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Is Negative HIV RNA Qualitative Test 13 Days After Sexual Encounter Conclusive?

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Posted on Fri, 27 Nov 2015
Question: Hi Doctor, I had protected sex with a sex worker the 28th of august, and Now I'm afraid that I might have contracted hiv, I took an Hiv Rna qualitive test from labcorp thursday 13 days post exposure (12 days and 12 hours) and it came back negative on sunday. But on saturday 2 days after I took the test I had a rash on my upper right arm, and it went away the same day at night . I felt releived on sunday because I got the results so i thought it was just a rash, but on monday 17 daya post exposure I got a rash again now on the bottom part of my arm, less noticeable than the first one, How accurate is the test I took doctor? I dont know if this rashes are due to hiv
doctor
Answered by Dr. Sandip Kabra (3 hours later)
Brief Answer:
RNA qualitative test is highly sensitive & specific test and very reliable.

Detailed Answer:
Hi,
Welcome to health care magic,

I have read your query and understand the concern.

If you had a protected sex with sex worker and your HIV RNA qualitative test is negative then I do not think there is anything to be worried.

HIV RNA qualitative test is highly sensitive & specific test, you can be sure of the test result as negative for HIV infection.The rashes could be due to some sort of allergy and seem not to be related to HIV infection here.

However,you can repeat the test after 8 weeks of exposure which will give you nearly 100% result to clear remaining doubt and to be in safer side.

Otherwise,there is nothing to be worried here as this tests is very reliable.

Regards,
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Sandip Kabra (2 hours later)
Thanks Doctor. I touched the condom at the end of the act, do you think the virus could have gone inside through any unnoticeable cuts in my hand? & have you ever seen a negative rna at 13 days change to positive later on? & is it possible to get the rash without other symptoms? Also very important, I got a flu shot about 5 weeks ago, can that interfere with the results?
doctor
Answered by Dr. Sandip Kabra (3 hours later)
Brief Answer:
Flu shot will not affect our test result.

Detailed Answer:
Hi,
Thanks for the follow-up,

It is rarely possible if you toched condone and virus can enter through unnoticed cut from the vaginal fluid over condom.I do not think so,this would have happened in your case.

Mostly,RNA test give negative results after 2 weeks of exposure accurately because it is highly specific and sensitive test but to repeat the test after 6 to 8 weeks will give nearly 100% result to clear remaining doubt.

The rash appeared on your body does not seem to be related to HIV infection because in infected individuals there may be much more symptoms than just rashes.

Also, it is unlikely that your flu injections can affect our test which was taken 5 weeks ago.

Overall,In my opinion you need not be worried about HIV as it does not seem to be here.

Still,if you want to be 100% sure repeat the test as I said.

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sandip Kabra (56 minutes later)
One last questions doctor, I took the test at 13 days because the lab said it is 97% accurate at 9-11 days post exposure, do you think it would have missed the virus if my rash is due to hiv? Should I take the hiv duo test antiboy antigens at 20 days or should I wait for 28 days? What teats do you recommend for me? Thankyou so much for your answes doctor. How can I contact you specifically in the future? Greetings from Florida, Us
doctor
Answered by Dr. Sandip Kabra (15 minutes later)
Brief Answer:
Almost no chance of false negative results in that test.

Detailed Answer:
Hi,
Thanks for the quick follow-up.

As I said earlier,RNA qualitative tests is highly sensitive and specific tests,so I do not think so there may be any chance of giving false negative results.

But to be more sure or to clear any remaining doubt I would advise you to repeat the test after 28 days or preferably after 6 weeks of exposure which will give nearly 100% accurate result.

Here, you are worrying too much despite having negative RNA tests and having no history of unprotected sex.

So,no need to worry and be rested.

You can ask me direct question to contact in the future or you can put your GP question by addressing my name (query for Dr.Sandipkabra) ,that will be forwarded directly to me by HCM team.

Wishing good health.

