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Is There A Risk Of HIV Infection After Unprotected Oral Sex?

Posted on Fri, 17 Jan 2014

Question: Hi sir, XXXXX My exposure was receiving a unprotected oral blow job from a massage center lady on November 24 th.i live in dubai I am not allowed to check there for HIV so I travelled to india for testing. My sister is working in blood bank so with her help I started testing for Hiv . 1.rapid test after 15 days exposure -negative 2. Cmia test after 17days exposure -negative 3. Id XXXXXXX after 20th day - not detected (Appollo) Symptoms I am faced is some itching allergy in my back then in my fore arms had some allergy .went to dermatologist gave me medicines its gone now. had some mild abdomen pain . Yesterday had a pimple like thing above my upper lip . This is my exposure which is putting me in fear and I am worried whether to go back and join work or stay here till my 8weeks period . My sister adviced me nothing to worry but I Needed a experts advice Sir. I have been in extreme pressure for this one month . I have a beautiful family I am afraid I should not cause any harm to them that's why..Hope you understand sir.

Answered by Dr. Sankaranantham Murugan (13 hours later)

Brief Answer: Oralsex lowrisk for HIV.Antigentest rulesout HIV Detailed Answer: Hi XXXXX, Welcome to XXXXXXX Thanks for posting your query. I can understand your concern. Unprotected oral blow job carries a very low risk for HIV. As per CDC,Atlanta, penetrative vaginal sex is considered to be one of the high risk activity and it has a risk of 5/ 10000 exposures only and oral sex carries a low risk means you can understand the remote possibility or almost negligible. So you need not worry about your sexual activity at massage parlor. Regarding the tests for HIV, all the tests done by you are carrying a high degree of specificity and sensitivity and the latest Id XXXXXXX test is almost 100% sensitive. But the thing is, all the test done by you were all antibody detection tests. Antibodies against HIV in the presence of infection can occur only after 60 days and these results are more conclusive after 90 days. If you are so anxious to get tested earlier (not necessary with oral sex) you can go for Antigen tests like P24 Antigen test, DNA PCR test or a 4th generation Combo/DUO test. That will rule out the HIV possibility as early as 10 days itself and more conclusive after 4 weeks. Do.t worry you will not have HIV. Dr S XXXXXXX

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

Follow up: Dr. Sankaranantham Murugan (27 minutes later)

Sir Thank you for the reply . As I was was advised XXXXXXX will identify the virus it self after 10days so thats y I went for this test. So should I take another test ..dosent my XXXXXXX conclude I am not infected. I am afraid to go near my wife after this incident. All test I perform was after 2 WEEKS the Cmia is a combo test as adviced to me . Can I stop testing or should test more to be sure Kindly reply sir.

Answered by Dr. Sankaranantham Murugan (16 minutes later)

Brief Answer: CMIA Combo test rules out HIV. you are HIV free Detailed Answer: Hi, Welcome back. CMIA technology can be used to detect both antibody and also antigen. If it is used as a combo test which can detect both antigen and antibody test, then you need no further testing. It is conclusive that you are free from HIV. Dr S XXXXXXX

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

Follow up: Dr. Sankaranantham Murugan (13 minutes later)

Hi sir, Feels good to listen from a expert you are hiv free. Kindly dont mistake me I am asking again. One more doubt the XXXXXXX test report is saying that XXXXXXX screening done for viral RNA/DNA HBV : NOT DETECTED HCV :NOT DETECTED HIV 1/2 :NOT DETECTED is it not more accurate than cmia sir. Can I have unprotected sex with my wife. Anxiety plays a big role than the infection sir.any how I will stop testing and go back to dubai. thanks for all reply and last reply expecting sir. Will pray to god he gives long health and happiness in you and your family. Thank you sir .

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer: XXXXXXX not detected HIV DNA/RNA.HIV free confirmed. Detailed Answer: HI, Welcome once again. Really speaking, I had no experience with Id XXXXXXX But nuclear amplification tests for HIV antigen is a common technique and highly reliable. Same principle is engaged in Id XXXXXXX You had sent the version of your test. It clearly meant that this test was performed to detect HIV Antigen (RNA and DNA). Naturally antigen based tests detects the infection as early as within week of infection. But this also becomes more conclusive after 3-4 weeks. Your test performed on 20 days (3 week) after the risk activity.So you need not have any more test as it was only a oral contact. I still assure that you are HIV free. You can have sex with your wife without any protection and hesitation. You and your wife will be safe. Dr S.Murugan

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

Follow up: Dr. Sankaranantham Murugan (2 hours later)

Thank you very much sir. This will be my last question. I was going through the cmia result it says Cmia ( blood & immunology ) Hiv 1 & 2 : non reactive (0.12) < 1.0 cut off index In case it will help wether for you to check the correct test has been performed. I want to put this incident behind and move on with my life because past 1 month I am not me this fear is playing all games with me. Thank you for your time sir. You are doing a great job . Thanks once again for helping me ..

