ARS Symptoms, high risk exposure

[worried12830]

35 days ago I had sex with a 19 year old white girl I do not know much (I think she has had many partners in the past) and the condom did not cover a cut on my penis. 8 days later I had a tingling pain in my penis followed by a sore throat, rash, white tongue, headache (2 weeks), spleen pain, eye vision changes, overall weakness, and tingling in my body. (All of these developed in the last 2-3 weeks).

At 18 days I tested with a DNA PCR test and antibody test and was found negative. (Labcorp)

At 28 days I tested with a DNA PCR test and was found negative. (Quest Diagnostics)

What are the chances that I was infected and all of these tests showed negative? I am extremely worried.

[Edward W Hook, MD]

Welcome to our Forum. I think you are overstating the risk of the exposure you describe.  Few heterosexual women have HIV, even those with many partners (whatever many means) and even with an uncovered cut on your penis, condom protected sex is safe sex.  I would have characterized your exposure as no risk for HIV.

That said however, you now have tests that rule out the possibility that the symptoms that you describe are due to HIV.  If your symptoms were due to HIV, your PCR tests would have been positive.  While we do not recommend PCR tests for HIV, we know that if a person is experiences symptoms related to recently acquired HIV, their PCR tests are positive at that time- yours were not and therefore rule out any relationship of your symptoms to possible HIV.  They are coincidence, nothing more.

I hope this reply is helpful to you. Take care. EWH

[Edward W Hook, MD]

In general we do not recommend HIV PCR testing for diagnosis is HIV infection for several reasons.  While the PCR is likely to become positive more quickly than other antibody detection tests (i.e. usual blood tests), at the present time the blood tests are becoming more and more sensitive and detecting infection earlier and earlier so that the time difference in detection between PCR test and antibody detection tests is becoming smaller and smaller and at present is, in general only a week or two.  In addition the time course over which the PCR tests become positive is less well described than for the blood tests and, as a result, it is difficult to make a definitive statement on what a negative PCR test means at any time within a few weeks of exposure to a HIV infected or possibly infected partner.  PCR tests are also more expensive than regular antibody tests.  Finally and most importantly, the false positive rate for PCR tests (i.e. a positive result in persons who do not have HIV) is higher than for blood tests.  Each of this on this Forum have seen a number of people who were worried needlessly because of false positive tests. For all of these reasons, we rarely recommend testing for HIV diagnosis using PCR.  

If there are further questions, they will be delted without comment.  EWH

[worried12830]

What would you say the main reason is for you not recommending these tests?

Also, how sure are you that the DNA PCR test would be positive when symptoms are present?

[Edward W Hook, MD]

Final answer.

That your partner was menstruating when youwere exposed makes no difference.  You wore a condom, you have negative tests (although not those that are recommended).  Symptoms are non-specific.  No change in my assessment or advice.  EWH

[worried12830]

I'm not doc, I seriously think she may have been on her period. You are very confident in pcr tests of symptoms are present?

[Edward W Hook, MD]

Your being silly.  No change in my assessment or advice.  EWH

[worried12830]

Also, if she was on her period, infection could have easily occurred. I think she may have been.

[worried12830]

Wouldn't it be more likely that the PCR test was wrongly administered or would not show the virus than me getting all of the ars symptoms 2-4 weeks after sex..

Are you this confident in the DNA pcr tests?

[Edward W Hook, MD]

You should forget about the possiblity that you were infected with HIV from the exposure you describe.  I provided you with the reasons for this above.  There are no good data on just how quickly a PCR test becomes positive after a person becomes infected but it would have occurred within the timeframe of your testing.  If you do not want to (or cannot) believe the PCR tests by now an standard HIV test would be positive. Thus you could prove to yourself (since I already know you did not get infected)  that you were not infected.  EWH

[worried12830]

what do you think about my chances man?

[worried12830]

My condom did not cover my whole penis (the cut was not covered and was inside the vagina) - I do not know if she may have been on a period, but it is possible.

I understand that the DNA PCR test would detect the virus if symptoms were due to HIV  but what are the chances that the two tests would not detect it at those two periods?

Is it likely that a mistake was made? Since it is a hard test to administer..

Basically, I am 99% sure I am positive.. I have never had a this tingling and rash as well as a weird headache.

I am actually concerned I already have aids which explains the white tongue and tingling. I was on humira before the encounter and am scared that my weak immune system has allowed the virus to already create cancers etc.

Right now my only hope is he negative pcr tests which I have a hard time believe especially since they are not approved etc.