Negative COMBI 42+... but symptoms... HIV-2?

[anxiouscab]

Hi,

Pls find below my potential exposure, symptoms, undergone tests and, finally, my questions...

My exposure (Brazilian CSW in Brazil/ Apr-16... not sure about her HIV status, despite she said she's -ve):
1) Deep kissing (not a risk)
2) Fingering (not a risk)
3) Unprotected oral (receiver/ negligible risk)
4) Protected vaginal (insertive) BUT exchanged condoms during sex... in this case, my "fingering hand" touched my penis head and penis inner foreskin while exchanging condoms (I had vaginal secretion in my fingers)... I have sub-clinical HPV and noticed some irritation in my penis inner foreskin in the following day...

Symptoms:
- About 10 Days: Muscle tingling (lower legs) + diarrhea
- About 14 Days: White tong
- About 21 Days: Strange rash in my legs/ arms
- About 25 Days: Mild sore throat
- About 36 Days: Sore throat + flu like symptoms (nasal/ ears congestion) -> went through medication... no fever... probably due to medication...
- Up to now (42+ days): Still with diarrhea, dry skin, muscle tingling over all the body (mainly in lower legs), white tong, ears congestion, tiredness... lost about 8 Kg since exposure...

Undergone tests:
- 14+ days: Undetectable HIV-1 viral load (cobas taqman roche 2.0)
- 25+ days: Undetectable HIV-1 viral load (cobas taqman roche 2.0)
- 28+ days: Negative HIV DUO (4th gen)
- 42+ days: Negative HIV DUO (4th gen)

Questions:
1) I'm glad not being infected with HIV-1, but could it be HIV-2? I still with symptoms, specially the muscle tingling, which had never happened before?
2) In the post "http://www.medhelp.org/posts/HIV---Prevention/Scary-Urgent-Help/show/2188539#post_10475814";;, Dr. Handsfield says a negative DUO is fully conclusive after 28 days, despite the high risk exposure (anal unprotected, in this specific case). Would the DUO be conclusive for HIV-2 as well?
3) Would you recommend any additional testing for me?

[anxiouscab]

Tks again and keep up this amazing knowledge sharing experience!!

[H. Hunter Handsfield, M.D.]

A general practioner would be fine for initial evaluation; or perhaps a neurologist.

[anxiouscab]

Dr. Handsfield, many tks for your prompt response. Which medical specialty would you recommend for the involuntary muscle contraction symptom? I'm really worried about it since it has never happened before...

Tks again.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

First and very briefly:  you had a low risk exposure, not one likely to transmit HIV; and your symptoms are not suggestive of an HIV infection.  But most important, the modern HIV tests always overrule both exposure history and symptoms.  Even if your exposure had been highest risk or if you had symptoms typical for ARS, the test results rule and prove you were not infected.

To your specific questions:

1) HIV-2 is detected by the tests you had; and HIV-2 is exceedingly rare in the Americas.  "Muscle tingling" is not a symptom of HIV or ARS.

2) Yes, the DUO test is definitive for HIV-2 as well as HIV-1.

3) No further testing is necessary.  See a doctor about your symptoms if they continue or if you otherwise remain concerned about them.  But you can be 100% certain they are not due to HIV or any other infection from the sexual contact a few weeks ago.

Best wishes--  HHH, MD