most specific test to detect HIV infection in first 2 weeks of exposure. Negative report on 13th day will rule out HIV infection.
In case you require any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Surgeon
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks dr again
Sorry again just to avoid confusion
I mean by no blood ( from my finger ) the burn was about 32 hrs before the exposure . I really can't say their was no blood from her side . I don't recall that .
So I should ask for a test called RT PCR ?
I heard of PCR but RT PCR is new to me .
It just about 72 hrs passed do you suggest me I take treatment like pep ?
Brief Answer:
Start PEP at earliest and condom use
Detailed Answer:
Hi
RT PCR is nothing but PCR of Reverse transcriptase of HIV virus. It's the same.
As the risk is higher in your case because of contact of finger with break in continuity due to burn and getting exposed to anal secretions which may contain high load of virus in case she is infected. I would suggest you to start with post exposure prophylaxis at earliest. First dose can be taken from the emergency department of any government or private hospital. Please do visit a physician.
I also would suggest you to use condom till the test come out to be negative.
Please be assured everything will be fine.
All these are necessary universal necessary precaution to avoid infection.
In case you require any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCH
Consultant Surgeon
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks dr . Now is it about 82 hrs from exposure . I asked my dr for pep and he checking with specialist . Is taking pep within 90 hrs of exposure will do !
Brief Answer:
Take PEP at earliest even at 90 hours
Detailed Answer:
Greetings,
Ideally PEP is to be taken within 72 hours of exposure. Its in ideal scenario. But when there has been significant exposure, it should be taken at earliest even 90 hours should be okay, the efficacy may be reduced, but will be worth taking
Take it at earliest, for continuation can be decided after getting RT PCR test. If its negative, and also P24 antigen assay is negative after 14 days of exposure, it can be discontinued.
Do get back to me if you need any further assistance.
Take Care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Shanthi.E
I am lost my dr. Says 80hrs is late and no point of taking . Can I get your contact number so I call you and make you explain or discuss to my dr pls
Brief Answer:
Go through the guidelines of CDC
Detailed Answer:
Namasthe
Following are the updated guidelines Of CDC( Centre for disease control) for PEP prophhylaxis.
Although animal studies demonstrate that PEP is likely to be less effective when started more than 72 hours after exposure,the interval after which no benefit is gained from PEP for humans is undefined. If initiation of PEP is delayed, the likelihood increases that benefits might not outweigh the risks inherent in taking antiretroviral medications. Initiating therapy after a longer interval (eg, 1 week) might still be considered for exposures that represent an extremely high risk of transmission.
I would still strongly advise you to take PEP at the earliest. There is really no point in delaying it further.
I am extremely sorry for not providing you the mobile number, for security and ethical reasons. It would be unethical of me arguing with another Physician, as he/she is equally competent . Opinions may vary.
It is advisable to stick on to the latest guideline available.
You can check the guidelines at he links provided below
As per the guideline, its to be ideally taken within 72 hours, merits of its efficacy after 72 hours is matter of calculation of risk and benefit ratio on every individual cases.
WWW.WWWW.WW WWW.WWWW.WW
Do get back to me if you need any further assistance.
When one is in confusion, majority of us would agree on following the latest available guidelines. There is definitely gray zone sometimes
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks dr. Understood
Link is not opening however my dr. Priscriped to me the following
Cap. Odivir. 1 a day. For 1 month.
Is this ok ?
Brief Answer:
Its absolutely okay.
Detailed Answer:
Dear Brother
Its absolutely okay.
You can search the guidelines in Centre For disease prevention website.
Do not be worried, its all going to be okay . I wish and pray that the reports are negative.
Would also suggest you to be careful next time.
Take Care
Best Regards
Dr Deepak K K
Above answer was peer-reviewed by :
Dr. Shanthi.E
Many thanks dr. I hope so . I will be carefull . God bless you to .
Brief Answer:
Take care
Detailed Answer:
Take care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dear dr .
Thanks . I have just started the 1st dose . It's 81 hrs after possible exposure . I hope all will be fine .
I have done p24 and PCR test at 36 hr of possible exposure .
P24 results came negative ,
I know p24 may be of no use at this stage , how about PCR ? At 36 hrs ? Results should come today .
I asked that female to do blood test . She said ok . Hope she will
Brief Answer:
RT PCR is more specific
Detailed Answer:
Greetings
RT PCR is more specific in first fifteen days following exposure.
I pray that PCR tests comes out to be negative.
Wishing you a great life.
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks brother
God bless you always
Brief Answer:
Take care
Detailed Answer:
Take Care
You require any medical assistance , write to me directly.
God bless you.
Wishing you a Happy new year in advance.
