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Author Topic: Didn't know where to put this one...  (Read 5693 times)

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Offline wimble

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Didn't know where to put this one...
« on: March 24, 2010, 03:21:16 pm »
Howdy guys,
as some of you will know, I'm newly infected and have probably been a tad annoying with all my inquisitive questions and threads...this one is no exception. OK, I'll start by mentioning that nobody is aware of my diagnosis yet apart from my doctor, of course....
A close friend of mine has recently split up with his girlfriend and decided to get checked for the whole shebang. I was pretty insistent he got tested without revealing my status.
He took a 90day test as well along with other common sti tests...all negative.
Their relationship lasted about 5/6 months...in that time he said he got chlamydia early on which made him worry.

His situation has led me to think a little bit too far outside the box through sheer curiosity. ...
Lets assume that his ex partner is HIV positive and they had been having unprotected sex for about 3months up until a week before they split up, if he had contracted the virus during his 6 month relationship would a 90 day test be adequate?
I say this because he tested a week after they split and not the 90 day mark. So much emphasis is put on testing so many weeks after the LAST exposure that I'm wondering whether  unprotected sex between two potential positives on a regular basis effectively rules out an antibody test because they tested so soon after their last exposure....so in all, i guess I'm asking whether i should try and make him wait a full 90days, abstaining from sex before testing again?
Is there any logic to this theory? Cheers.

Offline Matty the Damned

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Re: Didn't know where to put this one...
« Reply #1 on: March 24, 2010, 03:34:38 pm »
Your friend should be tested for HIV 90 days after his last incident of unprotected anal or vaginal sex.

It is very unlikely that his previous 90 day result will change, all things considered, but strictly speaking it's 90 days from the last unprotected risk behaviour.

MtD

Offline Ann

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Re: Didn't know where to put this one...
« Reply #2 on: March 24, 2010, 03:38:12 pm »
Wimble,

He needs to test for hiv three months after his last incident of unprotected intercourse. Syphilis shares a three month window. Most of the other STIs can be tested for after seven to ten days.

He doesn't have to abstain from sex until he tests, he just needs to use condoms for anal or vaginal intercourse.

I was with a negative man for eighteen months before I got my diagnosis and he was - and remained for the eight years of our relationship - hiv negative. We never used condoms before my diagnosis, but we did after.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline wimble

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Re: Didn't know where to put this one...
« Reply #3 on: March 24, 2010, 04:41:20 pm »
He doesn't have to abstain from sex until he tests, he just needs to use condoms for anal or vaginal intercourse.

Wrong term to use there, oopsy..and I thought i was well up on this HIV thing...quick responses always nice to see.
I realise its unfair of me to assume anybodys HIV status, heaven knows the likelyhood is they both will be fine. My questions was very hypothetical and i think I failed to accurately convey what i was trying to ask... Ok so, we'll use me as an example instead to try and hit the nail on the head...
As you know i contracted HIV from a one time vaginal incident, however lets say that i was woefully unaware of my infection and continued to have unprotected sex with the person that infected me...to the point where i only decide to get tested because i am no longer having sex with that person....so 4months have passed and were no longer having sex i decide to get a 90 day test a week after we stop having sex. Although I am already infected from the first exposure is it possible that I get a negative result given that my last exposure was a only a week prior to getting tested? or is this irellevant given that i was infected at the beginning of the relationship..
All very confusing and farfetched,

Peace ;)

Offline Matty the Damned

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Re: Didn't know where to put this one...
« Reply #4 on: March 24, 2010, 05:02:22 pm »
Wrong term to use there, oopsy..and I thought i was well up on this HIV thing...quick responses always nice to see.
I realise its unfair of me to assume anybodys HIV status, heaven knows the likelyhood is they both will be fine. My questions was very hypothetical and i think I failed to accurately convey what i was trying to ask... Ok so, we'll use me as an example instead to try and hit the nail on the head...
As you know i contracted HIV from a one time vaginal incident, however lets say that i was woefully unaware of my infection and continued to have unprotected sex with the person that infected me...to the point where i only decide to get tested because i am no longer having sex with that person....so 4months have passed and were no longer having sex i decide to get a 90 day test a week after we stop having sex. Although I am already infected from the first exposure is it possible that I get a negative result given that my last exposure was a only a week prior to getting tested? or is this irellevant given that i was infected at the beginning of the relationship..
All very confusing and farfetched,

Peace ;)

All this hypothetical friend shit is where you're getting confused. Let me spell it out.

