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Had Protected Sex. Having White Coating On Top Of Tongue, Sore Throat And Cold. Negative Result Shown In HIV Test. Take The Test Once Again?

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Posted on Fri, 25 Oct 2013
Question: I had protected sex with sexy workers about 6 or 7 weeks ago in Thailand. I inspected the condoms that I used making sure it didn't tear or to see if there was any leaks afterwards. The condoms didn't tear or leaked. Now for over a month I've white coating on the top of my tongue which doesn't hurt when I eat or drink. Also I've been getting a very mild sore throat that comes and goes where it feels like I'm getting a cold but the cold never comes.
After 8 days of my exposure I took the dna pcr with the antibody (Elisa) test which came back negative for both test.
At 4 weeks I took the dna pcr and the antibody (Elisa) test which came back negative again.

At 5 weeks and 4 days I tested for all STDs with the antibody (Elisa) hiv test and everything came back negative except for herpes 1 which I tested positive for herpes 1 and negative for herpes 2.

Should I repeat the test or should I be confident with the test that I've done so far?
doctor
Answered by Dr. Rakesh Karanwal (1 hour later)
Brief Answer:
You have Oral Herpes. No repeat of tests required

Detailed Answer:
Hi there,

Thanks for the query. I appreciate your concerns.

From the available details, you are Oral Herpes- a viral infection which is transmitted through oral secretions while kissing an infected sex partner, or sharing her toothbrush.

There is no cure for herpes simplex. Once a person has the virus, it remains in the body. The virus lies inactive in the nerve cells until something triggers it to become active again.

There is no further requirement of repeating the test(s). However, in view of the whitish coating of the tongue, possibility of co-existing fungal infection (called Candidiasis) cannot be ruled out through throat swab analysis/culture. Candidiasis, unlike oral Herpes, is treatable with 2-3 weeks of anti-fungal drug.

You may therefore discuss the matter with your treating doctor, who knows about the diagnostic test for Candidiasis and will prescribe most appropriate treatment for Oral Herpes and, if Candidiasis is confirmed, anti-fungal therapy.

Hope I have addressed your query to your satisfaction. If you have any further questions, I will be more than happy to answer.

However, if you do not have any further clarifications, you can close the discussion and rate the answer.

Wish you a speedy recovery and good health.

Dr. (Col) R Karanwal



Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rakesh Karanwal (50 minutes later)
I thank you for taking the time to answer my questions. I will make sure I rate you well for all your help I just have a few more questions pls. What could the sore throat be? It's very mild. it comes and goes especially when it's cold outside and I'm not wearing enough clothing, I get the sore throat, it feels like I'm catching a cold but the cold never comes. It doesn't bother me when I eat or drink, it usually goes away in a day or two.

Could the oral herpes cause the sore throat and white coating on my tongue?

How accurate are the hiv tests that I've done so far? To me sure that I'm not infected.

My test result from Quest Diagnose says for herpes 2 <0.90 and Range <0.90 and the final result says negative? What does < 0.90 mean? am I developing herpes 2 but not enough yet?
It says for value <0.90 and for range <0.90 result : negative.
doctor
Answered by Dr. Rakesh Karanwal (57 minutes later)
Brief Answer:
sore throat is due to herpes infection

Detailed Answer:
Hi there,

Thanks for seeking further clarifications.

* Recurrent, transient sore throats without sustaining common cold, is commonly seen in Oral herpes infection.

* Herpes, ordinarily, do not cause painless white coating of the tongue.

* Other possibility, it can be due to Candidiasis when it involves the back of the throat. Try to see in the mirror if there are white patches in the back of the throat.

* HIV test becomes positive only after 3-4 months of exposure. A negative HIV test conducted within 3-4 months after sex, is likely to be misleading. Hence, repeat HIV test after 6 and 12 months after your escapade in Thailand. You can relax if both tests are NEGATIVE.

* The normal range of herpes 2 antibody titers is 0 to 0.90
Titers more than 90 denote positive test for herpes 2.

If you have further clarifications, do not hesitate in reverting back.