Regards,
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sandip Kabra (7 days later)
Hi Doctor I had sex with a sex worker on august 28th as you already know. And I'm worried now of my risk of having contracted herpes because I touched the condom after sex. The vaginal sex lasted about 3 minutes, the last 2 minutes I was holding my genitals to avoid having any contact with her but the first minute of sex I did mot hold them and I dont know if They made contact with her. I went and got tested 25 days after the encounter and I need help with the results, the lab said that the test could detect antibodies at 3 weeks but it was recommended to test 4-6 weeks after exposure for better accuracy this are my results, they came back negative, it says 0.91 or less is negative and in my results it says that I have 0.91, why is it not less than that?:

HSV 1 and 2-Specific Ab, IgG
<0.91
HSV 1 IgG, Type Spec
HSV 2 IgG, Type Spec
0.00-0.90 index 01 <0.91
Negative
Equivocal 0.91 - 1.09
Positive >1.09
Note: Negative indicates no antibodies detected to
HSV-1. Equivocal may suggest early infection. If
clinically appropriate, retest at later date. Positive
indicates antibodies detected to HSV-1.
<0.91 0.00-0.90 index 01 Negative <0.91
Equivocal 0.91 - 1.09
Positive >1.09
Note: Negative indicates no antibodies detected to
HSV-2. Equivocal may suggest early infection. If
clinically appropriate, retest at later date. Positive
indicates antibodies detected to HSV-2.
I uploaded a picture of the results hope you can see it, I woukd put the link to make it easier for you to look at the results but they have my name and everyone woukd be able to see it.
doctor
Answered by Dr. Sandip Kabra (5 hours later)
Brief Answer:
All results are negative

Detailed Answer:
Hi XXXX,

Thanks for the follow-up.

I have seen your lab report (sample collection 2015/09/22) and here are my conclusions.

Your HSV 1 and HSV 2 specific antibody IgG value is less than 0.91 (<0.91) is suggestive that you do not have HSV1 or HSV2 antibodies.

Although the laboratory could have written some exact value of lesser than 0.91,in general if the value is within the reference range then they just give you report negative means below reference range.(like they wrote <0.91).

Your hepatitis A,B and C are also non-reactive so,I would not be personally worried about this after having those findings.

I think you are unnecessarily much worried about HIV or STDs despite having normal lab reports.

If still anything to clarify,feel free to ask me.

Regards,

Dr.Sandip Kabra




Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sandip Kabra (16 hours later)
Oh ok thank you for making it clear doctor do you know how accurate this herpes test are? They told me at the lab that its 97% to 99% accurate 4 to 6 werks after exposure, but does that mean it will detect it in 97% of people? Because I read in some websites that they say that only 50% of people will have developed antibodies at 5 weeks? The reason that I was worried about herpes now is because 6 days after exposure with sex worker I had sex with my girlfriend and she did unprotected oral sex to me and around 18 days later (this monday) she had something inside her mouth that looked alot more like a canker sore than a cold sore but I was worried that I had passed herpes to her because she said that she had bot had a canker sore in 4 years and it was quite painful, it wasnt on her lip though, it was close to it on the bottom of her mouth
doctor
Answered by Dr. Sandip Kabra (11 minutes later)
Brief Answer:
The tests is 99% accurate.

Detailed Answer:
Hi,
Thanks for the reply,

As your both HSV 1 and 2 antibodies tests results came negative after almost 4 weeks of unprotected exposure then I do not think there is anything to be worried.

Your girl friend has some oral issue like canker sore as you said which could be due to some other reason but it needs to be inspected at least once before coming to any conclusion.

In your case,if you have a still doubt then you can repeat the test after 15 days to be in more safer side.

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sandip Kabra (3 hours later)
Ok thank you doctor, do you think I need to test again after testing in 15 days? When will the results of this type of test be 100% conclusive? How conclusive do you think it is at 4 weeks? Does it look like herpes in the picture I sent you? She has not had fever or any other symptoms Neither have I. But it just makes me worried to see this at the time that I'm at risk because of my protected 5 minute exposure with prostitute. because she had not had anything in her mouth in 14 months that I have known her. Thank you so much for your help doctor I really appreciate it.
Is it a high rish exposure to herpes 3 minutes of protected sex without any noticeable outbreak in my situation?
Is it a high rish exposure to herpes 3 minutes of protected sex without any noticeable outbreak in my situation?
doctor
Answered by Dr. Sandip Kabra (5 hours later)
Brief Answer:
Nearly 100% accurate after 6 weeks.

Detailed Answer:
Hi XXXX,
Thanks for the reply.

As i said you can repeat the test after 6 weeks to clear your remaining doubt and to be for more sure,since it will give nearly 100% result because if anyone got infected with virus then antibody formation occurs in blood within maximum 6 weeks of time period.