The window period for HIV antibody testing is 13 weeks. That said almost everyone who is infected will seroconvert within 4-6 weeks of being infected. Only very few people take the full 90 days to test positive.

From that you should be able to work it out.

MtD

Offline wimble

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Re: Didn't know where to put this one...
« Reply #5 on: March 24, 2010, 05:19:47 pm »
Cheers dude, am not trying to get on your tits with all this 'hypothetical shit'...believe me Ive been  round the seroconversion roundabout countless times and I know all that stuff...I'm just interested to know whether  someone who is infected can get a negative test result after seroconversion because they are being repeatedly exposed to HIV, thus starting the antibody cycle over and over with each exposure without actual seroconversion, given that it has already happened and cannot happen again.

Offline Matty the Damned

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Re: Didn't know where to put this one...
« Reply #6 on: March 24, 2010, 05:26:28 pm »
Cheers dude, am not trying to get on your tits with all this 'hypothetical shit'...believe me Ive been  round the seroconversion roundabout countless times and I know all that stuff...I'm just interested to know whether  someone who is infected can get a negative test result after seroconversion because they are being repeatedly exposed to HIV, thus starting the antibody cycle over and over with each exposure without actual seroconversion, given that it has already happened and cannot happen again.

Ah! So you're wondering if being infected with HIV can make a subsequent HIV test return a  negative result because of immune system funkiness?

The answer is no but I would add that in some very rare cases people with end stage AIDS have been known to cease production of HIV antibodies, but obviously that doesn't apply in this case.

MtD

Offline wimble

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Re: Didn't know where to put this one...
« Reply #7 on: March 24, 2010, 05:35:39 pm »
Ah! So you're wondering if being infected with HIV can make a subsequent HIV test return a  negative result because of immune system funkiness?
Exactly! Sorry it took ten years to get to my point...i obviously have too much time on my hands to be thinking up something like this..but yeah I just thought about those couples out there who are HIV positive but don't know it...obviously they risk superinfection...which led me to think whether it was possible for doctors to give couples false reassurance of a negative result when in 6/7 years down the line they could be getting OI's or as you say advanced HIV in disguise and wondering why when their trusty doctor said otherwise...

Offline Matty the Damned

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Re: Didn't know where to put this one...
« Reply #8 on: March 24, 2010, 05:41:55 pm »
Not a problem Wim. I'm a bit dense so I was probably missing the point you were making.

Superinfection is a bit of a myth really. It is known to happen, but as far as I know it's only been documented in a couple of dozen cases worldwide. Even when it does happen, it's not really known if it's a big deal given the mad mutating style of HIV.

Of more concern to pozzies who bareback should be the prospect of being infected with an STD like HBV or syphilis.

MtD

Offline Ann

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Re: Didn't know where to put this one...
« Reply #9 on: March 25, 2010, 10:16:19 am »
Wim,

If one person in a couple is hiv positive and they have unprotected intercourse and the other person also becomes hiv positive, it won't matter if they continue to have unprotected intercourse.

Superinfection does not mean super as in "super-duper", it means super as in superimposed. One infection on top of the other. Our hypothetical couple have the same infection, the same virus, same clade, same resistance profile, so they cannot superinfect each other.

My current partner and I never use condoms. He is the man from whom I acquired my infection and therefore, as I stated above, we have the same virus. Neither one of us has any med resistance issues and we don't worry one bit about superinfection. We're also monogamous so we don't worry about other STIs either.

