Anonymous
Hello, in drunk state I topped a guy that I know unprotected ( Insertive anal sex).
About a month after, my eyes turned yellow I got tested and came back positive for Hepatitis B. I freaked out and asked that guy to get tested he came back POSITIVE for BOTH HIV and Hepatitis B ( I know he injects drugs so I shouldn't be surprised). Now it is 15 weeks after exposure, I got tested for HIV and It came back negative? How conclusive is that? I read that Hepatitis can delay seroconversion, is this true? Also, if Hepatitis B and HIV are passed the same way, is it possible that I only contracted one of them from a guy that is coinfected with both? Why would that happen? Now I have to wait till six months mark and get tested again for Hepatitis B to make sure that I will not be chronic carrier, should I also get tested for HIV at the same time to be sure?
Thank you
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Anonymous
Hi there and thanks for reaching out to the AIDS Vancouver Helpline. My name is Colin and I'm happy to answer your questions today.

I understand you are curious about how Hepatitis B may effect HIV test results and if it's possible to acquire one without the other. I hope the information I can provide is helpful for you.

Right away I can tell you that from what you've mentioned, it sounds like the HIV test you took 15 weeks post-exposure would be considered conclusive. Regardless of which test you took, any commonly available HIV test will be considered conclusive at or after 12 weeks, so I thought I'd get that one out of the way. (Congratulations!)

In terms of Hepatitis B's effect on your HIV test results, there is a lot of misinformation out there and this is one of those misnomers. There are only 4 factors which can alter the window period for an HIV test: if you are currently undergoing antiviral therapy for Hepatitis C, if you are currently undergoing a course of PEP for a suspected high-risk exposure to HIV, if you are undergoing chemotherapy for cancer treatment, or if you have a congenital immunodeficiency (this is something you would have had since birth and which you could not live this long without being aware you had). If you do not fit into one of these four categories then there is no reason not to consider your 15 week post-exposure HIV result to be conclusive for this encounter.

I would also mention about the possibility of acquiring Hepatitis B without acquiring HIV or vice versa, it is certainly possible. While the mechanisms of transmission are very similar, just because that may be the case, there are many other factors affecting whether or not either or of the viruses will successfully transmit. Factors such as amount of each virus in the body, numerous environmental conditions, etc can impact one's susceptibility and it may not be the same for each infection.

Last but not least, you mention that you are already scheduled to go back for a 6 month follow up to check on your Hepatitis B status. If I were you since you're going to be there anyway, I would probably go ahead and get a full STI panel done including HIV. Speaking for myself, whenever I end up having to get blood drawn for any reason, I just ask the clinician to throw all the STI work on there anyway as a matter of course. It saves you a trip otherwise!

I hope the information I've been able to provide has been helpful to you. Please feel free to post again if you'd like any more information or clarification.

All the best,

Colin

AIDS Vancouver Helpline
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