Dr. Karanwal
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rakesh Karanwal (1 hour later)
Again thanks for your response. I do not have a white patch on the back of my throat but I will try to see an ENT doctor for my throat.

How accurate is the early hiv detection (DNA PCR) test in detecting it early?

Thanks again

The recurrent of my sore throats or white coating could those be a sign of early hiv infection/symptoms?

Thanks again
doctor
Answered by Dr. Rakesh Karanwal (8 hours later)
Brief Answer:
DNA PCR test is highly sensitive

Detailed Answer:
Hi there,

* DNA PCR test is highly specific and sensitive : diagnostic of HIV

* I was discussing the mode of presentation of Oral Herpes/Candidiasis infection.

* Please note that HIV DISEASE manifests itself several years (7-10years) after exposure. But HIV INFECTION simply means that the virus are present in the body. But the body immunity remain INTACT. The patient remains healthy, without any symptoms for several years.

* Once the HIV disease sets in, the body's immunity is greatly compromised, which causes high susceptibility to opportunistic infections, particularly fungal and viral infections. So, in a manner, these symptoms may be indirectly attributable to HIV DISEASE.

In your case, IT WAS JUST TRANSMISSION OF HERPES (with or without associated fungi) INFECTION through kissing! That's All! JUST RELAX....if DNA PCR test is negative after 6 months of exposure...excludes HIV infection
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Rakesh Karanwal (6 hours later)
Hello Doc, I tested with the DNA PCR at 8 days and 32 days of my protected exposure. On both dates I tested negative. Is the negative DNA PCR test reliabil at 32 days of post exposure?

Thanks
doctor
Answered by Dr. Rakesh Karanwal (2 hours later)
Brief Answer:
DNA PCR at 12weeks' post-exposure is CONCLUSIVE

Detailed Answer:
Hi there,

* It is great to know that you're quite well informed.

* DNA PCR test has a window period of 2-3 weeks and has an accuracy of 99% after that, although guidelines still suggest testing at 12 weeks with a regular antibody for conclusive results.

* Going by this dictum, a Negative report of the test done 32 days post-exposure rules out HIV infection.

* But, I will still recommend to follow the laid-down guidelines. Repetition of DNA PCR test 12 weeks after exposure- if NEGATIVE- will CONCLUSIVELY RULE OUT HIV INFECTION.

Hope I have addressed your query to your satisfaction. If you have any further questions, I will be more than happy to help you.

However, if you do not have any further clarifications, you can close the discussion and rate the answer.

Wish you a speedy recovery and good health.

Fond regards and best wishes,

Dr. (Col) R Karanwal


Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Rakesh Karanwal

Internal Medicine Specialist

Practicing since :1980

Answered : 1357 Questions

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Had Protected Sex. Having White Coating On Top Of Tongue, Sore Throat And Cold. Negative Result Shown In HIV Test. Take The Test Once Again?

Brief Answer:
You have Oral Herpes. No repeat of tests required

Detailed Answer:
Hi there,

Thanks for the query. I appreciate your concerns.

From the available details, you are Oral Herpes- a viral infection which is transmitted through oral secretions while kissing an infected sex partner, or sharing her toothbrush.

There is no cure for herpes simplex. Once a person has the virus, it remains in the body. The virus lies inactive in the nerve cells until something triggers it to become active again.

There is no further requirement of repeating the test(s). However, in view of the whitish coating of the tongue, possibility of co-existing fungal infection (called Candidiasis) cannot be ruled out through throat swab analysis/culture. Candidiasis, unlike oral Herpes, is treatable with 2-3 weeks of anti-fungal drug.

You may therefore discuss the matter with your treating doctor, who knows about the diagnostic test for Candidiasis and will prescribe most appropriate treatment for Oral Herpes and, if Candidiasis is confirmed, anti-fungal therapy.

Hope I have addressed your query to your satisfaction. If you have any further questions, I will be more than happy to answer.

However, if you do not have any further clarifications, you can close the discussion and rate the answer.

Wish you a speedy recovery and good health.

Dr. (Col) R Karanwal