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ARS Symptoms and Testing Reliability
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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ARS Symptoms and Testing Reliability

Hi Doctors, I had a very real risk as described in my post:

http://www.medhelp.org/posts/HIV-Prevention/HIV-fears--symptoms--and-testing/show/2085178#post_9880760

After the post, I took a blood antibody test at 5 weeks and 4 days post exposure, and 3 weeks and 1 day after the onset of any symptoms.  It came back as negative.  This provided me some relief since I've read several times that antibody tests will indicate positive within two weeks of onset of ARS symptoms.  What concerns me is a post describing what can affect the reliability of these HIV tests, and one of the conditions was septicemia.  I've had several symptoms after my last post that indicate I may have been septic (possible petechiae and purpura, mild jaundice, light stools, etc) and I guess my question is, if septicemia is a result of acute HIV infection, could this result in a negative antibody test 3 weeks after the onset of symptoms?  I'm very concerned and anxious, as I've had many very suspicious symptoms.  Any info would be appreciated.  For what it's worth, my partner said he is negative and was tested about a week before we met up.  He thinks I'm overreacting, but I am very scared.

http://www.medhelp.org/posts/HIV---Prevention/ARS-Symptoms/show/1477486
http://www.medhelp.org/posts/HIV---Prevention/13-week-test/show/1732458
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Welcome to the forum.  Thanks for your question.

First of all, it isn't clear that septicemia or other life-threatening health problems would alter HIV test reliability.  It's a theoretical possibility with few if any actual reported cases.  Second, you obviously don't understand septicemia.  It is a devastating condition, usually with shock and often unconsciousness, and immediately life threatening without massive antibiotic therapy (and often despite antibiotics). Nobody with septicemia looks or feels outwardly healthy.  A few petechiae (if that's the actual cause of the spots you saw on your skin) would never be the only manifestation.

The HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition.  As long as enough time has passed since the last possible exposure (4-8 weeks, depending on the specific test or combination of tests), the result overrules all other factors:  no matter how high the risk and no matter how typical for ARS a person's symptoms may seem to be, the test result rules.  In addition, as you say yourself, if symptoms have been present more than a few days are due to HIV, the blood tests are positive.  There are no exceptions.

And on top of all this, apparently your only current sex partner is HIV negative.  So I really don't know why you are concerned.  Your partner is exactly right that you are overreacting.

So stop worrying and stop testing.  Move on without worry.  Best wishes for a mutually rewarding, romantic, and sexually fulfilling relationship with your new partner.

Best wishes--  HHH, MD
6 Comments
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Avatar_n_tn
Thank you for your assessment Doctor.  It has reassured me that this has to be the result of something other than HIV.  I will continue to test out to three months for my own sanity, but in the meantime I'll schedule an appointment with my doctor to see if I can figure out the cause of my symptoms.  Again, I appreciate what you do and apologize if I came off and anxious, the last several weeks have been very emotional for me.  I will keep the post updated with my results.  Thank you again.
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Avatar_n_tn
I'm sorry dr, I probably seem like a anxious worried well to you, but I am scared and planning to get retested next Friday at the 8 week mark, my first test was at the five week mark post exposure.  My risks were initially described above, but I did have another encounter with someone different around the same time where I was an insertive and receptive partner - this encounter was fully protected to my knowledge, which is why I didn't mention it initially. My symptoms make me wonder whether or not he purposefully removed the condom at some point w/o me knowing.  He insists he did not and I don't remember him removing it.  

Anyways, my follow up question at this point is just confirming that had my symptoms been due to hiv, my icma antibody test done by labcorp 5 weeks post-exposure and 3 weeks after fever would have shown as positive, right?  Nothing could affect this?

I'm sorry, I've experienced a sickness like I never have before and I'm frightened.  I am still, five weeks after onset of symptoms, very tired a lot of the time, have general muscle soreness, and just feel unwell.
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Avatar_n_tn
I guess I was specifically asking about the possible thrombocytopenia affecting the hiv test?
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239123_tn?1267651214
This is covered in my original reply:  "...it isn't clear that septicemia or other life-threatening health problems would alter HIV test reliability.  It's a theoretical possibility with few if any actual reported cases."  This applies to any and all known medical conditions, including those that can cause thrombocytopenia.

Continue to work with your doctor about your symptoms and their cause; it isn't HIV.

That will have to end this thread.  I won't have any further advice.  Good luck.
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