At 4 weeks this tests may give 97 to 99 % accurate result,so by that point also you have not acquired herpes.

The picture you sent is a canker sore and it could be due to variety of causes like vitamin deficiency,hormonal changes or viral infection or constipation or stressful conditions but it would be very difficult to say the underlying cause from just picture.

However,in your case if you have no clinical symptoms like fever,severe pain with negative herpes antibody tests,then you should not be worried about herpes.

Also,if you had a protected sex then there will be very less chance of getting viral infection to the either partner.

You are unnecessarily bothersome despite having no clinical significant symptoms and normal lab reports.

regards,

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (4 days later)
Hi Doctor I forgot to tell you that 25 days post exposure I took a standard hiv antibody test and it came back negative, the lab reccomended takibg it 1 to 3 months post exposure, but I see some doctos saying that this test at 4 weeks is 90% reliAble and others saying that its useless at that time in different websites, do you know what the accuracy of thai test might be? Today its been 18 days with this rash, when I wake up I have sort of red bumps and as the day goes by usually at night time Its hardly noticeable, the rash is mainly on my elvows, it looks like its mostly going aways but some days it comes back, the part of the rash that has gone away still doesnt feel smooth and The bumps look kind of white on my skin now
In The upper of my arm near my elbow the rash does look red and its not raised bumps as it is on my elbows, is it possible to only have one symptom from Hiv when seroconverting? I had never had a radh before :( , I also took a 4th generation duo test yesterday at 32 days post exposure and the anxiety is killing me I keep thinking it will be positive specially because I have this rash that I had mever had before in my life
doctor
Answered by Dr. Sandip Kabra (3 hours later)
Brief Answer:
No need to be worried.

Detailed Answer:
Hello XXXX,
Thanks for the continuour follow-up.

I have read your question and understand your problem.

As we have already discussed in my first answer that HIV RNA qualitative test is highly specific and sensitive which was negative earlier and you did also antibody testing later on which was negative too.

Generally incubation period of HIV ranges from 1 month to 3 months and if you did the test after 25 days of exposure then it could give around 90% accurate result.

As you said you had this rash since 18 days and suppose if this rash would have been due to HIV infection then there is more chances of having either of these tests positive.

So,I think there will be a rare chances of having HIV infection in your case despite you acquired this rash for the first time in your life.

However if you still have some doubt in your mind then you can repeat the test (ELISA test and western blot test) after 3 months of exposure which will give you nearly 100% result to be damn sure.

Till that time,no need to worried about HIV as our both tests was negative.

Most probably your 4th generation duo test will be negative as far as i am thinking.

Regards,


Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Sandip Kabra (7 hours later)
Thanks Doctor, I also had one pimple filled with a little bit of pus on the bottom left side of my stomach, the rash is mainly om my right elbow and I have a little bit on my left elbow too, Can herpes or another std cause a rash there? My girlfriend is starting to develop the same rash near her elbow, I only had sex with her one time after my encounter with the prostitute and it was 6 days after that.
we had Protected vaginal sex but she did unprotected oral sex to me, can it be herpes or another std?
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
Kindly send pictures.

Detailed Answer:
Hi XXXX,
Thanks for the follow-up.

Kindly send me pictures of that pus filled pimple on your abdomen and rash on the both elbow.It would be helpful for me to understand it properly by that photos.

As far as herpes or STDs concern,your lab reports for Herpes 1 and 2 were negative with hepatitis and HIV.So, we will think that possibility later on.

But before that let me see your pimple and rash.

Get back to me with images.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sandip Kabra (5 hours later)
Hi Doctor I sent you the pictures kindly advise me what it looks like please
doctor
Answered by Dr. Sandip Kabra (33 minutes later)
Brief Answer:
Send some clear pictures.

Detailed Answer:
Hi XXXX,

I have checked all the images you sent.

I am sorry but all images are blurred and can not be viewed properly.

Kindly send just one or two but clear image so that i can review them.

regards,
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Sandip Kabra (4 days later)
Hi, I have provided some attachments. Please review them.
Hi Doctor I just wanted to inform you thay my 4th generation hiiv duo test at 32 days came back as non reactive but I keep having a rash and yedterday I had a headache all day and I've been forgetting things I dont know if thats due to all the stress that I've been having, how conclusive is my test at 32 days? What are the odds that my test will turn positive at 3 months with a negative at 32 days?
doctor
Answered by Dr. Sandip Kabra (1 hour later)
Brief Answer:
Now,no need to go for testing at 3 months.

