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Possible HIV exposure + a lot of symtoms(symptoms)
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Possible HIV exposure + a lot of symtoms(symptoms)

Hello Doc,

The intercourse lasted about 30 minutes and was totally unprotected; after the intercourse I recall seeing a lot of amber stains on the sheet of the bed so there was some blood involved, no oral sex and had a small cut on the finger and fingered her.

Symptoms:

it started 2 days post exposure with anal and buttock itchiness,
and a flare back of penile yeast infection (that is yet to date not fully treated even after applying multiples creams and lotion; I get these often but resorb quickly)
pronounced lower back pain and flank pain started 10 days post exposure,
than I noticed some swelling in the nodes around my groin on both sides
2 - 3 days after I begin to feel some pain under my armpits, first only on right side but now on both,
throughout the following week I had extreme headaches, I NEVER get these,
I had 1 episode of night sweats during that same week,
week after headaches progressively stopped and got replaced by extreme joints pain and back pain,
very mild sore throat was coming and going away but I had feeling of lump in my throat,
week after my hole body started to itch, especially the scalp, nose, forehead and ears,
my face skin got suddenly really oily and some red patches of what I think is seborrheic dermatitis appeared around my nose, skin was red and scaly and peeling very quickly like I had a constant sunburn,
I got a ringworm on my left bicep that I treated quickly with penile anti-fungal,
I got some swollen nodes in the neck area, neck was really stiff the whole time,
lastly I noticed some tiny red dots appearing under my skin all over my body, I think they are petechiae but I am not sure.

9 weeks: I still have a lot of pain in nodes near groin, inner tights, armpits, jawline and even behind knees,lower back is also really bad, general itchiness, not well at all.

Tested 4th gen combo and other stds 10 day, 21 days, 42 days post exposure.. neg

What should I do?

239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

Good news:  for sure you don't have HIV.  Most important, the modern HIV blood tests are among the most accurate diagnostic tests ever developed, for any medical condition.  The results always overrule exposure history and symptoms, as long as enough time has passed since the last possible exposure -- and with the 4th generation ("combo") test for both HIV antibody and p24 antigen, that time is 4 weeks.  Your negative result at 6 weeks proves with 100% certainty you didn't catch HIV.

In addition, I would judge your sexual exposure as probably low risk, since it sounds like your partner is female, and HIV is quite rare in women in eastern Canada.  And your symptoms are not at all what one would expect in someone with a new HIV infection.

Your symptoms also are not typical of any other STD infection.  Assuming your STD panel included a urine test for gonorrhea and chlamydia, you can be sure you have neither of those.  Most other "STD panel" tests are done on blood, and all blood tests -- e.g., syphilis, herpes, viral hepatitis -- take several weeks to turn positive.  However, your symptoms don't suggest any of these problems.  I doubt you have any infection of any kind from the sexual exposure described -- just a coincidence of timing.

If your symptoms persist and/or you remain concerned, you should see your primary care provider or other doctor to check things out.  But truly, you need not be at all worried about HIV, and I don't recommend any additional testing for it.

Best wishes--  HHH, MD
4 Comments
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Avatar_m_tn
Thank you for quick answer.

1 - Girl was from western Europe and it was on a trip in another country.

2 - I read recently that 6 weeks 4th gen combo could be considered conclusive IF the patient do not show signs of a major underlying sickness; are my symptoms considered a major underlying sickness to you? And is this fact verified... the paper I read was specifically talking about generalized lymphadenopathy starting in acute period and lasting for a very long time ( like me i.e. roughly 2 months now)

3 -  I got tested for HepB, Syph, Clam ,Gono as well as HIV; they specified a 4 weeks windows for HepB and Syph at clinic so I should be okay for these.

4 -  Lastly, if your judgement is still the same what could be the cause of all my problems and especially my generalized lymphadenopathy... I mean it's getting really serious.

Thank you for your help, greatly appreciated.
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Avatar_m_tn
Sorry I did not see I was supposed to fill up to "To" box; last comment was dedicated to you doc.

..and girl was from Eastern Europe actually.

Thank you
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239123_tn?1267651214
These comments do not change my opinion or advice.

1) Western Europe:  Low risk of HIV in women, unless commercial sex workers or immigrants from HIV-endemic areas like tropical Africa.

2) In theory severe illnesses might interfere with testing.  But that means immediately life-threatening conditions like terminal cancer or overwhelming infection like severe pneumonia.  Your symptoms would have absolutely no effect.  Your test result is 100% reliable.

3) Sorry, but 4 weeks is too soon for syphilis and some cases of hepatitis; 6 weeks is better.  However, you were at near zero risk for both, so I really wouldn't worry about it.  If I were in your circumstances, I would not be tested further and would continue unprotected sex with my wife without fear of infecting her with anything.

4) See a doctor to learn the cause of your lymphadenopathy and other symptoms. Your test results PROVE it isn't HIV.
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