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Unprotected sex and itchy pink dots on backside

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I have had a sex with a lady with unknown history and it was unprotected sex this was last year may. After time a got seriously worried after I found some etchi red/ pink dots in my back side, I had flu after 2 months of that day and diahrria for three days. I went to the hospital and I test for all STD's and all found negative as my doctor said this could be syphillis (syphilis), the result was negative for syphilis. I went to another doctor he said this is just a kind of allergy. After three months I have done full blood test including STD's ( compo p24 and anti body ) test was negative however, my white blood count was low 2.6 and the avg is 4 to 11. The doctor said you don't have hep A antibody and he recommend to have two injection 6 months in between, he said its good to have it, I did took them. Two months after the first injection i had swallen lumps nodes at my neck close to my ear ( left side ) for almost two months and it's not painful and not solid, I have directly tested CIMA test and all std are (-). It disappeared by it self with no midsection . Two months later the same lump node got swallen it's really small but I can feel it. Tested again and all std (-).
So I have tested in :
2,3, 5 during hepa A ammune vaccine, 7 months, 11 months after the second injection all are cima test done in seoul.
After one year completed I have tested again and HIV was (-) and hepa A antibody was reactive.
1- do I need to be tested after 1 year and half as I heard that hepa A vaccine can delay the HIV virus window period?
2- I have always have the lump node near my ear swallen and it's small and not solid and not painful is this consider as hiv indecation?
3- is cima ag/ab considered accurate as Elisa?
4- cima test take less than a day almost, is it reliable?
5- what are the things that delay HIV virus window period?

I am so tired I need you help please, I always thinking of this matter

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 30 Doctors Online

Thanks for your queries at Doctor Spring. I understand your frustration and I will try my best to answer all your questions.

1.The chemilluminescence, CIMA test for HIV 1 and 2 antigens and antibodies is a new and accurate test for HIV. If you have tested negative even one year after exposure (considering no recent exposure) then consider this a definitive negative. No you do not need to be tested again.

2.A persistent lymph node is NOT specific for HIV infection. If you have ruled out HIV infection by testing, then consider the possibility of another. If the lymph node is small, and is not causing much trouble such as pain, or increasing size then it may be nothing to be concerned about.

3.Yes, cmia is more accurate than ELISA. CMIA tests for p 24 antigen is sensitive for antigens even in the window period. During the window period, ELISA can produce false-negatives especially if there is not enough antibody produced yet.

4.See above.

5.Starting antiretroviral therapy during the window period can delay detection of antigens/antibodies in the bloodstream. Hepatitis A vaccination is not known to delay this period.

Understand the accuracy of these tests and be assured that the negative test results are conclusive. I assume that your WBC count is normal now. WBCs vary in number and it is normal.It just says your WBCs are functioning normally. So bottom line is you DO NOT have HIV infection. You will not need further HIV testing. If the low WBCs persists consider getting a Complete blood count and Peripheral smear done in consult with your Doctor.

Hope this helps. Take care. Please ask follow up questions if any.

Patient replied :

Dear Dr. Thanks for you kind reply.. Actually my WBC is low around 2.6 now just checked yesterday. It's always low and the report says its leukopenia and I searched in the internet and one major cause of leukopenia is HIV I got too much worried now than before, even I have tested HIV and it's (-) antibody test.. So please let me know if my result is considered final or the low WBC May impact the window period of the virus?

Appreciate your kind support and understanding


Could please share the other blood values ? Like Platelet count, RBCs, Hb etc ? Are they all normal ? Was test called "Peripheral Smear" done ?

Thank you

Patient replied :

Dear Dr , yes test was done and it's nigative
Negative PB smear : leukopenia
No animea with normocytic, normochromic RBCs.
Normal PLT count
Abnormal immature cells are not seen.
WBC :2.6low (4-10)
RBC: 5.08 (3.5-6)
Hematocrit: 45.3 (36-52)
MCV: 89.3(82-98)
Platelet count: 194 (150-450)
TSH: 0.78 (0.34-5.60)
FreeT4: 0.78 ( 0.58-1.64)
T3: 89(65-150)
Retlculocyte count: 0.9(0.2-2.5)

That's all doctor, I really now got worried I will appreciate if you can really explain it to me and provide me with your consultation

First of if the WBC count is low persistently it has to be evaluated. A viral infection (including HIV) could cause it, but with negative HIV tests the focus should be on a haematological problem. If the Haematological problem is ruled out and if there is still low the HIV test may be repeated (an antibody based test will do).

Evaluation of Leukopenia (low WBC count) involves test for blood components, Bone marrow tests and tests for infections.
Hope this helps
Thank you

Patient replied :

Thanks doctor, but my last relation was almost a year and I have done around 10 tests all antibody ( CIMA and eleisa) based!! I am now scared to death as I understood that my leukopenia can be caused by HIV. Can you please recommend me a test to do? Or any thing to confirm I am not hiv ?

Your support is highly appreciated

With available information - You do not have HIV , period . However if the leukaemia is persisting it should be evaluated. And there should be a Haematological evaluation + ANA, Epstein-Barr virus, cytomegalovirus, HIV, measles, hepatitis antibodies, Vitamin B12 , Folic acid, Bone marrow and some other tests (to be decided by your Doctor.).

This of course should be done in consult with your Doctor after repeating the WBC count.And if all these tests become negative you may have to repeat the HIV test to be sure.

Hope this helps
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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