Hiv Insanity...

[toddg2323]

On July 5 I had a condom slip off with a HIV infected female partner on Art drugs with an undetectable viral count.  5 days latter I develop strong HIV symptoms including swollen lymph under my armpits and inner arms and on inner legs with flu like symptoms.  Iv also noticed little red bumps appere that could resemble a mild rash.  I had never experience symptoms like this before in my life.  I'm still experiencing then today which is post 5 weeks at 38 days post possible exposure.  I had a HIV DNA early detection test in combo with an ELISA test conducted by STD Express on Day 10, day 14 and day 32 post exposure.  All tests came back negative.  I know that Pcr by qualitative is not approved by the FDA, But still would like your heart centered feelings around the accuracy of my test along side of the negative Elsa tests.  Do you feel that I can count on the accuracy of these tests?  If the symptoms are real would I be creating antibodies by now to create positive antibody test.  Are there any recorded cases of HIV symptoms lasting this long?  Can HIV Symptoms start as early as 5 days.  Am I being my own worst enemy?

[Edward W Hook, MD]

I'm please i could help. Take care. EWH

[toddg2323]

Just wanted to check in and let you know I got my results from my 9 week post possible exposure Elsa test today and they came back negative.  I wanted to again thank you for you support over the following weeks.  

[Edward W Hook, MD]

.  Final answer.  There will be no further answers:

The rapid tests are slightly less sensitive than the blood tests up until about 8 weeks after exposure. After that the tests are equivalent and have to perform equivalently to be licensed for distribution by the FDA.  EWH

[toddg2323]

I know my OCD is probably getting the best of me but I'm curios if the rapid swab early detection test I took is as accurate as the blood test .  

[Edward W Hook, MD]

This test would have picked up over 95% of recent infections.  A test at 8 weeks will be definitive.  EWH

[toddg2323]

Today 6 weeks after possible exposure.  Just finished up with a rapid test and it came back negative.  What point of action next Doc.  I was thinking another test at 3 months.  

[Edward W Hook, MD]

The combination of an HIV PCR and an HIV antibody test performed at any time more than 4 weeks after expsoure is eqivalent to the performance of a combination HIV p24 antigen/HIV antibody test and provided defintive information at that time.  If you have both negative PCR and antibody tests at any time beyond 4 weeks, you did not get HIV.  EWH

[toddg2323]

Ok one last question before I take off to my 6 week Elsa test.  I know the FDA dose not approve PCR testing, but I was curious how you felt about them especially as my were at 10, 14, 21, and 28 days.  Do you trust them personally and if not why.  Ill also make sure to keep you posted on following results.  I greatly apreciate your support and any advice..

[Edward W Hook, MD]

No, the duration of your symptoms is not suggestive of the ARS either.  The ARS typically lasts about a week and certainly no 35 days.  You are correct however, if you did have the ARS, antibodies would be detectable within 4-5 days after symptoms began.  EWH

[toddg2323]

Thanks for easing some of my concerns.  I was also wondering if ARS can last for 35 days as that would be the day I'm on now even though you did say the do not star until post 2 weeks after exposure.  The second would be if they were true ARS symptoms would that mean I be creating antibodies that would show up on a Elsa test.  Ill be doing my week 6 Test Friday so keep you fingers crossed for me.  

[Edward W Hook, MD]

Welcome to the Forum. Despite the fact that your partner had HIV, this was a low risk exposure.  The average risk for acquisition of HIV from a single unprotected genital sexual exposure is less than 1 infection per 1000 exposures.  In your case this risk is lower still because your partner was receiving ART and has an undetectable viral load.  Carefully performed research studies have shown a direct relationship between the amount of virus present in the blood and the risk for infection through sexual contact.  ART is proven to reduce the likelihood of infection by over 90%, making your mathematical risk go from about 1 in 1000-2000 to 1 in 10,000 to 20,000.  You can learn more about the use of ART in infected persons to prevent transmission by searching for literature on "HIV treatment as prevention".

In your own case, the testing since your exposure makes the likelihood of infection lower still since had you been infected there is a high, although not absolute likelihood that one of your tests over the past 4 weeks would have been positive.  

Finally, I should add that I am confident that the symptoms you experienced were not due to HIV. The symptoms of early HIV do not begin much before two weeks after exposure.

I hope these comments are helpful.  It is very, very unlikely that you were infected through your condom mishap. EWH