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Prasad
Hi dr , its me again
i started taking peo ( odivir -400 kit ) , i started on the 82 hrs after oossible exposure . I have so far took for 2 days . i know its strong thing i even some times feel like drunk . My questions are
1- will this medicene creat damages to my orgins like kidney or brain or whatever ?
2- any additional recommandations that i shoud do or things i should not do like food ? Extra Water ? Avoid ....
3- you may recall i took p24 abd pcr after 36 hr of exposure both negative is this tesult of any use at 36th hr ? when can i teste p24 anf or pcr ? Today its 5th day after posdible exposure . Can p24 ot pcr be reasonabily accurate at 9th day ?
- will taking test under this medical effect the test results i.e gives false results because of the medicence effect ?
Thanks 4
Brief Answer:
It's common side effect
Detailed Answer:
Greetings
1. The medicine will not cause any damage on the brain and skin.
2. Consuming plenty of oral fluids and we'll balanced high fiber diet is important. No other food precautions to be taken.
3. RT PCR is accurate at 9th day.
Would suggest you to use condom till the results are negative
Taking anti retrovirus therapy does not affect the results of the tests.
A well balanced diet, lots of oral fluids , and good sleep are very important.
It's from the experience from the patients whom I have started on PEP and my own personal experience following accidental exposure while operating.
Rest be assured there is no cause of concern.
You may sometimes experience symptoms like getting drunk or a little clumsy gait,consuming orange juice and good sleep helps. Over a week the symptoms should settle down.
In case you require any further assistance, will be glad to assist you.
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Avoid alcohol
Detailed Answer:
Namasthe
It will preferably be good if you could avoid alcohol while you are on anti retroviral treatment. It will worsen the side effects of drugs .
No , liver and kidney will not be damaged.
P24 is more helpful after 15 days of infection.
In case you require any further assistance feel free to contact any time.
Take care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi dr. As an update pls recall my possible exposure was 15th , i had that female to test on 19th dec i.e 4th day after whatever happen , she tested bith p24 and pcr and she was -ve . The pcr called MTB - DNA detection using equipment called Rotor gene 3000 from Corbett research , autralia , specimen EDTA blood
I wish to share my continues concern is she teseted at 4th day which is early ( i am going extreme case that incase she had a sexual experience on 14th or 13th with some one who had hiv then her pcr and p24 on 19th become not firm ) am i correct ?
Now i am still on the pep , how do you see if i test on 26th for both p24 and pcr ( same as anove ) ?
If results fine dose that mean fine and i can stop the pep ?
Frankly dr beside the un easiness in taking this i am going to be with my family on 28th . It will be quite dufficult to explain what medicience i am taking . Howevet if yoy feel i must continue it to min period of time do let me know .
I surely dont want a risk for my family or me .
Having said that pls advise all pcr tests are also dna ?any var types of pcr tests ? Any spesific test name ?
Brief Answer:
Get back with reports of 26th December
Detailed Answer:
Greetings
Even if your exposure is significant, it is not advisable to think to extreme level.
The possibility of she acquiring HIV infection before 15th and she testing negative and even you negative, it's highly unlikely that you are infected.
Reverse Transcriptase PCR that is RT PCR and P24 antigen assay are all that are required by you.
RT is reverse transcription of mRNA into DNA and is highly specific.
Negative test in the exposed rules out HIV infection with a specificity approaching nearly 100 percent when combined with P24 assay.
If the above tests are negative you can discontinue use of PEP keeping the thing in mind that you will be with the family.
There is no cause for concern with all these detailed tests carried by you.
Rest be assured you are safe.
Test result for both negative on 26 th December. Just forget the incident and be assured you are safe. You can discontinue pep.
Wishing you happy new year 2014.
Do get back with the results. I'm sure they will turn out to be negative.
Take care
Best Regards
Dr Deepak Kishore
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks Dr. Wish you the same dr . Will surely come back to you . Where do i get this RT pcr test in mumbai ? The gril made test i think called Mycobacterium tuberculosis dna - detection . Now i am not even sure if this an hiv test or what ? Under interpretation says a positive result indicates presence of active TB . What that means ? Why TB when we are looking for hiv ? No where in her pcr report the word hiv mentioned . She made thr test in metropllis lab .
Sorry asking again just want to make sure i dont miss guide you
Brief Answer:
Highly likely your results will be negative
Detailed Answer:
Greetings
The test undergone by lady concerned is for Mycobacteria tuberculosis and is a specific test for confirmation of Tuberculosis infection.
I would suggest you to leave her hiv status at bay and let's concentrate on your status with the thing in mind that you were exposed to potential HIV source.
Irrespective of whatever her status is, negative RT PCR and P24 assay of you will rule out HIV infection.
I would suggest you to try either SRL Ranbaxy Or Metropolis for the investigation.
It's highly likely that your results will turn out to be negative.
Rest be assured everything is alright.
