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Is There Any Test To Detect E CRF01_AE Subtype?

Posted on Mon, 3 Feb 2014

Question: had xposr with csw in thailand 8 mths ago .immidiately after two days had urethral burning senstain in penis ,this was followed by ARS like symptoms swollen nodes,dry cough,chest pain that lasted for around 6 months,oral ulcers that lasted for about a month including one big oral ulcer that also took over a month to heal after which had dry mouth for a month with candidias and mild seborrhea around nose dry lips dry crusty nose mild fungal infection an skin svere fatigue and dizziness for close to a month which got better whn 1500mcg of b12 was taken per day ...also palms and soles itched a lot ,creeping crawling weird itching sensation on face ONLY DURING SLEEPING..girlfrnd had symptoms like small boils on scalp ,sudden acne ..kissing recurrent ulcers on labia that stayed for a month despite antibiotics but resolved post application of nadibact cream ..and svre facial rash which was probably triggered by use of a cream for acne..r have dn tests done for all stds herpes,syphillis,chlamydia,HTLV antibodies at 8 months post exposr all came negtve also got HIV 1and 2 RNA and CMIA duo at over 7 Mths post xposr in INDIA which was also negtv currently only on d3 and b12 (1500mcg) per day ..all tests have been negative RNA 1/2 CMIA 1/2 negative want to knw if these tests also detect subtype E CRF01_AE found in thailand aas exposr happened there and also other rare subtypes can the tests post 8 mths be taken as conclusive

Answered by Dr. Roopa Hiremath (1 hour later)

Brief Answer: HIV 1 and 2 testing Detailed Answer: Hi Mr. XXXX, Thanks for choosing health care magic for your query. I have gone through your query details and I understand your concern regarding HIV test results being conclusive or not. I would like to discuss your symptoms since exposure and rule out HIV infection. HIV enters into the body through the mucosa of the genitals and reaches the local lymph nodes to multiply and then it spills back into the blood after 4-11 days and is detectable in blood sample after 4 days of exposure. Acute retroviral syndrome usually has symptoms of flu like illness 2-4 weeks after exposure and the person recovers after 1 week. Mouth ulcers and rashes are very rarely seen. After ARS, the patient may remain without any symptoms for more than a year and this is called latent period. HIV testing has to be done to confirm the infection. HIV tests of choice in early exposure that is within 3 weeks is PCR and p24 antigen testing. After 3 weeks, HIV antibody testing can be done. Coming to your symptoms, you seem to have acquired an urinary tract infection after exposure which explains the burning sensation in the genitals. Later you seem to have had a very stressful time as you had an upper respiratory infection for more than 6 months. This stressful time could have caused decrease in your immunity and you might have got mouth ulcers and other mild infections. These do not indicate HIV infection. HIV 1and 2 RNA and CMIA duo at 7 months exposure if negative, then it can be concluded that you are HIV negative. I suggest you quit worrying about HIV exposure and continue the vitamin supplements. CRF01_AE is a recombinant form of subtype E of HIV 1 which was first isolated in Thailand and has spread to South east Asia. This subtyping is important for epidemiological purposes and does not affect the course of disease. PCR tests for HIV RNA of type 1 and 2 detect the HIV RNA in the blood to confirm infection with HIV virus and not subtypes. I hope I have cleared all your doubts. Please get back if any more clarifications. Thanks.

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

Follow up: Dr. Roopa Hiremath (19 minutes later)

thank u for ur prompt and detailed response so basically onecan takee these reports as conclusive irrespctiveof where the exposure my have happenedand irrespective of tge subtypes?also kindly look inrto gilfrnds symptoms ...attatching reports so that onu can have an even clearer p

Answered by Dr. Roopa Hiremath (22 minutes later)

Brief Answer: HIV tests and uploading of reports Detailed Answer: Hi Mr. XXXX, Welcome back. You can take the report of HIV RNA PCR and CMIA duo as conclusive and do not bother about subtypes. Regarding your girlfriends symptoms, I am suspecting seborrheic dermatitis with acne. I would suggest a detailed examination by a dermatologist to rule out seborrhea. I am not able to see any reports attached with your query. Please upload the JPG images of the reports on the link provided on right hand side of the web page. I would like to examine those reports and then comment further. Thanks.

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

Follow up: Dr. Roopa Hiremath (2 minutes later)

may have to attatch one by one the attatchments seem to be too big...

Answered by Dr. Roopa Hiremath (19 minutes later)

Brief Answer: Not able to view reports Detailed Answer: Hi Mr. XXXX, Sorry, I am not able to view the reports. I would suggest you give more details regarding your girlfriends present symptoms and also type the tests done with final report in your query and I would be able to assist you based on that. Thanks.

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

Follow up: Dr. Roopa Hiremath (2 hours later)

apologies will try and send again

Answered by Dr. Roopa Hiremath (7 hours later)

Brief Answer: Please give details about symptoms Detailed Answer: Hi Mr. XXXX, If you are not able to upload the reports, please type the details. Thanks.

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

Follow up: Dr. Roopa Hiremath (1 hour later)

hi unalble to upload reports...could u give me a mail id whr one could mail it to u also ...one has already listed the symptoms in the above post RNA PCR FOR BOTH HIV 1 AND 2 BELOW 20 AND 900 COPIES RESPECTIVELY ..CMIA DUO ARCHITECT 0.13 (non reactive) western blot in isolation without elisa negative six months post ....