And by the way, it is extremely unlikely that a man would become infected from just one incident of unprotected vaginal intercourse, unless the woman had an extremely high viral load. Hiv is much more difficult to transmit from a woman to a man. In your hypothetical situation, the man would more likely have been infected sometime during the four months, but not likely the very first time. Remember, I was (unknowingly) in a poz/neg relationship for eighteen months and no transmission took place despite having lots of unprotected intercourse (you know what relationships are like in the beginning!). My situation is not unusual.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline wimble

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Re: Didn't know where to put this one...
« Reply #10 on: March 25, 2010, 12:07:03 pm »
Superinfection does not mean super as in "super-duper", it means super as in superimposed. One infection on top of the other. Our hypothetical couple have the same infection, the same virus, same clade, same resistance profile, so they cannot superinfect each other.
Thanks for clearing that one up Ann...so is it safe to suggest that two people with the same virus can continue to have unprotected sex as long as they stay monogamous? Pretty interesting really because I have  always thought that because HIV mutates so much there could be slight differences in each virus regardless of it being the same strand.....your own experience shows us that obviously this is not the case. Just out of interest did your specialist OK the unprotected sex, surely they would advise against it?
And by the way, it is extremely unlikely that a man would become infected from just one incident of unprotected vaginal intercourse, unless the woman had an extremely high viral load.

I'll always take that with a pinch of salt because this is what happened to me....HIV as a lottery with an unlucky recipient at the receiving end... could be the first time, could be the 100th time! I agree with what you said though Ann..
Next week I'm planning on winning the actual lottery just to balance it out ;)


Offline Ann

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Re: Didn't know where to put this one...
« Reply #11 on: March 25, 2010, 12:26:46 pm »
My partner and I have the same doctor and yes, he knows we don't use condoms and he has no problem with it. However, not all doctors have this opinion. Because we go to a clinic in a teaching hospital, we sometimes see other doctors. I let it slip about the barebacking once to a young woman doctor and she freaked out. I told her to talk to my specialist and do some reading of the literature on superinfection. :)

Superinfection is rare and so far has only been seen in a few people who were newly infected to begin with. What's probably going on is they're being infected with a different strain before their body has learned how to have some control over the first virus.

I agree that it is totally possible to become infected from one instance of being the insertive partner in vaginal sex, it's just not very likely unless the woman has a very high viral load or has a concurrent infection with something like chlamydia or other STI.

I've been planning on winning the lottery too, for balance, but it hasn't happened yet. :D
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline wimble

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Re: Didn't know where to put this one...
« Reply #12 on: March 25, 2010, 12:44:07 pm »
Superinfection is rare and so far has only been seen in a few people who were newly infected to begin with. What's probably going on is they're being infected with a different strain before their body has learned how to have some control over the first virus.
Where there is a slim possibility superinfection could happen, do you think this would cause antibodies to become 'confused' and not know whether to continue fighting the original strain, or put all their effort in battling the new strain to keep it under control? So much so that if that 'superduper' person was to do a new HIV test it would come out negative because there aren't enough antibodies to fight the new infection yet?
Don't worry I'm not planning on winning this lottery again that's for sure! ha. wonder what the odds would be...when you do win the lottery Ann you can treat everyone on the forum...were all in it together after all  ;D
« Last Edit: March 25, 2010, 12:45:53 pm by wimble »

Offline Hellraiser

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Re: Didn't know where to put this one...
« Reply #13 on: March 25, 2010, 12:57:02 pm »
Where there is a slim possibility superinfection could happen, do you think this would cause antibodies to become 'confused' and not know whether to continue fighting the original strain, or put all their effort in battling the new strain to keep it under control? So much so that if that 'superduper' person was to do a new HIV test it would come out negative because there aren't enough antibodies to fight the new infection yet?

Heh that's not how your body works.  Once you're positive the antibodies will always make a test become reactive.

Offline wimble

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Re: Didn't know where to put this one...
« Reply #14 on: March 25, 2010, 01:06:16 pm »
Heh that's not how your body works.  Once you're positive the antibodies will always make a test become reactive.
Yeah, go figure..was worth the ask though given that the minimal reportings of superinfection. Thought that maybe the body might react differently to a subsequent new infection...back to biology classes to work on a super-duper body formula then i guess...

