ARS Symptoms and Exposure about 5 weeks ago

[Vineetj]

Dear Dr Edward,

I am a 27 year old male. I had a exposure with a CSW in first week of May in Thailand. While having sex my condom slipped exposing the top of my penis head partially, which may have been for a minute or max 2. Though I did not come inside her. The CSW was very young may be 18 or 19 and was very clean no sign of drug usage. She then left and I cleaned my self. Later about 18 days after I developed infection in my stomach and penis and viral soar throat infection with dry mouth and a ulcer. The infection in the penis and the stomach subsided but the throat infection is still continuing despite medication from a doctor. At 24-25 days i had pink pimple like things on my right hand alongwith white heads, these where a little itchy but went away in a day. these were about 10-12 in numbers. Also at 28 days i started feeling swelling on my body and every morning when i get up i have swollen lips cheeks and jaw. I have been feeling some pain in my arms as well. Together my fingers go numb while I am sleeping. Since the 18th day, i have had on and off mild fever but never crossed 99 degree mark. I got my self checked and I do not have any swollen lymph nodes. I am not sure are these symptoms for HIV or not I would like to have your thoughts on the same. Also I has HIV combo tests on the 22, 28 and 35 day which all came to be negative.
Do you think these symptoms are related to HIV, or are these related to the viral throat infection which I got?
Do i require any further testing ?
How accurate are these HIV Combo tests? Most people even in this forum do not recognise it?
I have never had any diseases in the past hence I belive my immune system is in good condition so does that mean i should have produced antibodies by now?
Are a lot of things related to anxiety ?
I have researched on the web and honestly confused about it all, need some direction on the same

Vineet

[Edward W Hook, MD]

Your exposure to this partner was partially protected.  It is statistically unlikely, even in Thailand, that she had HIV and even if she did, only one of 1000 unprotected exposures lead to infection.  To your credit you used a condom which, unfortunately slipped off.  As a result you were partially protected but his is better than no protection at all and makes it even more unlikely that you would have caught HIV from the exposure you describe.

Your symptoms are not due to HIV.  Your test results prove this.  If your symptoms had been due to HIV, tests taken a week after the onset of symptoms would be positive.  This is not the case for you and therefore, on the basis of your negative tests you can know that they are not due to HIV.  They may be due to the anxiety and guilt that you are experiencing after the exposure you describe.

In answer to your specific questions:
1.  No, these symptoms are almost certainly not due to HIV and could be due to some other viral cause of your sore throat.
2.  We tell clients that testing after 6-8 weeks can be counted on as accurate.  You were tested at 5 weeks (35 days).  This makes it very unlikely that you have HIV, a final test at after 42 days will provide final assurance that you did not get HIV from the exposure you describe.
3.  The combo tests are very accurate.
4.  Yes, I would have expected your immune system to have produced antibodies by now
5.  Yes, I suspect anxiety is contributing to this
6.  There are many causes of white tongues including a fungal cause of sore throat caused thrush.  This does not mean you have HIV. You may wish to discuss this with a doctor who can take a look and comment to you on the potential causes of your sore throat.

Your experience on the internet is typical.  The information found at many sites there is both confusing and sometiomes wrong.  Hope this helps.  EWH

[Vineetj]

Dear Dr , I Missed I have had a feeling of unclean mouth since 18th day onwards, it feels as if some thrudh is coming in. and even the ulcer on the gum took about 2 weeks to go.

[Vineetj]

What i mean is that I have had a white tongue since the 18th day onwards and it still persists.

[Vineetj]

Thank you Doc your comments are very assuring, just one last question, I had a HIV Combo test at week 5, does this mean my chances of  a negative 6 week test are virtually 100%. As the test would have picked up antigens if nt antibodies

[Edward W Hook, MD]

Yes, virtually 100%.  As I said, you do not need to worry.  EWH

[Vineetj]

Thankyou Sir.

[Vineetj]

Dear Dr EWH

I had my 42 day test today and it came back negative. In your opinion shall I continue to test or seeing my exposure I do not need it?
One thing more in the test I have been havinf the Index value has been in the range of 0.10 to 0.20 flactuates off and on. Does it have anything to do . or this is normal. the result says it should be below 0.90 and it is well below.
I do not have symptoms any more except dry skin and itching over my body past 3 days

[Edward W Hook, MD]

You do not need further testing.  The negative test indicates that you did not get HIV from the expsoure you mentioned.

It is normal for the index values to fluctuate from day to day. This sort of fluctuation is no reason for you to be concerned.

Your symptoms are not due to HIV.  If they trouble you , you should see your doctor for his/her assessment.  EWH

[Vineetj]

Hi Doc, I am sorry to be writting to you again, after your conformation. I took a 46 day test ( just a little short of 7 weeks). It came back negative. But it seems my trhost infection has still not subsided. I met with an ENT and he diagnosed that as a Chronic Pharyngitist with swollen lymph nodes in the neck and a stiff neck. I have had this since the 4 th week after exposure. Do you think this can still be a concern for me? Also in my CBC test my Lymphocytes have been diagnosed as high at 42% contrary to the range of of 20-40%. I want to be confident I do not have HIV. But such diagnosis continously make me anxious.

[Vineetj]

Dear Doc EWH.. I would really appreciate your comments on the same. This is my final post to you ..

[Vineetj]

Dear Doc EWH.. still awaiting your opinion

Rgrds

[Vineetj]

Dear Doc EWH... I would really really appreciate you inputs.. Rgrds

[Edward W Hook, MD]

Your HIV tests are negative.  You do not have anything to worry about.  I will not repeat myself.  This thread is over. EWH