Take care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks dr. RT pcr in one of the 2 mebtioned on 26th . Will that and p-24
B.regrads
Brief Answer:
RT PCR and P24 assay
Detailed Answer:
Good morning
It's RT PCR and p24 antigen assay you need to get it done
Take care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Prasad
Dear dr. I am planing to go for my test tmrw . I am still in my pep . I believe tnrw i can take my dose and go for the test , this will not effect the test tesults . Am i correct ?
Brief Answer:
pep will not affect results
Detailed Answer:
Greetings
You are right, it will not affect the result.
Take care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Noted abd thanks
Brief Answer:
Take care
Detailed Answer:
Greetings
Have a wonderful day.
I am sure the test would be negative.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good day dr. . Many Thanks . I gave the test , they say Rtpcr teults on momday .
Brief Answer:
Take care
Detailed Answer:
Take care
Wishing you happy new year.
Best Regards
Dr Deepak Kishore
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Not wanting to bother you , but if i dont send sms the secission closes atumstically . Fyi p24 came -ve . Can this by any chane taken as a good indication ?
Brief Answer:
nenegative P24 is very good
Detailed Answer:
Greetings
Negative P24 can be taken as a very good indication. It's highly unlikely you have got infected. Negative RT PCR will be very much reassuring and will definitely rule out infection.
You can ask me any query anytime. It's your right.
Take care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Many Thanks dr.
God bless you
Brief Answer:
Take care
Detailed Answer:
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi dr , i am trying to attach a report from the lab as my self not sure if its a full or part report .
Brief Answer:
Attached report are normal
Detailed Answer:
Namasthe
Greetings
All the hematological parameters in the report are normal.
There is no cause for concern.
P24 antigen assay is negative.
If I am not wrong you are expecting RT PCR report tomorrow?
It will definitely be negative, will be waiting for confirmation of the same from your side.
Take care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good day Dr. Kindly find the Attachments ( RT PCR ) . Pls go throught them in details and suggest. Frankly speaking i am still thinking to carry on the pep till 5th XXXXXXX and do p24 . Pls let me know your advice .God bless you .
B. Regards
Brief Answer:
PEP ART can be discontinued
Detailed Answer:
Greetings
Both the specific qualitative test done for HIV 1 and 2 are negative and there is no cause for concern. It certainly rules out HIV infection with lot of accuracy.
ART-PEP when started is ideally continued for 4 weeks(1 month). It is discontinued in following circumstances.
1. Development of non tolerable reaction to PEP ART drugs
2. When specific confirmatory test for HIV are negative.
As your previous P24 antigen assay and RT PCR and including RNA for HIV 1 are negative. I would suggest that you can discontinue use of ART PEP.
If you consider to use more caution and plan to continue using PEP, its ok. In case you develop any side effects and intolerance then don't hesitate to discontinue it.
Also would request you to be always safe , then going through this stress.
Wishing you a Happy New Year 2014.
Take Care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I fully agree with you dr. To be more careful , frankly normally i am tol careful , hell that was a very odd case for me , but surely i thank you for all the advices you gave me . I have carried with me enought for 19 daya in rotal drom strat of pep , thats why i thought i may continue to p24 on 21day of possible exposure . Do you really believe now i should have a good peace of mind ? Wishing you happy 2014
Brief Answer:
Time to be relaxed.
Detailed Answer:
Greetings
You definitely need to have a good peace of mind now. Rest be assured everything is alright.
Enjoy with your family the beginning of one more beautiful year in your life and many more to come.
You can definitely continue using pep for 21 days as decided by you.
It's time to be relaxed and enjoy the new year to fullest.
Take care
Best Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Many thanks bro . Wishing you a long happy life ahead .
Brief Answer:
Wishing you a very happy new year
Detailed Answer:
Thanks Brother
Wishing you and your family the same.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Happy bew year , in continuation to my subject matter , the female kindly agreed to re test . I am attaching her report for your kind reading and advisr .
Best regards
Brief Answer:
No cause for concern, everything is alright
Detailed Answer:
Greetings of the new year from our family brother,
Before we start interpreting her test, one important factor to be considered is she got tested about 18 days after your exposure.
The results reveal that the viral load is below quantifiable limit (even if its present in her blood, it cannot be detected by this Real time PCR done). Minimum viral load required is 72iu/ml. It just goes to say that either she is not infected or even if she is infected, the viral load is too low to be detected by this method.
Among 100 normal males who are exposed to HIV infected individuals, it is only 40-60 who contact disease.
In your case , you have already tested negative for all the investigation done on multiple occasion, and the person from whom you were exposed has either NO infection or very low viral load.
Hence be assured that its very much unlikely you have contracted the infection.
Rest be assured everything is alright. Continue ART PEP for 21 days as planned by you.
Wishing you a happy and healthy life ahead.