Offline Assurbanipal

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Re: Didn't know where to put this one...
« Reply #15 on: March 25, 2010, 01:14:21 pm »
The antibodies see an HIV virus and target it -- they don't care too much about what strain it is as long as they can recognize it.

Resistance is a different issue.  It is about the drugs you take to interfere with HIV, rather than your own antibodies to it.  The big worry about superinfection is that you might get infected with a strain that is resistant to the drugs that were working for you.  There's ongoing discussion and research into the likelihood of that happening.


But it sounds like you might need some help getting a handle on how the drugs work in the first place.

If you are interested in learning about how they work there are some great videos at the Boehringer-Ingelheim site.  http://www.boehringer-ingelheim.com/news/media_material/image_videos/indication_areas.html

It might be best to look at them first to get the mental image.  Then the written material on this site here http://www.aidsmeds.com/articles/hiv_life_cycle_5014.shtml  covers all the different types of drugs and is easier to refer back to.

There's a lot to get your head around at first...


A


Edited to say that I can't seem to get the link to open to the videos -- it currently brings up the image library and you need to click on the orange button labeled videos to get to the right spot (and then scroll down)
« Last Edit: March 25, 2010, 01:17:02 pm by Assurbanipal »
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline Ann

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Re: Didn't know where to put this one...
« Reply #16 on: March 25, 2010, 01:17:10 pm »
Wim, once a person tests hiv antibody positive, they will always test hiv antibody positive. It would be useless to use an antibody test to look for superinfection. What they would do is a genotype or phenotype that looks at the virus, not the antibodies. These are the tests they use to look for drug resistance.

They do the resistance tests before they put you on meds, and some doctors will do a resistance test when you are first diagnosed, so they have a baseline to refer to later on. My doctor did.

If you have had a resistance test done as a baseline - with no resistance found - and then another one done later on when you start meds and resistance HAS been found, then you were probably superinfected at some point. This is probably the only real way to know if you have been superinfected.

But seriously, superinfection isn't really something to put too much energy into worrying about.

And by the way, I'm just curious, and maybe a little bit nosy. You don't have to answer if you don't want to, but I'm wondering if you are continuing a relationship with the woman from whom you acquired your infection. Is that where all these questions about superinfection are coming from?
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline wimble

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Re: Didn't know where to put this one...
« Reply #17 on: March 25, 2010, 01:52:55 pm »
Thanks for the links, Assur...useful stuff..am sure the link will work properly eventually..il come back to it when i can digest it!

And by the way, I'm just curious, and maybe a little bit nosy. You don't have to answer if you don't want to, but I'm wondering if you are continuing a relationship with the woman from whom you acquired your infection. Is that where all these questions about superinfection are coming from?
Gosh, how nosy are you?!  :D only joking. I'm just curious really, anybody (myself included) that would risk their health and another pozzie's for a second time would be incredibly stupid..of course I'm not talking about monogamous positive couples here, as you have now educated me on the matter.
Funnily enough I have considered getting back into contact with the person i acquired the virus from...I think I kind of got past the anger/resentment stage, and at one point realised that she was suffering too so why not suffer together instead of being 'alone' dealing with the illness...But then I thought well hold on..  'Am I actually attracted to this person?'
The answer is no, I am not nor am I in a relationship with her...sure I now know that we could potentially have unprotected sex given that we both have the same virus and have no other sti's, but when it comes down to it she would only be there to fulfill sexual needs, I don't think I could love her long term...it just boils down to the loneliness we could face in our situation...if i am just after unprotected sex from her then what have i learned? NOTHING...who knows one day she may become attractive or might be constantly drunk and we may be together, but i doubt it.
I do know however that, any relationship, if any, I manage to get in the future will be with a poz so that we can deal with things together..I'd feel too much of a burden on a negative individual.

Offline Assurbanipal

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Re: Didn't know where to put this one...
« Reply #18 on: March 26, 2010, 05:55:41 pm »
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

 


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