Detailed Answer:
Hello XXXX,
Welcome again.

I am happy that your 4th generation HIV duo test has come negative which I was expecting,so I do not think you need to be worried now.

I have seen all the images you uploaded which all are same.These rashes could be due to some allergic reaction for which you can take OTC antihistamines with pain killer for headache and see dermatologist for further evaluation to detect the underlying cause of this rashes.

Frankly speaking,I will not be able to tell you the exact reason behind this rashes but one thing is sure these rashes are not due to HIV or any other STDs from all above our long discussion.

I do not think that you will now require for 3 months testing as you had already had numerous reliable tests which all came non-reactive for HIV.Means it can very very rarely turned out to be positive now.

I will repeat my words that you are unnecessarily bothersome and taking extra stress despite having normal lab reports.

Wishing you good health.

Regards,

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Sandip Kabra (28 hours later)
Thanks Doctor, today at 40 days post exposure my nail changed turned into a dark colo I sent you the picture, is this a symptom of Hiv? I got really scared because last night I was reading that nails change with Hiv infection and today when I woke I noticed that in my nail
doctor
Answered by Dr. Sandip Kabra (5 hours later)
Brief Answer:
Does not seem to be related to HIV infection

Detailed Answer:
Hello dear XXXX,
Welcome again.

I have seen the pictures you uploaded.It seems to be having subungual hematoma (means bleeding under nail) and not related to HIV infection.So,I will not think about the possibility of HIV infection from this nail bed color.

Here,I want to clear one thing that it is not the color change of nail but it is bleeding or clotted blood under the nail.Generally it is not the serious problem and does not require medical attention.

It may be caused by some blunt hitting or slamming or dropping of some heavy object over the great toe.

Do you have any blunt or crush injury to your toe recently?

In case if there is pain or mild swelling take over the counter pain killer and use cold compression.It will be subsided within 3 to 4 days.

Regards,


Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Sandip Kabra (8 hours later)
Thanks Doctor. I do remember someone stepping hard on my foot 13 days ago while playing football soccer. Could that be the cause or has it been too many days? And also Doctor are my results at least 95% conclusive or are they 100% conclusive? I still want to test one more time for full peace of mind what test should I take if I do it?
And when? Because I dont want to wait until 3 months. Some countries like in the Uk they say that the 4th generation test is conclusive at 4 weeks but here they say 3 months
Also Doctor does my rash look like a bed bug rash or no? BecAuse i saw 2 small animals in my bed Nd i dont know if theyre bed bugs, I have a little bit of it on my leg too
doctor
Answered by Dr. Sandip Kabra (1 hour later)
Brief Answer:
Go for ELISA tests.

Detailed Answer:
Hi XXXX,
Thanks for asking again.

It is quite possible that subungual hematoma could be because of foot stepping during football.

As we had a long discussion previously,I do not think that you have any chance of HIV infection now but you can go for ELISA testing or P24 antigen testing which will give you nearly 100% result after 6 weeks of exposure especially when if you do not want to wait till 3 months for confirm antibody testing.

However,I would not recommend you personally as your treating physician because you had already undergone various tests which all have come non-reactive.

I had already my given opinion about your rashes but if you will upload a picture of these rashes then I will try again to help you as far as possible.

Wishing you good health.

Regards,

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sandip Kabra (26 hours later)
Hi Doctor I have uploaded the picturesnof my rash Kindly tells me if it looks like a bed bug rash, also Doctor I was reading some websites say the hepatitis can make the results of Hiv tests give false results because it delays seroconversion is this true? The lab recommends to test for hepatitis after 8 weeks
Is Hepatitis easy to transmit ? Because i touched condom
doctor
Answered by Dr. Sandip Kabra (31 minutes later)
Brief Answer:
Does not look to be having bed bug rash.

Detailed Answer:
Hello XXXX,
Thanks for follow-up.

I have seen all the images you uploaded and after reviewing them, this rash do not look to be having bed bug rash from those pictures,it could be simple allergic reaction or urticaria.

I am not agree that hepatitis can interfere with antibody formation to HIV in our body or it delays the sero-conersion.

