Worried

[steve05]

Doc,
Thanks for the everything you do with this site, it has already provided me with a lot of anxiety relief.  First let me start off with an overview of my worries before I ask my questions.  I am on assignment in honduras and have been down here since august 05.  On about april 1, 2006 I had a one night stand with a women i met at a club.  We had unprotected vaginal sex on two occasions that night lasting about 20 mins per.  I believe the hiv rate in honduras is slightly higher than the US, about 1.8%.  About a week later I started to become very paronid about my stupid mistake so i went and had an hiv test at 9 days past exposure.  Of course it was negative but then i started surfing the net and realized that this was too soon so I retested at 31 days (test was sent to brooks afb lab)which was negative and another test at 43 days past exposure with home access which was also negative.  I felt relieved for a little while until i started reading about the whole window period and how home access uses 1st generation.  I had a sore throat about two weeks after exposure which only last a day and a half and went away when i took some meds.  My right tonsil appears to enlarged and i can feel my lymph nodes under my jaw and my cervical nodes at the back of my neck and can see little lumps when i turn my head.  I went to the doc to have my neck nodes and tonsil examined and the nurse came in and said that i had swollen nodes on both sides of my neck under my jaw.  Then the doc came in and said my nodes were fine and my tonsil looked fine so that really didnt help getting two different opinions although the doc probably knew a little more about it than the nurse i would hope.  At times my nodes have been tender to touch.  Im not sure if it is because of my constant worry and poking and pressing that is causing this or if it is ars.  Also, I have been taking doxycyline ever since ive been here for malaria prevention.  Now that I have given you an overview, id like to ask you my questions.

1.  Would my doxycyline tablets which i take daily since ive been here have altered my hiv tests?

2.How confident should i be with the tests that i have taken, two through brooks afb lab and one with home access?

3.  Do my symptoms sound anything like ars?  I do not think ive had a fever, is it possible to have an ars fever and not know it and would my nodes still be swollen 10 weeks past exposure?

4.  Do you recommend another test?

Thanks for your time on

steve

[H. Hunter Handsfield, M.D.]

It's certainly possible to cause pain and tissue swelling by repeated poking and prodding.  But I don't know whether lymph nodes themselves can be enlarged that way.  (You cannot assume that a lump you feel is a lymph node.  Self-diagnosis of lymph node enlargement is very unreliable.)

HHH, MD

[steve05]

thanks doc.  One last thing.  Is it possible to flair up your lymph nodes by poking and pressing?

[H. Hunter Handsfield, M.D.]

Your symptoms cannot be due to HIV.  In order for you to have HIV, you have to invoke several highly improbable events, all of which have to come up the wrong way:  the odds your partner was infected, the odds of transmission if she was, the chance of delayed seroconversion, and the odds of HIV versus something much more common as a cause of the symptoms you describe.  That analysis adds up to zero risk of HIV, certainly less than one chance in a billion.

1) There is no medicine that affects HIV testing, with the possible exception of potent chemotherapy for cancer.

2) 100% confident.

3) Almost all garden variety viral infections cause symptoms with some similarity to ARS.  Yours do not sound particularly suspicious.  And as I said to start, the overall situation essentially proves your symptoms CANNOT be due to HIV.

4) Definitely not.

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