Take Care
best regards XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks dr. Any need for me to do p24 test ? Monday i am going dor knee operation and i guess i have to stop the pep ( as dr will give some anti biotics for tge operation ) do i need to test p24 tmrw which will be the 20th day after possible exposure ?
Brief Answer:
No need for further workup
Detailed Answer:
Dear Bro
There is no need for further investigation.
Wishing you good luck and speedy recovery for the surgery.
Do get back if you need any further assistance.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear bro , many thanks , i feel hard to stop communication with you as a frnd and brother , i asked ur contact which was not possible to give to me . I wish in this case to send you my email id , YYYY@YYYY , rest assured i will respect the policy and on medical advices i will only use this application
God bless you always
Brief Answer:
Take Care
Detailed Answer:
Dear Bro
Noted
Take Care
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry dr . I gave a sample for antigen and anti body test today on the hope i will get the final result today , and to stop the pep , lab let me down and said results tommow . My question here is my knee operation monday morning and result of lab may come sunday pm. Any harm to take my morning daily dose of the pep ? By any chance will the dose effect the local anisthitc?
Brief Answer:
Can be taken with sip of water
Detailed Answer:
Dear Bro
Greetings
There is no harm in taking morning dose of PEP with sip of water.
It will not affect the efficacy or dosage of local anaesthetic.
Wish you best of luck.
Take care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good evening dr . I just got the report for which i am attaching , i am not liking the lab reporting as it is showing less and above . My question dose this result mean they have detected some thing ?
Brief Answer:
The test result are negative
Detailed Answer:
Greetings of the day
Dear Bro
The result for HIV 1 and 2 are negative. The reporting will be the same even in normal not at high risk individual, it detects the titre of antibodies and antigen, the result is never mentioned as zero. But a level > 1 is considered positive.
Rest be sure there is no cause for concern.
Take Care
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks bro , today i took the pep and tmrw my knee operation , i will stop the pep .i know you will wish me best of luck . Thanks for your extreme abd wonderful care. God bless you always.
Brief Answer:
Best of luck for Surgery
Detailed Answer:
Dear Bro
All the best for the surgery
God bless you and fulfill all your wishes.
Be in touch
Take care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry , My brother suggested me full anisthic and not partial for my knee operation , my question dr i have taken the pep dose today , dose this pep have a reaction on full anisthic ? I didnt tell my knee dr who will do the operation about the pep sorry again dr but any reactions ?
Brief Answer:
No major Interaction with GA or LA with PEP
Detailed Answer:
Dear Bro
The anti retroviral drug which you are using is Odivir( Its a combination of Efavirenz+Lamivudine+Didanosine), correct me if i am wrong.
Efavirenz is inducer of enzyme CYP 3A4 and 2D6( These enzyme also metabolize some of the anaesthetic drugs especially opioid ), and hence a dosage adjustment of some of the General Anaesthetic agents would be required
No other major interaction with anaesthetic both local and general anaesthesia.
To be doubly sure, I just had a word with my anaesthetist maintaining professional secrecy, he said its okay to go ahead with Surgery and both local and general anaesthesia safe.
Wishing you best of luck.
Take Care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks attached a photo of the combanation for your ref . You may kindly check and advisr
Brief Answer:
No information about drug combination present
Detailed Answer:
Hi
I did not find any drug combination attached, its the WHO classification of HIV/Aids
Waiting for your reply
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry wrong attachment
Brief Answer:
okay
Detailed Answer:
ok bro
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Pls find the correct attachment
Brief Answer:
No Major Interaction with GA/LA
Detailed Answer:
Dear Bro,
The combination is the exactly same which i had mentioned earlier.
Efavirenz( other two drugs have no interaction) is the only drug which promotes the enzymes previously mentioned.
Increased dose of some of anaesthetic agent like Opioids may be required, which the anaesthetist will definitely adjust even depending on the response to it.
Good part is it does not increase the toxicity of the anaesthetic drugs and other serious interactions between PEP .
So go ahead, wishing you a speedy recovery.
All the best
Get back to me after the surgery if possible.
Take Care
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks brother , trying to be on safer side i postponded the operation to after tmrw . Thanks bro
Brief Answer:
All the best
Detailed Answer:
Ok bro
Take Care
Best Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear bro , just to share some good news with you , i have done my knee operation and all well. God bless you
Brief Answer:
Take care.
Detailed Answer:
Dear bro
That's really nice to know everything went fine.
God bless you and your family.
May all your wishes come true.
Take care
Best Regards
Deepak and XXXXXXX
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks dear , i wish you the same
Brief Answer:
Take care
Detailed Answer:
Take care
Be in touch
Regards
Deepak & XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Will do , tmrw my appointment with the dr. Will be in touch
Brief Answer:
All the best
Detailed Answer:
All the best bro
God bless you
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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