Is it possible for STDs to show up a year after exposure?

Patient

Q: Hello, I had sex with a prostitute 10 months (october 2010) ago n' my condom broke and 2 times (after 6months and 10 months) I've tested HIV, hepatatis B, syphillis and HCV and it was non reactive. I was suffering from meningitis 2 months ago, after few days i was suffering from fever, now there is few small painless lymph nodes on my neck (past 2 months) and urine is yellow most of the times. Is there any other diseases that i must get tested than can spread through sex? Is there any test for EBV virus ? Will any STD develop 10 months after sex ? My marriage is after 3 months, please reply.

Doctor

A:   Since you have been tested 2x already, it is very unlikely these diseases are not detected up to now. May I ask if you had a complete Hepatitis B work up? There are several antibodies and antigens (HBs ag, anti-HBc IgM, HBe ag, HBV DNA, etc) to detect Hepatitis B. With HIV, it is almost always detectable within 6 months from exposure. You can ask your doctor if you were tested for all these. For the lymph nodes on your neck, lymph nodes >2cm should warrant further investigation. If they’re smaller, they may be caused by self-limiting infections. Normal appearance of urine is clear and yellow. If it is turbid, concentrated, has blood and there is some discomfort in peeing, then there would be reason to believe for the presence of an STD. You should also ask your doctor if you have been tested for Chlamydia, gonorrhoea and herpes (HSV) since these are also common. EBV can be tested using the Monospot test. In your case, EBV is unlikely because it will usually present several weeks after exposure, not several months. I would say though that most, if not all STDs have asymptomatic states. Some tests are not 100% accurate. For example, herpes is one of the common infections w/ asymptomatic states. Sometimes, you can acquire it and not have symptoms for months, even years. When your immune system gets suppressed (too much stress, diabetes), it will appear as a painful bump or rash; some will have pain on peeing. Once you acquire this virus, you can not get rid of it but can greatly decrease transmission to others by taking maintenance medications. I do hope I have appeased your concern and take care always.

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