Answered by Dr. Sankaranantham Murugan (24 minutes later)

Brief Answer: Test value is less than cut off value. HIV free Detailed Answer: Hi, Welcome back. You need not bother about cut off values. Every test has a cut off value as indicated in the instruction manual as per the marketing company of each test kits. Your test value is far less from the cut off value. So the test is expressed as CMIA is nonreactive for HIV. Test performed correct only. So just forget the past incident and carry on you routine work. Have great day. Dr S.Murugan

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

Follow up: Dr. Sankaranantham Murugan (6 days later)

Hi Sir, How are you. With continuation to the previous coversation i have travelled to UAE on 28th before travelling i wanted to be again clear from my doubts so i went fro another test elisa exacltly on 33rd day after my receiving oral exposure. The report says Serology Anti Hiv 1 & 2 ( Elisa ) - 0.16 Anti Hcv - 0.22 Hbs Ag (Elisa) -0.10 < 1.0 non reactive > 1.0 Reactive. Question 1: I told the lab person to perform P24 antigen test i am not sure wether they have performed that test in this please confirm sir. Question 2: The test was performed after 33 days so can i take this as conclusive with my previous tests because for 3months conclusive test i have to travel again to india because i am not allowed to test here Kindly need your advice wether i have to re-test . Test's performed as their period : 1.rapid test after 15 days exposure -negative 2. Cmia test after 17days exposure -negative 3. Id XXXXXXX after 20th day - not detected (Appollo) 4.Elisa ( 4 generation as informed by lab to me ) - 33rd day Non - Reactive . I am not able to stop thinking of this incident i dont know why ? Sir have attached the report in case you want to review . thank you sir for the past help & future .

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer: 4th generation ELISA detects P24 Antigen. Detailed Answer: Hi, Welcome back. ELISA 4th Generation test detects both antibodies and P24 Antigen. So it becomes conclusive at 33 days after the high risk activity. Now it is confirmed beyond doubt that you free from HIV. So you just erase that incident from your memory and concentrate on your day today career. Dr S.Murugan

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

Follow up: Dr. Sankaranantham Murugan (11 hours later)

Sir I told the lab technician to do p24 test I am not sure wether they have done it kindly confirm. Do you suggest for confirmation test at 3 months.because I have to plan my travel before hand. The lab person told I have to come again in 3 & 6 months so I told I will discuss with my doctor as you are my doctor in this thats why I am asking should I retest . I am not able to come over this incident sir .my friend is also helping me the guilt is only troubling me this was my first incident with some one .I will come out . Waiting for the reply sir.

Answered by Dr. Sankaranantham Murugan (1 hour later)

Brief Answer: Both antigen and antibody tests ruled out HIV. Detailed Answer: Hi, Welcome once again. Antigen test is more reliable as it is recognizing the viral particles itself than that of antibody tests. For you, both ELISA for antibodies against HIV, HCV, HBV and Antigen screening for HCV,HBV and HIV 1&2 had been done and all were negative. ELISA at 33 days can not be considered as conclusive where as a negative ID XXXXXXX for HCV, HBV and HIV is very much conclusive and reliable. Don't rely the technicians word. You need no more test. You are free from HIV,HCV,HBV infections. Just forget about the past incidence and concentrate on your daily routine. You need no guilty complex about the same. Good day to you. Dr. S.Murugan

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

Follow up: Dr. Sankaranantham Murugan (40 minutes later)

Sir Thank you This will be my last question I was undergoing treatment for allergy due to Dandruff as adviced by Dermatologist in fore arm and my back of neck after the XXXXXXX test (had the allergy for 15 days before XXXXXXX was taken ) and till the day before of the elisa test tablets it took was ATARAX ( 10 tablets ) AF 400 mg - 2 tablets ( 1 a week ) and i had a big bulge in my thigh due to friction as doctor told me. so i took IMOL tablet for 1 week . Will this any how affect the result of elisa. Kindly reply for this doubt sir. Sir you have made all my doubts clear in the past and now i have come to 95 % normal after having discussion with you sir. And Wishing you a Happy New Year Sir. Let 2014 bring you all XXXXXXX and happiness in you and your family.

Answered by Dr. Sankaranantham Murugan (3 hours later)

Brief Answer: Drugs mentioned by you not affect the results Detailed Answer: Hi XXXXX, Welcome again. Thank you for your New Year wishes. Definitely 2014 is going to bring a lot of fortunes and success. XXXXXXX test detects viral particles and no drug will interfere the outcome or delay its sensitivity. Drugs like Atarax, AF 4oo, and Imol tablets are not related to steroids and don't have any immunosuppressive action and therefore it has no effect on ELISA. So nothing to worry and you are HIV free beyond any doubt. Wish a happy New year. Dr S.Murugan

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

Follow up: Dr. Sankaranantham Murugan (21 minutes later)

Happy new year Sir. Blessing's for you means much to me personally. Thank you for all the help .

Answered by Dr. Sankaranantham Murugan (6 hours later)

Brief Answer: You are most welcome. Detailed Answer: Hi XXXXXXX You are most welcome. If you have any more questions feel free to ask. If you have no more questions to ask you can close the conversation. Wish you a bright future. Dr S.Murugan

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