HIV and HPV Risks: PEP Efficacy and Autoimmune Concerns

Q: HIV and HPV Risks: PEP Efficacy and Autoimmune Concerns

First, let's look at the information about HIV： The HIV virus has three main transmission routes： 1. <br>Sexual transmission： Engaging in oral, anal, or vaginal intercourse without a condom with an HIV-infected individual or exchanging other bodily fluids carries a risk of infect

HIV infection HPV infection

Hello, Doctor.
I have a question.
After performing oral sex on a woman, I noticed small red spots on my abdomen two days later, which made me very anxious.
I quickly went to a clinic and had a blood test for HIV, which came back negative.
I started taking post-exposure prophylaxis (PEP) 66 hours after the oral sex, and after 28 days, I returned to the clinic for another test, which was also negative, with an HIV Ag/Ab duo result of 0.215.
What is the success rate of PEP when started 66 hours after exposure? I have an autoimmune disease called Sjögren's syndrome; will this affect the accuracy of the HIV test and potentially prolong the window period? The clinic doctor tested for HPV the first time, and it was negative, but the second time, the doctor did not test for it.
I'm not sure why.
If someone is infected with high-risk HPV, can the virus be transmitted to family members through sneezing, or if we share a meal from the same dish, is the transmission risk high? If someone is infected with high-risk HPV and also has an autoimmune disease, are they at a higher risk of developing cancer compared to someone without an autoimmune disease? Thank you very much for your assistance.

A Hong, 40~49 year old female. Ask Date: 2024/04/05

Dr. Liao Zhongxin reply Internal Medicine

First, let's look at the information about HIV: The HIV virus has three main transmission routes: 1.
Sexual transmission: Engaging in oral, anal, or vaginal intercourse without a condom with an HIV-infected individual or exchanging other bodily fluids carries a risk of infection.
2.
Blood transmission: This includes receiving or coming into contact with blood or blood products contaminated with HIV, sharing needles, syringes, or diluents with injection drug users who are HIV-positive, and receiving organ transplants from HIV-infected donors.
3.
Vertical transmission from mother to child: An HIV-infected mother can transmit the virus to her baby during pregnancy, childbirth, or breastfeeding.
The incubation period refers to the time from HIV infection to the appearance of clinical symptoms, typically ranging from 5 to 15 years (currently referred to as the asymptomatic or subclinical phase).
However, some HIV-infected individuals may experience flu-like primary infection symptoms approximately 2 to 6 weeks after infection, characterized by a high viral load and increased infectiousness, known as acute primary infection.
The progression of HIV infection varies among individuals.
During the window period or asymptomatic phase, many patients may not exhibit symptoms, and they might continue engaging in high-risk sexual behaviors, potentially transmitting the virus to others.
After HIV infection, it takes some time for HIV antigens and antibodies to appear in the blood (body fluids), and this period during which the infection cannot be detected is known as the window period.
Generally, the window period lasts about 3 to 12 weeks, depending on the testing method used.
For example, with the latest confirmatory testing method, HIV molecular biology nucleic acid testing (NAT), the window period can be shortened to 11 days.
For information on what tests are available, please consult the respective testing institutions.
During the window period, the virus is already present in the body, and the individual is infectious.
If someone has unsafe sexual contact and tests negative, but still suspects they might be infected, they can retest after the window period or consult a physician for NAT testing if necessary, but they should avoid unsafe sexual practices during this time.
Therefore, it is important to know whether the partner has any sexually transmitted infections (including HIV); if the partner is healthy, everything is fine; if the partner is infected and not adhering to treatment, then follow-up testing should be done at three and six months at a healthcare facility.
Regarding HPV, transmission occurs through direct contact; casual talking or sneezing does not transmit the virus.
Moreover, HPV testing is expensive, so it is not conducted every time.
High-risk HPV types can cause penile cancer, anal cancer, and oral cancer in men, particularly types 16 and 18.
As for whether the HPV vaccine may lead to autoimmune diseases, the medical community is still researching this, and no conclusions have been reached yet.

Reply Date: 2024/04/05

More Info

When it comes to understanding the risks associated with HIV and HPV, as well as the efficacy of post-exposure prophylaxis (PEP) and the implications of autoimmune conditions, several key points need to be addressed.

Firstly, regarding the efficacy of PEP, it is important to note that PEP is most effective when initiated as soon as possible after potential exposure to HIV. The ideal window for starting PEP is within 72 hours (3 days) of exposure, and the effectiveness decreases the longer one waits. Starting PEP 66 hours after exposure is within the recommended timeframe, and studies suggest that when taken correctly, PEP can reduce the risk of HIV infection by about 80% or more. However, this percentage can vary based on factors such as the timing of initiation, adherence to the medication regimen, and the specific circumstances of the exposure.

