hiv scare

[helpspring]

At the end of February 2010, I had 2 sexual encounters with a new female acquaintance of unknown HIV status (?promiscuous).  The encounters were exactly 1 week apart and included protected vaginal intercourse with proper condom use.  However, they were both preceded by BRIEF (1 min at most) UNPROTECTED ORAL SEX with just the woman performing on me.  She did not appear to have any external oral lesions.
2 weeks after the first encounter (1 week after the second encounter),  I came down with a febrile illness involving fatigue, nasal congestion (?initial sneezing) and blown nasal discharge especially in the early morning.  Fever was felt definitely 1 day after (Day 1) onset of notable fatigue.  Fever lasted 1 evening and possibly 2 evenings.  Malaise was most notable on Day 1 with nasal congestion following along with justified or unjustified use of Mucinex and Claritin.  There was no rash, swollen glands, nausea, vomiting, diarrhea, significant muscle/body aches and no major loss of appetite.  Symptoms steadily improved and abated by Day 5/6.  I was somewhat slowed down by symptoms, but was able to carry out my demanding work. There was vague and subtle scratchy throat the following week with no significant pharyngitis.  My body weight was about 1 pound below my normal range 2 weeks after initial onset of symptoms.
I initially dismissed the illness as the Flu (?first week of March, but I was on an airplane 1 week prior to the start of symptoms), but I am now concerned about acute HIV.  See, in late May I noticed small/single horizontal ridges (elevations) on all 10 fingernails.  They are fading now and advancing upwards with nail growth.  I have no acute symptoms now.  I read that these horizontal ridges are concerning and represent past serious systemic illnesses.  In my case the illness in March comes to mind.  I also had a lot of personal stress in March and April.  I am worried that what I experienced in March was acute HIV.
Please help me with your answer.

[Edward W Hook, MD]

This will be your last answer.  I recommend testing because I am confident it will be negative. Then you can decide what to do about your symptoms which are non-specific.  

I will not venture a guess as to what this might be.  That should be explored by you and your own doctor.  

I also will not entertain any further "could this be HIV" questions.  You need a test to put the matter to rest.

This ends this thread.  EWH

[helpspring]

I am just scared.  What do you think about my constellation of signs and symptoms described above?  Are you recommending that I get tested to confirm your anticipated seronegativity and to move on with my life?  Or do you think there is a medical possibility of the presence of HIV especially given the current physical findings?  Thank you.

[Edward W Hook, MD]

You have my advice.  To not get tested is silly.  If you did have HIV, what would delayng evaluation do?  EWH

[helpspring]

Thank you very much for your response and recommendation.  You provide a vital service.  Approximately a year ago, I mustered up the courage to have an HIV test which turned out to be negative.  Currently, I am extremely worried that I contracted HIV.  That diagnosis would dramatically impact my personal life and I just don't know how I would confront the concrete evidence of a postive test.  My professional life would be ruined.  I am just noting concerning bodily changes.  At the start of the diffuse nail ridges in May, there was underlying nail bed redness.  Now a red/brown arc can be seen toward the end/tip of my nails.  I read that this is called Terry's nails, a condition that is observed in HIV patients.  I don't have any established liver/kidney disease or nutritional issues to explain these nail changes.  Since mid May I've also felt a prominent right preauricular node and the left is slightly felt (I read that they usually cannot be felt).  I don't feel additional significant lymph glands in the body.  Friends have observed that I look thinner...

I just don't know what to do.

[Edward W Hook, MD]

Welcome to our Forum.. I would like to endorse your original assumption, that you had a cold or other community acquired viral illness.  Your genital exposures were condom protected and therefore safe sex.  As for your oral exposures, the quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  Thus I would not be concerned about these either.

As for your symptoms, they are all non-specific and not something to worry about.  Early HIV does not cause nail changes but stress and nutritional deficits can.  

Finally, I do not see anywhere in your post that you have had an HIV test and cannot help but wonder why not. The clinical diagnosis of HIV is terribly non-specific for highly trained clinicians and even more difficult, if ot impossible for non-clinician.  On the other hand, the blood tests for HIV are amongst the best tests ever created.  My advice is for you to go and get a single HIV blood test.,  I am confident that it will be negative. With that information you should put any concerns that you might have caught HIV from the exposures you described behind you and move forward.  

Hope these comments are helpful to you. Take care.  EWH