HIV rapid test results, symptoms and fear

[hemave]

Dr.

I had a sexual encounter with a CSW in Hong Kong on January 29; the encounter was protected vaginal sex and some mutual masturbation (no oral); after the encounter I took off the condom and looked at it and it seemed intact; A couple of days after I started getting skin burning sensations and my eyes were burning severely; I started feeling really guilty and anxious and I have felt the same way ever since; I tested negative with an Oraquick test @ week 2 past the exposure and took a rapid test (pinched finger for blood) at planned parenthood @ week 4 then 6 then week 8.8 (62 days after exposure); all of the tests came back negative; Since then I have somewhat come to terms with what happened that day and my health has somewhat improved; however the week prior to my last test I had flu-like symptoms with runny nose and some sneezing and cough and it took about a week and half to recover (when I went for the last test @ 62 days past the exposure I was basically almost fully recovered from the flu-like symptoms): I was tested for other STD's and was found to be HSV2 positive (this was debastating in itself since I was not aware of this situation nor have presented symptoms of HSV2 ever but according to the test I carry those anti-bodies) my questions are:

1. do you believe that at 8.8 weeks my test is conclusive based on this exposure?
2. Do you believe my symptoms could be related to HIV infection? Or am I in the clear and my symptoms are a product of my anxiety? I am now on week 10 and I am really scared to go back and test @ week 12:
3. do you advice I take another test at week 12? Based on your experience what do you believe the outcome of that test would be? I am worried sick and my legs hurt; I have been sleeping poorly and can't seem to get over this - Please help me

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to address your questions.  To start with, there is no meaningful risk for HIV from the exposure you describe.  Most commercial sex workers do not have STDs (including HIV) and even most unprotected exposures to infected partners do not lead to infection.  Your vaginal exposure was condom protected and therefore effectively no risk and there has never been a case of HIV documented to have been acquired through receipt of oral sex. Thus there was no risk of HIV to start with.  Your test results since that time confirm that you did not get HIV.

As for your specific comments.
1. do you believe that at 8.8 weeks my test is conclusive based on this exposure?
Yes.  Believe the test results.

2. Do you believe my symptoms could be related to HIV infection? Or am I in the clear and my symptoms are a product of my anxiety? I am now on week 10 and I am really scared to go back and test @ week 12:
No, I doubt that your symptoms were due to HIV.  Your initial symptoms began before the two week period when symptoms of early HIV typically appear and your most recent symptoms  occurred rather late for HIV.  Further, even when symptoms occur at the correct time, they are 100 times more likely to be the coincidence of some other, non-STD process such as a community acquired viral infection than to be HIV.,  Finally, when symptoms and test results, disagree, the test results are invariably correct.  Believe your test results.  I would not even waste time testing further.

3. do you advice I take another test at week 12? Based on your experience what do you believe the outcome of that test would be? I am worried sick and my legs hurt; I have been sleeping poorly and can't seem to get over this - Please help me .
See above.  I see no reason for further testing.

I hope my comments are helpful.   I will add that unless you had a herpes outbreak following the exposure you mentioned, it is unlikely that you acquired HSV2 from the exposure you mentioned. That topic is beyond the scope of this Forum but if you wish to explore this more you can post another question on the STD Forum.  EWH

[Edward W Hook, MD]

Your question is on the HSV expert forum and will be answered by Terri.   You'll need to be patient.  EWH

[hemave]

Here is my question posted to that forum Dr Hook

I went for a screening to planned parenthood on april 1st due to the following symptoms (burning skin sensations on back, legs, excessive sweating, sore throat, flu like symptoms and some mild joint pain) I was tested for HIV (rapid test), HSV2 , Clymidia, Gonhorea  and Syphilis and was found negative on all of them but HSV2 - I immediately told my girlfriend and she went for an STD panel as well and was found to be negative for the same tests; Since the end of January (Which was the last time I had a sexual encounter that bared any risk (protected one night stand) I have tested negative for HIV @ 9 weeks past that encounter in January and have been assured by and specialist that my test @ that point are conclusive

I have never had a cold sore (but I do feel hot flashes on my lips and around my nose from time to time)
Never had a genital lesion or outbreak in the genital area

My questions are the following:

1. Could an HSV1 and HSV2 diagnosis from planned parenthood be wrong?
2.Could I have HSV1 and HSV2 (as diagnosed by PP and never have a cold sore or a genital lesion?
3.Could my symptoms be a product of HSV1 and 2? Maybe Zoster?
4.Is a 9 week rapid HIV test negative conclusive of my HIV status based on the described exposure?
5. Could that change @ week 12?
6.Are the symptoms described common symptoms of HSV1 or HSV2?
7. What do you recommend I do to treat my symptoms? (Planned parenthood gave me a prescription for Acyclovir but my primary care doctor said that acyclovir is only used as suppressive therapy for people with many outbreaks or to help alleviate outbreaks faster (since I have never had an outbreak I don't know if I should take it)
8. Could this symptoms be related to a more serious condition that has nothing to do with the current diagnosis of HSV2?

[hemave]

Hey Doctor Hook: I posted a paid question on the HSV forum but never got an answer for it - could you please check and see if you guys got it?

Thanks