Answered by Dr. Roopa Hiremath (9 hours later)

Brief Answer: HIV negative status, Skin consult Detailed Answer: Hi Mr. XXXX, Based on the details in your queries, your girlfriend also has a HIV negative status. The other symptoms suggest seborrheic dermatitis which is a skin disease that mainly affects scalp, causing itchy, red skin and dandruff. It can also affect the face, upper chest, back and other areas of the body that have many sebaceous glands. She needs to get a skin consultation and get a prescription for anti-dandruff shampoo and acne cream. Some acne creams cause dry skin and rashes and must be used as prescribed by doctor and with precaution. Kissing ulcers on labia are caused by a bacteria called Hemophilus ducreyi which is usually a sexually transmitted infection. This bacteria responds to antibiotics like azithromycin, ceftriaxone, ciprofloxacin, and erythromycin. I hope I have cleared all your doubts. Please let me know if I can assist you further. Thanks.

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

Follow up: Dr. Roopa Hiremath (42 minutes later)

my apologies such intensive investagation was nt done on her these were details of my reports however if i am neg m super sure she'd be too ....also i dont need to go crazy over subtypes na and consider self negative considering the details of reports one has given ? however m still trying to find a concrete reason for the coincidental symptoms such as dry mouth candidias ...dry flaky skin around nose extreme tiredness dizziness and girlfrnds symptoms ...antibiotics were given but the ulcers continued and resolved after a month of taking them and then application of nadibact cream ....all in all can one be considered safe

Answered by Dr. Roopa Hiremath (17 hours later)

Brief Answer: Vitamin deficiency can acuse similar symptoms Detailed Answer: Hi Mr. XXXX, Please do not worry about subtypes of HIV, you have tested negative for HIV 1 and 2 and that would suffice. Oral ulcers and dry skin most commonly occurs in vitamin deficiency and that seems to be the reason in your case too. You also are responding well to vitamin supplements therapy. Chancroid, as I mentioned earlier responds well to antibiotics and heals within 10 days. In some cases due to repeated antibiotic use, the organisms become resistant to the antibiotics used and do not respond to therapy. This kind of resistant organisms do need treatment by stronger antibiotics and for a longer time. Nadibact cream is commonly used for treatment of pimples. If her acne is responding to Nadibact she can continue with that treatment till her acne clears away. I hope I have answered all your queries. Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Roopa Hiremath (17 minutes later)

u are asweetheart thank u for being such an XXXXXXX

Answered by Dr. Roopa Hiremath (1 hour later)

Brief Answer: Thank you Detailed Answer: Thank you. Wishing you a healthy life.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Roopa Hiremath (5 hours later)

hi one detail just remembered so thought of sharing 6 weeks post exposr had a full body check up in delhi where everyyhing was fine but the throat swab had streptococus and and genital swab had diplococci gram positive ....also remembered that girlfrnd had got a TORCH test done which was IGG positive for CMV and ruebella

Answered by Dr. Roopa Hiremath (46 minutes later)

Brief Answer: Everything is fine Detailed Answer: Hi Mr. XXXX, Welcome back. Streptococci are bacteria which are commonly found in the human throat as commensals, meaning they are present as normal microbial flora and they are not causing any infection. Genital mucosa is also covered by commensals, most commonly diplococci. So isolation of these bacteria is not significant. Coming to TORCH test, this test is a panel which tests for Toxoplasmosis, Rubella, Cytomegalovirus and Herpes infections. Many of us are exposed to Cytomegaolvirus and Rubella virus in childhood and would have developed immunity against those infections which are usually asymptomatic and self limiting. So many of us will be positive for IgG type of antibody against these viruses. This does not indicate active infection. This TORCH panel is important and most commonly done for pregnant women because these infections can be spread from mother to baby during pregnancy or delivery and cause congenital deformities in the growing fetus. Please quit worrying unnecessarily about these findings. Wishing you all the good luck in future. Thanks.

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

Follow up: Dr. Roopa Hiremath (40 hours later)

hi one more thing got a cd4 cd8 count done while fighting common cold and the results were as follows : cd4 528 cd4 38% cd8 336 cd8 33% cd4,cd8 ratio 1.14 10 days later whenone was feeling a bit better got the counts again results were as follows cd4 1187 cd4 42% cd8 730 cd8 27% cd4 cd8 ratio 1.57 only medicine one took during this time was 1500mcg of remylin (vitamin b12) and calcirol XXXXXXX (vitamin d3) anything to be concerned about

Answered by Dr. Roopa Hiremath (2 hours later)

Brief Answer: CD4, CD8 cells CD4,CD8 ratio Detailed Answer: Hi Mr. XXXX, Welcome back. The CD4 and CD8 cell count and CD4:CD8 ratio is within normal range and you do not have to worry. Normal values are approximately 30-60% CD4 and 10-30% CD8 depending on age (ratio 0.9 to 3.7 in adults) I hope I have cleared your doubts. Thanks.

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

Follow up: Dr. Roopa Hiremath (26 hours later)

hi in the urethral swab there was also gram negatv bacilli seen does it explain anythg