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Dr. German
Dr. German, Doctor (MD)
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Hi. I am 40 years old, kidney transplant taking daily rejection

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Hi. I am 40 years old, kidney transplant taking daily rejection medicine.

May 2nd : I met woman from a bar. She is a sex worker. She gave me unprotected oral sex; I kissed her and put my finger in her vagina. I washed my hands with water and soap, dried them but 5 minutes later the same finger was wounded and bleeding. I quickly sprayed it by a perfume. During the next two weeks the following happened: I felt very tired for 2-3 times, 2 hours each. My bones and joints were okay but during these short periods of feeling tired, i felt as if my legs cannot carry me or lap top is becoming heavier when I carry it. I had night sweating for 6-7 nights. 3-4 times breathing difficulty for 20 minutes each. Red skin rash on shoulders, back, and stomach. Diarrhea for 3 weeks with stomach pain. I had blocked nose for 2 weeks. Aso felt that my tongue is becoming white especially before eating ( I take rejection medicine that could lead to such thing?) On the other hand: I had no fever at all. My temperature did not exceed 37.1 max and usually in the range of 36.5. I had no swollen glands. No headache. No pain in bones or muscles.

Blood tests:
1- 14 days from exposure, I tested for HIV PCR DNA (sample was collected in Beirut and done in Paris): It was below the threshold i.e. below 20 copies and the lab doctor told me it is negative
2- 21 days from the exposure, HIV Combo (HIV1/2 & P24 antigen) and it was negative for both bearing in mind no antibodies will appear in my case quickly and might take longer because my rejection medicine, but more importantly the P24 antigen was negative as well.
3- 62 days from the exposure, I repeated the HIV PCR DNA test and it was negative. again collected in Beirut but done in Paris.

My questions:
1- From the above, am I at the risk of HIV? Are the 2 PCR DNA tests considered conclusive?
2- If I do the HIV antibodies test on the 90th day will it show ( bearing in mind that I am taking rejection medicine but my white cells are good -Total Leucocytic Count (The White Cells) was 8.7, while the reference is 3.5-10.5
3- If planned anti bodies test ( on the 90th day) is negative, can i consider it conclusive? although my rejection medicine or shall i wait for 6 months?
Welcome and thanks for your question I am Dr. German I would be here to help you and give you assistance until you are satisfied, to begin with :

1-Although the PCR HIV DNA test is not the standard HIV INFECTION diagnostic test and it is commonly used to monitor patients who are already HIV positive , to measure their viral load and determine if their antiviral treatment is being effective or not or to detect an early HIV infection in babies of HIV positive mothers . The test is also extremely reliable to detect an early HIV infection ,the window period is 28 days . This means your PCR DNA tests are already conclusive and the advantage of this test is that its results are more reliable , even if you are taking rejection medication which could affect the antibody production but not your HIV viral load . So yes, your HIV PCR DNA NEGATIVE results are conclusive.

2- Even if you are taking rejection medicine , most patients seroconvert at 3 months . So yes ,the antibody test will be positive at 3 months and show after 90 days .

3- But the longer period for conversion is 6 months .
However , there is no need to worry you are HIV negative . If it gives you peace of mind ,take an antibody test at 6 months , but it is not really necessary.

If you need any additional information I will be happy to continue further and assist you until you are completely satisfied . Good luck to you and have a good day !

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