Any chance this is NOT ARS?

[anychance]

Bi-male - receptive anal sex with HIV+ partner (he told me after the fact) - no internal ejaculation. I kept a very detailed log of symptoms and responses, but I am editing it down to what I feel are the important details.

Approximately 7-10 days after exposure, I started to notice a slight difference in my breathing. I would not call it "difficulty in breathing" or "shortness of breath", but just different.

From approximately days 10-20, I became tired more easily, but no other symptoms during this time - perhaps some muscle tenderness in my back.

On day 21 after exposure, I started to develop a fever, swollen lymph nodes, stiff neck and headaches (all around the same time). My fever ranged from no fever (98.4F/36.9C) to relatively high low-grade fever (102.5F/39.2C).

Between day 21 and 45 after exposure, I had a total of 3 night sweats; fever was oscillating between nothing and 102.5F/39.2C. Ibuprofen relieved the headaches and stiff neck.

Day 50+: Very few symptoms, if any; the majority seem to have resolved.

I know you always say that symptoms are not a reliable indicator, but how about situation + timeframe + symptoms? You can't just multiply your way out of that.

I am waiting for the 3-month mark to be tested again, but I am almost certain that I will hear a positive result. So here are my questions:

1) Does this sound like classic ARS to you? When you combine all the factors, it just seems very unlikely that I am NOT infected. From your experience, would you be very concerned right now?

2) What is a high fever as related to ARS? You have said this several times when eradicating fears, but how exactly does an ARS fever present? Is it constant or oscillating? What is the range? Please explain this is more detail.

[H. Hunter Handsfield, M.D.]

Apparently you don't say when you were tested, only that you're waiting for 3 months to be tested again.  If you have been tested 4 weeks (and definitely if 6 weeks) after exposure, you can be confident you did not catch HIV.  On the other hand, you had the highest of possible high risk exposures (you don't say whether with condom, but I assume unprotected),  So I cannot say you aren't infected, especially if your latest test was within 3-4 weeks of the event.

1) Your symptoms are consistent with ARS, but also with any number of other causes.  Your symptoms started somewhat late; I consider day 21 (fever) the onset of symptoms that might suggest ARS--the earlier ones don't sound suspicious.  The test results tell the truth; symptoms often lie.

2) I don't know that any research has systematically analyzed the pattern of fever in ARS.  If so, I don't know the conclusion.  I haven't been the primary provider to enough patients with ARS to have a personal opinion.

Good luck--  HHH, MD

[son222]

More importantly, you do not specifically say if there was a condom involved??

[anychance]

Yes, you were correct. This one time was unprotected (no condom).

[anychance]

I think my phrasing confused the question. I have not been tested yet, which is why I was curious about the symptoms and timing. I meant to say that I am waiting until the 3 month mark so I can be absolutely sure when I hear the result - good or bad.

Doctor, you say that the symptoms started a bit late for me, in your opinion. What do you mean by this statement? From what I have read (including your comments), this is almost textbook: 3 weeks to the day after exposure.

I know you tire of answering the same questions over and over. I know I tire of reading them - especially when its "I kissed someone and my arm hurts, do I have HIV?" type of questions. It might be helpful if you shared a "typical" ARS example, if there is such a thing. For example, do ARS fevers oscillate or are they constant? When do symptoms usually begin (you said 21 days was a bit late)? Do the night sweats have any particular characteristics vs. typical flu? I felt great after my night sweats, but then the fever returned within a few hours. I think this is atypical of flu, but likely if your immune system is under bombardment.

[Willl]

It doesn't matter about how you felt. You are past 50+ days and a test is worth 10 times as much at this point than what you felt like during the third week.

[JohnnyV]

Anychance,

I wish you the best with your test. Hope it turns out okay. We are rooting for you.

J

[confused516]

Any fever can bring on a night sweat and hundreds of viruses can bring on a fever.  You did have an exposure so you should get tested but the odds are still way in your favor that you didnt get hiv from this.  Keep us posted when you get your neg results I think it will help alot of people realize that symptoms are not reliable.

[H. Hunter Handsfield, M.D.]

One of my main points is that symptoms make little difference in assessing the likelihood of ARS.  I'm certainly not going to reinforce emphasis on symptoms by taking the time to describe a typical case.  There are plenty of online sources for that, and they cause no end of headache for anxious users (and indirectly for me).

It is a mistake to wait 3 months for your first test.  Given the high risk nature of your exposure, you should have seen a health care at the first suspicious symptoms (your fever etc at 21 days) for diagnostic testing, which might have included an HIV RNA test, depending on the provider's judgment.  In any case, if your symptoms are due to HIV, you will have positive results now by standard antibody testing, or the duo ELISA/P24 test.  Don't sit around stewing about it for several more weeks.

HHH, MD

[confused516]

Would you recomend the same if it was vaginal or oral sex?  You always say symptoms are not a indicator AND one time exposure is low risk

[H. Hunter Handsfield, M.D.]

This is not an emotional support website.  It is intended to providly educational information and your repeated anxiety-driven "yes but" and "what if" questions do not serve that goal.  Enough.

HHH, MD

[confused516]

Yes, but when your "eductional information" tends to change some people might want to know why. You said "symptoms are not an indicator FOR or against hiv" and then in this post you tell the person to get tested because of the fever.  Is it because it was anal sex or would you have said the same thing with vaginal and oral sex with a fever at 21 days?

[FiveCantonas]

You have to go and get a test, pluck up the courage you will find a lot of support on this forum, let us all know how you get on?

At this stage a modern test should give you 99% + results...

[avatarx51]

Yes i agree with everyones advice here, go to a health center and get some tests done now, dont wait and stress yourself any furter a test at this time will be almost as good as a standard 3 month test.

ARS usually occurs 2-4 weeks after exposure.
It usually includes fever, a rash, fatigue, loss of apetite, swollen lymph nodes, joint pain, night sweats, oral ulcers, and so on.. but these symptoms can also come from other things, this is why you can never use symptoms to diagnose HIV.

I wont lie to you, your exposure was very high.. your ARS symptoms fit the timeline.. but having said that alot of people go through the same siutation as you and come out negative i seen it many times before, so dont stress it out.

go get the test ASAP. good luck im rooting for you all the way, and hopefully when you get your negative result you will always use protection so you wont have to go through this situation again.