In your case, since you tested negative for HIV both at the initial test and after completing the 28-day PEP regimen, it is a positive indication that you likely did not contract HIV. The window period for HIV testing can vary, but with modern testing methods, a negative result after 28 days is generally considered reliable. However, it is recommended to follow up with additional testing at 3 months to confirm your status, especially considering the potential for any late seroconversion.

Regarding your autoimmune condition, Sjögren's syndrome, it is crucial to understand that autoimmune diseases can sometimes affect the immune response. However, they do not typically prolong the window period for HIV testing. The tests for HIV are designed to detect the virus or the antibodies produced in response to it, and autoimmune conditions generally do not interfere with these tests. If you have concerns about your immune system's ability to respond to infections, it is advisable to discuss this with your healthcare provider.

As for HPV, it is primarily transmitted through direct skin-to-skin contact during sexual activity, not through casual contact such as sneezing or sharing food. Therefore, the risk of transmitting high-risk HPV strains through activities like sneezing or eating from the same plate is extremely low. HPV is not spread through casual contact, and the virus requires direct contact with infected areas for transmission.

In terms of cancer risk, individuals with high-risk HPV infections may have an increased risk of developing certain cancers, such as cervical cancer in women and oropharyngeal cancers in men. Having an autoimmune disease may further complicate health outcomes, but the direct correlation between autoimmune diseases and increased cancer risk due to HPV is still an area of ongoing research. It is essential to maintain regular screenings and follow up with healthcare providers for any abnormal findings.

Lastly, regarding the HPV vaccine, it is recommended for individuals who are at risk of HPV infection, even if they are already infected with one or more strains. The vaccine can help protect against other strains of HPV that may not be present. Maintaining a healthy lifestyle, including a balanced diet and regular exercise, can support your immune system, which is beneficial in managing both autoimmune conditions and viral infections.

In summary, while PEP is effective when taken promptly, ongoing monitoring and testing are crucial for confirming HIV status. Autoimmune conditions do not typically affect HIV test accuracy, and HPV transmission risks are primarily related to sexual contact rather than casual interactions. Regular health check-ups and vaccinations are vital for managing risks associated with HPV and maintaining overall health.

Similar Q&A

Understanding HPV and HIV Risks: Key Insights for Urology Patients

Doctor: Hello! The high-risk period has exceeded 20 weeks (high-risk from early August), and there are currently no symptoms in the genital area. Can we basically rule out the possibility of genital warts? Additionally, I have researched some information online, and I understand ...

Dr. Xu Weikai reply Urology
Hello, K: Since there have been no epidermal warts for over three months, infection can likely be ruled out. Further testing should not be necessary. If there are any unclear points, feel free to ask again, and we can discuss and research further. Responses on the internet should...

Does HPV Vaccine Affect HIV Test Results? Key Insights for Patients

Hello Dr. Liao, I would like to ask if having no sexual intercourse from January 1 to May 31 for five months and testing negative for HIV would be affected by receiving the HPV vaccine on March 6 and May 6. Additionally, since I have been infected with trichomoniasis and HPV, how...

Dr. Liao Zhongxin reply Internal Medicine
This issue is a duplicate of <a href="https://adoctor.tw/article/209131">#209131</a>.

Understanding HPV Infection Risks, Testing, and Treatment Options

1. Risk assessment for HPV infection: Online sources indicate that the transmission routes for HPV include sexual contact, vertical transmission from mother to child, and environmental contact, which also carries a risk of infection. Therefore, I would like to ask Dr. Duckbill fo...

Dr. Du Shixi reply Urology
1. The description of risky behaviors is as follows: - No risk: masturbation - Low risk: mutual masturbation, light kissing, mutual rubbing, sexual activity with condom - Moderate risk: deep kissing, oral sex, withdrawal method - High risk: unprotected sexual activity, result...

Can I Get the HPV Vaccine While on PEP Treatment?

Hello Doctor, I received my first dose of the HPV vaccine at the end of February and was originally scheduled to get the second dose in mid-May (after a 2.5-month interval). However, I accidentally had a high-risk sexual encounter (the condom broke) at the beginning of May, so I ...

Dr. Cai Zhuorong reply Urology
The Chinese package inserts for Gardasil 9 and Cervarix do not list antiretroviral medications (used for PEP prophylaxis) as contraindications, nor do they mention them in the drug interaction section. Currently, there is no clear medical evidence indicating that the two cannot b...