In your case,you have already been tested for hepatitis A,B and C which all came non-reactive.Generally,hepatitis come positive after 2 or 3 weeks of exposure and it is quite uncommon to transmit hepatitis virus with the touch of body fluids.

If you have still any doubt remained in your mind,then you can go for ELISA testing or P24 antigen testing which will give you nearly 100% result after 6 weeks which I have already answered.

Also,there is no need to be worried about hepatitis infection,I think there is almost no chance of contracting this virus in your case.

Here,I am not able to understand why you are so much worried about HIV or hepatitis despite having normal lab reports.

Regards,
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sandip Kabra (22 hours later)
Hi Doctor I went for a genital herpes test today at 6 weeks post exposure, the website said I didnt need any fasting for the test so I didnt fast. The reason I went is because last night when I was in my bed going to sleep I felt something in my genital area again and I look at it & it looked irritated and one of the lines of the skin in the genital area looked like a small razor cut, but I havent shaved for 2 months, so is deffinetly not a razor cut. Could not shaving for that long cause irritarion? Or what do you think can cause it? I read on the internet that herpes sometimes loon like razor cut so I got scared
I read on the Internet from some doctors that they say only 60-70% of people will be detected at 6 weeks, the test I took the lab says it is 97% accurate at 6 weeks so what dies this mean?
I felt only a little bit of burning in the area that lolls like a small razor cut, no pain at all.
doctor
Answered by Dr. Sandip Kabra (1 hour later)
Brief Answer:
Cut near genital area could be due to friction.

Detailed Answer:
Hello XXXX,
Welcome again.

As you had already negative HSV1 and HSV2 results earlier,then I do not think your this tests can become positive.

Also,the small razor cut near the genital area could be due to friction but after inspecting the lesion I will be able to say exactly.However,it is very unlikely to be due to herpes in your case.

Herpes lab results usually comes positive within 4 to 6 weeks of exposure,so this tests result would be conclusive in your case and as far as i am thinking it may come negative again.

Burning over that cut will be subsided within 4 to 5 days,you can apply any antiseptic cream and keep your genital area dry,better to avoid moisture which might induce infection.

Hope it will clear now.

Regards,


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sandip Kabra (2 days later)
Hi Doctor I am still waiting for my results, they are taking longer than last time, I dont know if thats bad news. I just sent you the picture of what looked like 2 pimples on the palm of my hand when I woke up, could that be herpes since I touched the condom with my hand after sex with the prostitute? I am so worried as I have heard herpes tests are not very accurate and some people can take up to 4 months to develop antibodies, amd herpes is common in The US so yhe chances that the prodtitute had it are high, also Doctor is there a test for Hpv?
Also Doctor when I was a kid I had the varicella virus or chicken pox whatever is called, its the virus that causes shingles. Can that delay the production of antibodies to herpes 1/2 ?
doctor
Answered by Dr. Sandip Kabra (49 minutes later)
Brief Answer:
Do not look to be herpes from the pictures.

Detailed Answer:
Hello,
Welcome back.

I have seen all the pictures you uploaded, pimples or rashes do not look to be from those pictures.

I have seen many cases of herpes,they do not look like this what you are much bothered about.

Also,herpes virus and chickenpox virus (varicella) comes from the same herpesviridae family,they do not interfere delay antibodies formation.

Varicella virus which causes chickenpox in childhood and the same virus causes shingles (herpes zoster) in adulthood because virus remains in the dormant form throughout the life in our body when we get infected with chickenpox in childhood.

Virus got reactivated by local injury or fever,stress,or low immunity and get replicated causing shingles.

Hope this will help.

Regards,
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (2 days later)
Hi Doctor, I sent you pictures of the lessions that I told you I had on my genitals, can you please tell me what it looks like? Is it herpes?
doctor
Answered by Dr. Sandip Kabra (3 hours later)
Brief Answer:
Kindly send some clear picture.

Detailed Answer:
Hello XXXX,
Welcome again,

I have seen all the images you uploaded which all are same.

The quality of images is not so good and also it is difficult to locate the lesion which you are talking about.

So,kindly send some clear pictures and if possible locate the lesion with markers.

