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HIV Prevention (Expert Forum)
Any chance this is NOT ARS?
Answered by
University of Washington
Seattle - WA
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No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
Any chance this is NOT ARS?
by anychance, Aug 05, 2006 12:00AM
Bi-male - receptive anal sex with HIV+ partner (he told me after the fact) - no internal ejaculation. I kept a very detailed log of symptoms and responses, but I am editing it down to what I feel are the important details.
Approximately 7-10 days after exposure, I started to notice a slight difference in my breathing. I would not call it "difficulty in breathing" or "shortness of breath", but just different.
From approximately days 10-20, I became tired more easily, but no other symptoms during this time - perhaps some muscle tenderness in my back.
On day 21 after exposure, I started to develop a fever, swollen lymph nodes, stiff neck and headaches (all around the same time). My fever ranged from no fever (98.4F/36.9C) to relatively high low-grade fever (102.5F/39.2C).
Between day 21 and 45 after exposure, I had a total of 3 night sweats; fever was oscillating between nothing and 102.5F/39.2C. Ibuprofen relieved the headaches and stiff neck.
Day 50+: Very few symptoms, if any; the majority seem to have resolved.
I know you always say that symptoms are not a reliable indicator, but how about situation + timeframe + symptoms? You can't just multiply your way out of that.
I am waiting for the 3-month mark to be tested again, but I am almost certain that I will hear a positive result. So here are my questions:
1) Does this sound like classic ARS to you? When you combine all the factors, it just seems very unlikely that I am NOT infected. From your experience, would you be very concerned right now?
2) What is a high fever as related to ARS? You have said this several times when eradicating fears, but how exactly does an ARS fever present? Is it constant or oscillating? What is the range? Please explain this is more detail.
Approximately 7-10 days after exposure, I started to notice a slight difference in my breathing. I would not call it "difficulty in breathing" or "shortness of breath", but just different.
From approximately days 10-20, I became tired more easily, but no other symptoms during this time - perhaps some muscle tenderness in my back.
On day 21 after exposure, I started to develop a fever, swollen lymph nodes, stiff neck and headaches (all around the same time). My fever ranged from no fever (98.4F/36.9C) to relatively high low-grade fever (102.5F/39.2C).
Between day 21 and 45 after exposure, I had a total of 3 night sweats; fever was oscillating between nothing and 102.5F/39.2C. Ibuprofen relieved the headaches and stiff neck.
Day 50+: Very few symptoms, if any; the majority seem to have resolved.
I know you always say that symptoms are not a reliable indicator, but how about situation + timeframe + symptoms? You can't just multiply your way out of that.
I am waiting for the 3-month mark to be tested again, but I am almost certain that I will hear a positive result. So here are my questions:
1) Does this sound like classic ARS to you? When you combine all the factors, it just seems very unlikely that I am NOT infected. From your experience, would you be very concerned right now?
2) What is a high fever as related to ARS? You have said this several times when eradicating fears, but how exactly does an ARS fever present? Is it constant or oscillating? What is the range? Please explain this is more detail.
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 05, 2006 12:00AM
, Aug 05, 2006 12:00AM
Apparently you don't say when you were tested, only that you're waiting for 3 months to be tested again. If you have been tested 4 weeks (and definitely if 6 weeks) after exposure, you can be confident you did not catch HIV. On the other hand, you had the highest of possible high risk exposures (you don't say whether with condom, but I assume unprotected), So I cannot say you aren't infected, especially if your latest test was within 3-4 weeks of the event.
1) Your symptoms are consistent with ARS, but also with any number of other causes. Your symptoms started somewhat late; I consider day 21 (fever) the onset of symptoms that might suggest ARS--the earlier ones don't sound suspicious. The test results tell the truth; symptoms often lie.
2) I don't know that any research has systematically analyzed the pattern of fever in ARS. If so, I don't know the conclusion. I haven't been the primary provider to enough patients with ARS to have a personal opinion.
Good luck-- HHH, MD
1) Your symptoms are consistent with ARS, but also with any number of other causes. Your symptoms started somewhat late; I consider day 21 (fever) the onset of symptoms that might suggest ARS--the earlier ones don't sound suspicious. The test results tell the truth; symptoms often lie.
2) I don't know that any research has systematically analyzed the pattern of fever in ARS. If so, I don't know the conclusion. I haven't been the primary provider to enough patients with ARS to have a personal opinion.
Good luck-- HHH, MD
Doctor, you say that the symptoms started a bit late for me, in your opinion. What do you mean by this statement? From what I have read (including your comments), this is almost textbook: 3 weeks to the day after exposure.
I know you tire of answering the same questions over and over. I know I tire of reading them - especially when its "I kissed someone and my arm hurts, do I have HIV?" type of questions. It might be helpful if you shared a "typical" ARS example, if there is such a thing. For example, do ARS fevers oscillate or are they constant? When do symptoms usually begin (you said 21 days was a bit late)? Do the night sweats have any particular characteristics vs. typical flu? I felt great after my night sweats, but then the fever returned within a few hours. I think this is atypical of flu, but likely if your immune system is under bombardment.
I wish you the best with your test. Hope it turns out okay. We are rooting for you.
J
It is a mistake to wait 3 months for your first test. Given the high risk nature of your exposure, you should have seen a health care at the first suspicious symptoms (your fever etc at 21 days) for diagnostic testing, which might have included an HIV RNA test, depending on the provider's judgment. In any case, if your symptoms are due to HIV, you will have positive results now by standard antibody testing, or the duo ELISA/P24 test. Don't sit around stewing about it for several more weeks.
HHH, MD
HHH, MD
At this stage a modern test should give you 99% + results...
ARS usually occurs 2-4 weeks after exposure.
It usually includes fever