HIV Symptoms to Antibodies detection

[johnny409]

Background:
-I had a high risk encounter June 03/09.  Male on female.  I say high risk only because I have no idea what happened (potentially drugged), except I know there was sex invovled.
-No symptoms until about week 8-9.  Symptoms include swollen lymph nodes, sore throat.  The lymphs are not swollen to see, but there is defiantly something not right in my neck.  I beleive there is minor swelling and my skin around my neck is hot, which is causing sweats - yet another sign.
- I tested negative for Anitbodies (rapid tests) at the end of week 9.  I tested negative again at the end of week 10. I only went to get tested again becuase the symptoms were becoming more obvious.
- I am now into week 11 and the symptoms persist - FYI, I never have swollen lymphs or flus in general so either something is wrong or this is a crazy coincedence.  I don't have a surpressed immune system.
- No matter what you say, I will be getting a test done at the end of week 12 and I will not be putting anyone at risk in the meantime.

My question is this:
-I'm looking for some sanity in the next 1.5-2 weeks.  Is it possible that I could have symptoms for a week or more and the antibodies still not be present?  Have there been any studies to measure the average (or 99.9 percentile:)) time people take from the time real symptoms happen and when the body produces detectable antibodies? I was tested at the end of week 10 - I'm just hoping that there is enough buffer build into the 3 months such that a healthy, normal guy like me couldn't have HIV and still test negative @ 10 weeks :(

Any info you provide would be helpful - thanks

[Edward W Hook, MD]

Welcome to the Forum.  I hope my comments will help you to gain some perspective on your risk from this exposure although I must say, your comment "No matter what you say......) makes me wonder.

You do not have HIV.  You may or may not know much about your partner but I can tell  you that unless she was an IV drug user, there is a less than 1% chance that she had HIV and, even if she had used IV drugs, her likelihood of HIV is less than 1 in 10.  In addition, following  a single exposure, your risk of getting HIV is 1 infection per 1000 exposures.  Finally, you have had an HIV test at 9 weeks when virtually all persons who acquired HIV more than 8 weeks earlier would be expected to have a positive test. Thus, putting these numbers together. your risk  of HIV from the exposure you describe is less than 1 in a million.

As far as whether or not your sore throat is the ARS, the answer is no. The ARS begins 2-3 weeks following exposure, not at 8+ weeks.  I don’t dispute that you have a sore throat and perhaps even swollen lymph nodes but I am confident that you do not have HIV.  I know of no HIV expert who is aware of anyone who has not received antiviral therapy for HIV who has seen ANYONE who developed a positive test more than 8 weeks after their exposure.  You are not going to be the first.

I would suggest you talk to your doctor about your cold/flu.  I suspect he/she may be able to offer so symptomatic relief.  Hope this helps.  EWH

[johnny409]

Thanks - very helpful in so far as the probability of testing positive after a 9week negative test is well in my favor.  I didn't mean to sound direct on the "no matter what you say", but most answers I get tell me to "get tested at 3 months to be sure and don't expose anyone in the mean time" .... SO, I was just stating the obivous.

As for the other stats, the partner was in HongKong while I was on a business trip.  I'm not sure where HK falls on the HIV epedemdic list, but I'm sure the "1 in whatever" stats are much worse than EMEA or NA?

[Edward W Hook, MD]

In Hong Kong, the risk fo your partner being infected with HIV is certainly lower than if she were an IV drug user.  How much lower is hard to say.  Thus again., your risk of infection is lower, and probably far lower than 1 in a million.  EWH

[johnny409]

One last comment on this thread (I know how annoying it is for you guys when threads go on for ever):

It would seem to me that most people who *think* they have HIV get tested very earlier on when it's too early for a test to be postive AND then again after 3 months (because that is what they are told after the first test).

Therefore, when you say virtaully everyone tests positive after 8 weeks, are there stats on this?  If almost all people wait until the 3 month stage, how can one break the weeks down to say "after 8 weeks, you're good"?

Hate to be a pessimist, but had to ask.

[Edward W Hook, MD]

Most people do not wait until 3 month.  The data we provide is based on a number of different published studies as well as informal polls both Dr. Handfield and I have conducted with out colleagues.  From both sources there is concesus- no seroconversions after 8 weeks with current generation, FDA approved tests for HIV.  EWH

[johnny409]

Thanks for your answers EWH.  I'm not sure if you and your collegues realize how great it is to be able to get good answers to these kinds of questions.  Keep up the good work!

I'm off to the doctor to see what is really wrong with me......