Regards,


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sandip Kabra (9 hours later)
Hi Doctor I sent you 3 new pictures, I don't have a marker so I zoom in in the pictures specifically to the area of the lessions, in the first 2 pictures I stretched my skin to make it more noticeable, and in the last picture I did not stretch my skin so that's how it looks like when the skin is not stretched, can you see the pictures more clear now Doctor? If so then What does it look like?
doctor
Answered by Dr. Sandip Kabra (53 minutes later)
Brief Answer:
Does not look to be herpes.

Detailed Answer:
Hello dear XXXX,
Well,thanks for sharing clear picturs.

I have seen all the images you provided but they all are same and there is no stretched pictures as you said.

The redness skin lesions do not look to be herpes from the picture which you doubted earlier.

But very honestly saying,it is very difficult to diagnose those lesions just from the single look at the pictures without clinical symptoms and examination.

So,if the lesions are troublesome and creating discomfort then you will need to consult dermatologist who can do clinical assessment and can make some diagnosis.

Otherwise there is no need to worry about STDs.

Regards,


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (3 hours later)
Thanks Doctor, I stretched my skin on the genital area to be able to see better, could this lessions be due to excessive touching that area? I will make an appointment with a dermatologist as soon as I can Doctor
And I don't have any discomfort or pain
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
It is not a serious issue.

Detailed Answer:
Hello dear XXXX,
Welcome again,

May be it is due to excessive touching or stretching of genitals but I would honestly say that it is very difficult to comment the exact reason behind it.

But one thing I can say is that it is not the serious issue and yes,it is not due to any STDs for which you were much bothered about earlier.

As you had no pain or discomfort and your previous tests were also negative for STDs.

If you have any more doubt,feel free to ask anytime,I will be happy to answer that.

Regards,

Dr.Sandip
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sandip Kabra (4 days later)
Hi Doctor XXXXXXX please help me, I noticed this lession yesterday, I'm sending you the pictures
The first 2 photos that I sent you are from when I noticed the lession yesterday, and the last 2 photos that I sent you are from the same lession 14 hours after appearing, Is this herpes Doctor?
doctor
Answered by Dr. Sandip Kabra (1 hour later)
Brief Answer:
Does not look to be herpes.

Detailed Answer:
Hell XXXX,
Welcome back again,
I have seen the picture you uploaded.

It does not look to be herpes rather it could be some insect bite or allergic after going through the lesions.

But let me know,
Is there any burning sensations?
Is there associated pain?

Regards,

Dr.Sandip
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sandip Kabra (1 hour later)
There is no burning or pain, maybe a little bit of itching (not significant) if any at all maybe because of my anxiety, I became very anxious when I saw it, my muscles in my left arm and lower back did hurt 2 days ago I dont know if it is due to me playing football because I did play for about 5 hours this weekend, and I saw this yesterday, I didnt see any ulcer, I took the picture as soon as I saw it
It did have a little bit of like fluid as you can see in the picture, I don't know if thats normal of an insect bite or if its because of the area its in or if its herpes
doctor
Answered by Dr. Sandip Kabra (42 minutes later)
Brief Answer:
Apply topical antihistamine

Detailed Answer:
Hello,
Thanks for sharing more information.

I do not think you should be worried for hepres as the lesion is something other than herpes.

Although I cant surely tell you if this is insect bite or something else,but usually it subsides with symptomatic treatment alone.

You can apply antihistamine ointment like benadryl twice daily over this small lesion.

And do not to be panic for herpes as we have already discussed in out long discussion that herpes lesions are completely different.

Still if you have any query then just let me know,I will be happy to help you.

Regards,


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (3 hours later)
Thanks Doctor I took some more pictures of how it looks now 22 hours after I saw this lession. Theyre very clear, whats your opinion? On a scale of 1-10 how close does this look to herpes?
The third image is of something that I had on my arm a couple days ago when I woke up, what does it look like?
Please give me a long and detailed answer doctor
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
Will five 0 out of 10 for herpes.

Detailed Answer:
Hello dear XXXX,
Thanks for follow-up.

I have seen all the images you uploaded.

There is no chance of having herpes as it does not represent like this.

Herpes also doesn't typically cause anything like reddish circular bumps.It's usual appearance is one of clustered vesicles (blister-like lesions).

It much looks towards some insect bite or preferably spider bite because we can see central dot around the circular reddish or whitish bump.There is no such kind of appearance seen in herpes.

