Question about a an expert opinion

[AZ69]

According to a previous post the patient had a month and a half of nightsweats 3 weeks past exposure, he did not mention any fever. After consulting with an "HIV expert", the latter was very concerned about those night sweats. Nevertheless it seems that his HIV test was negatve.
My question is why was this "HIV expert" was worried about the nightsweats?
I thought ARS/AIDS nightsweats are alwyas due to high fever breaking at night, isn't that so?
Can an HIV infection produce nightsweats without a fever present?
Thank you Doctor

[lola1973]

A related discussion, Night sweats was started.

[AZ69]

Thank you doctor for your detailed response

[H. Hunter Handsfield, M.D.]

I should also have said that most "false" night sweats probably don't last 3 weeks.  Such long duration is more consistent with a fever-causing illness.  Therefore, if fever wasn't mentioned, I imagine the other expert assumed it was present or was likely.  But if the questioner had taken his or her temperature several times and it was always normal, and the expert knew that, his or her response probably would have been something like mine.

[H. Hunter Handsfield, M.D.]

Night sweats are a sign of literally hundreds of illnesses, not just HIV.  And you are exactly right about the cause of true night sweats, which occur because a fever "breaks" (sharp reduction in temperature) during the night.  Thus, a person without fever cannot have true night sweats.  Other mechanisms than fever can result in sweating at night (too warm a room, heavy covers, anxiety, hormonal anomalies), but those mechanisms have nothing to do with HIV.

I cannot speak for or criticize the expert you quote.  But I suspect that on reflection, s/he would agree with my perspective.

I hope this helps.  Best wishes--  HHH, MD