HIV - Prevention Expert Forum
Tested and worried
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Tested and worried

Dear Drs hello.
I had an affair with a colleague, outside the wedlock. The condom broke during sex and the date was October 26th. I was shocked to discover that. Despite her reassuarances that there was nothing to worry about, about 2 weeks after the condom braking event, I started having symptoms. A bit of feeling cold, a very mild fever, a few sweats, lost appetite, slightly enlarged neck and jaw lymphnodes.
I asked her to do an hiv test, and she did, 3rd generation Elisa, result negative. I relaxed a bit after that. However after a few days I had a sore throat, perhaps pharyngitis, that I did not treat with anything apart from paracetamol oral pastilles and tea.
Still feeling stressed I decided to get tested, mainly of me not knowing for sure her past.
Firstly at 41 days post condom braking event,
Secondly 10 days after (51 days post the condom braking event).
Both tests were 4th generation tests (HIV I & II Antibody + HIV 1 p24 Ag) Tests done in the same clinic and lab. Their result were thank God negative.
I still feel neck  and throat discomfort, and also sometimes under the jaws. My tongue has now got a white film on it especially from the inner half, backwards.
My penis probably had fungus from an antibiotics course in June that were elevated after the sexual incident and I use anti fungal cream.
My Questions:
1) Are  the symptoms described connected to an HIV infection,that I may have?
2) Could the tests I have done missed any Infections if present?
3) What is the possibility of me being a late seroconvert?
4) I have read contradicting information even for the 4th generation test window period. Are my tests considered conclusive? Am I free from hiv, or,
5) Do I need further testing?
6) Can I resume unprotected sex with my spouse?
I am still very anxious. I want to resume my normal family life again, and put behind me this stupid mistake, but I sense it will not be easy, if at all.
Hopefully you can help me.
Regards
300980_tn?1194933000
Welcome to our Forum.  I'll e happy to address your questions.  The bottom line however is that your partner is very low risk (particularly given her negative test) and your test results prove that you did not acquire HIV from the exposure that you have described.  4th generation HIV tests such as the ones yuou were tested with provide definitive answers 4 weeks after exposure, thus both of your test results lead to the same conclusion- that you did not get HIV from this exposure.  

As for your symptoms, they are not due to HIV.  Typically when symptoms and test results are in disagreement, the test results are always right.  

1) Are  the symptoms described connected to an HIV infection,that I may have?
Isolated sore throat such as you describe is not suggestive of HIV.  

2) Could the tests I have done missed any Infections if present?
No.

3) What is the possibility of me being a late seroconvert?
"Late seroconversion" is an internet-based urban myth which does not exist.  

4) I have read contradicting information even for the 4th generation test window period. Are my tests considered conclusive? Am I free from hiv, or,
5) Do I need further testing?
Your tests are conclusive and there is no need for further testing.'

6) Can I resume unprotected sex with my spouse?
Yes, you can resume unprotected sex with your regular partner.

I hope these comments are helpful. EWH
10 Comments
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Avatar_n_tn
Dr Hook thank you for your prompt response.
I have been an otherwise healthy person, early 40's. Reading the numerous posts I was confident enough to say that I havent contracted hiv, given the test results.
However what made me look for reassurance was the fact that my symptoms have not yet gone away, and as I've written earlier, today I have found a white coating in my tongue. The million dollar question is why then I still have mild symptoms, that I have never so far experienced for such a long time? In my understanding if it is not hiv then why dont they just go away, like normal after some period of time and they keep persisting, or just appearing. A connection to hiv then becomes inevitable.(lymphnodes, white tongue, a slight burning sensation in the lower genital area)
My concern is if - worst case scenario - something, I dont know, has gone terribly wrong, the onset of ARS is  slow and gradual ( I read that not all people get ARS and even if they do, symptoms might go unnoticed) and the tests failed to pick up either the antigen or the antibodies. (false negatives)
I would like your comments on that, even if to your proffesional knowledge and experience may seem irrational.
Best regards
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300980_tn?1194933000
Again, when tests and symptoms disagree, the tests invariably are correct.  Findings such as a sore throat are quite non-specific and can linger.  They typically reflect the sort of communtiy acquired, non-STD viral infection than most people get from time to time and which vary greatly in how they resolve.  It is not at all uncommon for folks whose senses are heightened related to concerns related to recent sexual encounters to notice findings which they would have not noticed or discounted in other circumstnaces.  Perhaps this is happening to you.  Beyond that I do not have a good explanation but I remain convinced, based on your report that you did not acquire HIV from the encounter you descirbed.

False negatives are very, very rare and virtually unheard of on repeated testing such as you report, despite what people see all too often on the internet.

EWH

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Avatar_n_tn
Thank you doctor
So bottom line is that according to your opinion, knowledge and experience, on the facts outlined above, I am HIV negative?
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300980_tn?1194933000
Correct, as I said above. EWH
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Avatar_n_tn
Thank you doctor
happy new year, all the best
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Avatar_n_tn
Dear doctor
I was tested negative again (thank God) at exactly 90 days post exposure, just to be along with international and WHO guidelines.
I still have though a small shadow of a doubt having to do with the reliability of the lab. Could it be that the specific test they use is a mismatch with my blood type (O+) or the equipment used is not up to standard. Btw the lab is accredited with JCI an American I believe organisation for lab's reliability( lab is based in the UAE.). Are you aware of this organisation (joint commission international)
For this I am thinking of retesting again in a different lab.
I would like your opinion on this and also,a general question
Suppose someone had ars and is gone, could it be that those symptoms could reoccur at first opportunity?
Thank you and please accept my question even if it sounds irrational
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300980_tn?1194933000
the symptoms of the ARS do not recur.

For you to test further is a waste of time and money.  The results of further testing will be no different than the tests you've already had.  EWH
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Avatar_n_tn
Thank you doctor
I understand what I asked about a blood mismatch or lab's reliability of accurate reporting is not valid or is rejected as not possible to happen.
One last question and thread is closed. The reason I asked about the ARS recurring is because I was diagnosed ( with a 10 minute quick test) with influenza type B. I have fever, sore throat, stuffed nose, tiredness and dry cough. When paracetamol is taken symptoms are relieved but come back after about 10-12 hours.
Is it possible for ARS to occur now (after my history of negative tests) but still test positive with influenza ? Or if it is only ARS then influenza test will be negative?
Once more thank you for this last answer for my otherwise irrational question.
Sincere regards.
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300980_tn?1194933000
LAst answer.  You have a flu-like illness, a positve flu test and negative tests for HIV at a time when if you had HIV the test would positive.  I have a hard time understanding why you then wonder if this could still be HIV.  The tests are used for diagnosis and should be believed.  Be confident you do not have HIV form the exposure you mentioned earlier.

There will be no further answers. EWH  
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H. Hunter Handsfield, M.D.Blank
University of Washington
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