If I will your treating doctor then I would have given 0 out of 10 for herpes after carefully physical examination.

Over the counter antihistamines (benadryl) cream or ointment application over that bumps would be helpful.

But I thing I want to assure that these lesions are not herpes in any way,so you must not need to be bothered about it.

Hope this will clear now.

Regards,


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (4 hours later)
Thank you Doctor, When you say that you would give it 0 out of 10 are you saying for the lessions on my arm or on my genital area? Which one? What rate for each? My test for herpes was negative at 6 weeks, They say that 70% of people would have antibodies by 6 week, & 80% at 8 weeks & 90% at 12 weeks & 95% at 16 weeks, So I know that my results are not conclusive yet, & the reason I'm so worries os because my girlfriend did oral sex to me 6 days after I had sex with the prostitute & about 17 days later she had inside her mouth a pimple which looked more like a canker sore also because it was inside her mouth & herpes is typically outside the lips, but this os what has me worries because canker sores & cold sores are sometimes similars based on what I have read on the internet
Also Doctor I had a headache the day that this lession appeared, I know thats a symptom of herpes but I know it can also be cause by my anxiety and how worried I've been
doctor
Answered by Dr. Sandip Kabra (6 hours later)
Brief Answer:
0 out of 10 for both of your lesions.

Detailed Answer:
Hello XXXX,
Thanks for the reply.

Well,I will give 0 out of 10 for both of your lesions on arm and genital-scrotal area in earlier discussion.

Also,percentage counting at different different periods is only on theoretical basis but it does not have clinically much significance because when the lesion does not appear to be herpes and if you have been tested negative for herpes at 6 weeks then clinically I would count this result conclusive.

So,you do not need to be worried thinking that your result is still inconclusive.

Headache is a very common symptom,I would not link it with herpes which is not the possibility here.

And yes,it might be related to your anxiety.

Let me know if you any more doubt.

Regards,
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Sandip Kabra (4 hours later)
Thanks for your help Doctor, do people have headacheds when they're going to have an outbreak or at any time? My girlfriend had a hedache yesterday too, I hope its due to something other than herpes, when I had sex with the prostitute after the first minuteI grabbed my scrotum to avoid contact with her vagina & the sex lasted 4-5 minutes but I know that can be enough time to get herpes, I wasn't examining myself for ny lessions the first 2 weeks because I was more worried about hiv, but I didn't feel anything uncomfortable or painful, I hope I am clean
doctor
Answered by Dr. Sandip Kabra (13 minutes later)
Brief Answer:
Not necessarily.

Detailed Answer:
Hello,
Thanks for follow-up.

It is not always necessary that one would have headache when they are going to have an outbreak of STD or HIV or any other contagious illness.

Rather headache is a common symptom seen among people.

Your girl friend could have tension type of headache which is a primary or simple headache caused by some precipitating or triggering factor and mostly it is relieved by OTC analgesics (ibuprofen or naproxen or diclofenac) and eliminating of this triggering factor.

Tension headache may last for few hours to some days depending on triggering or precipitating factor like dehydration or decreased water intake,heavy sunlight exposure,sleep deprivation,wrong or uncomfortable posture,eye strains,stress,long working hours in one position etc.

She can OTC analgesic which suits her and take bed rest and adequate sleep with muscle relaxant and antacid if gas trouble.Try to avoid contact with triggering factor.

As far as your exposure is concern,you do not seem to be acquired any kind of STD or HIV infection as we have already discussed in our previous long conversation.

Regards,

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Sandip Kabra (2 hours later)
Thanks Doctor , so do you think my test at 6 week is 100% conclusive for herpes or should I take another one & if yes when should I take it? Is it okay to have sex with my girlfriend or no?
The first picture that I sent you is how the lession looks today 40 hours after seeing it, & the second one is of the lessions that I had told you looked like razor cuts that you said they could be from friction or excessively touching the area
I just sent you one last picture Doctor is that lession on my genitals the one that you said looks like a spider bite or the ones that I had on my arm?
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
Conclusive clinically.

Detailed Answer:
Hello dear XXXX,
Welcome back.

As i have seen all the pictures of your lesions after your sexual exposure which all are not indicative of herpes and your 6 weeks HSV test was also negative,so clinically i would consider it 100% conclusive.

However,you may go for repeat testing at 12 weeks for your peace of mind.

Yes,you can have sex with your girlfriend,there will be issue.

All your pictures I have seen so far during out long conversation since 5 weeks,from which I have not felt a single doubt for them to be herpes,so do not worry.

The lesion on your arm was appearing to be some insect bite (may be spider bite or some other insect) but not this one.

Although it is very difficult to diagnose this kinda lesion from just looking at a picture but one thing is sure it is not herpes.

Treatment part we have already discussed in our previous conversations.

Wishing you a good health XXXX,

Regards,


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Sandip Kabra (7 hours later)
I just sent you another picture Doctor where you can see that the lession has a little bit of fluid in it, it looks a little bit wet, is your rate still 0 out of 10 even with the lession having a little bit of fluid? I want to go get tested tomorrow at 8 weeks
doctor
Answered by Dr. Sandip Kabra (3 hours later)
Brief Answer:
0 marks for herpes.

Detailed Answer:
Hello XXXX,
Thanks for sharing pictures.

I have seen the pictures you sent which are not suggestive of herpes lesion in anyways.I will give 0 out of 10 for herpes.

It might be folliculitis or may be some insect bite but it is not the herpes which should be clear to you now after our long discussion.This lesion can be subsided spontaneously within few days or oral small course antibiotic can be effective.

I can understand that you had a sexual encounter with some unknown sexual partner but that does not necessarily mean that you will have infection of herpes.

First thing is,if she was not infected with herpes then you do not have any any chance of getting herpes and second this,even if she was infected with the same,it does not necessarily mean that you will also get infected with herpes, although spread of transmission rate is high but not always 100%.

Hope this will clear now.

Regards,


Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Sandip Kabra (2 days later)
Hi Doctor I just wabted to informed you that I tested at 8 weeks and my reaults came negative for all stds even though I'm still worried about herpes & anything I see in my genitals makes me worried, I have a little piece of skin that looks irritated if it starts getting suspicious I'll send a picture to you? Whats your opinion on my tests being negative at 8 weeks?
doctor
Answered by Dr. Sandip Kabra (2 hours later)
Brief Answer:
Absolutely no chance of herpes.

Detailed Answer:
Hello Dear XXXX,

Welcome again for your reply.

Nice to hear that your 8 weeks test came negative for all STDs which I was anticipated in my previous answers.

As we have already talked in our long discussion,your lesion does not look to be herpes (0 marks for herpes) and your previous test (at 4 weeks) for herpes was negative and this one is also came negative,then I do not think about the possibility of herpes in future because of that exposure.

Still,if you have any doubt regarding any skin lesion,you can send me pictures at any time,I will be happy to answer that.

Wishing you good health.

Regards,

Dr.Sandip Kabra
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Sandip Kabra (43 hours later)
Hi Doctor I just sent you 2 pictures of something that looks like a pimple in my pubic area, is this herpes? I'm at work so I haven't been able to take more pictures, I just noticed it 30 minutes ago
doctor
Answered by Dr. Sandip Kabra (4 hours later)
Brief Answer:
Does not look to be herpes.

Detailed Answer:
Hello dear XXXX,
Welcome again,

I have seen the pictures you uploaded and made a circle with marker pen.

It does not look to be herpes and I will give 0 marks out of 10 for the herpes.

It may be either small boil or furuncle due to bacterial infection and usually subsides by itself within 3 to 4 days.

If anything else to clarify, then just let me know.

Regards,

Note: Get personalized answers to your HIV related queries You can choose to talk face to face with your doctor. Book a Video Call now.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Sandip Kabra

General & Family Physician

Practicing since :2009

Answered : 3078 Questions

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Is Negative HIV RNA Qualitative Test 13 Days After Sexual Encounter Conclusive?

Brief Answer: RNA qualitative test is highly sensitive & specific test and very reliable. Detailed Answer: Hi, Welcome to health care magic, I have read your query and understand the concern. If you had a protected sex with sex worker and your HIV RNA qualitative test is negative then I do not think there is anything to be worried. HIV RNA qualitative test is highly sensitive & specific test, you can be sure of the test result as negative for HIV infection.The rashes could be due to some sort of allergy and seem not to be related to HIV infection here. However,you can repeat the test after 8 weeks of exposure which will give you nearly 100% result to clear remaining doubt and to be in safer side. Otherwise,there is nothing to be worried here as this tests is very reliable. Regards,