Opinion on symptoms and test timing

[Guy1975]

Dear Dr,

had unprotected vaginal intercourse with a Filipina bar worker in Singapore 29 days ago.

18 days post exposure - tested -ve with Oraquick test.

27 days post exposure - experienced tenderness under right jaw-feel node; painful to press and makes throat irritated; eye pain when moving eyes left to right; body aches commenced.

28 days post exposure (yesterday) - visted same doctor - confirmed swollen node in jaw; confirmed fever of 38.2C
Requested retest with Oraquick - again -ve result

Doc indicated is a standard virus and to get some rest - stated no suggestion of HIV infection.

Can I please request your opinion with respect to reliability and confidence I can derive from the results given the above.

My anxiety comes from the timing of the symptoms and time since possible exposure (I can never recall a swollen node in jaw before, esp together with confirmed fever). Would presence of HIV infection symptoms at 28 days mean it likely that antibodies would be present and the test would pick this up?

Appreciate your advice - thank you.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

You did not catch HIV and should not be worrying about it.  Test results always outweigh symptoms in judging whether or not someone has HIV.  The identical symptoms occur with many conditions, all more common than HIV -- and anyway, the symptoms you describe don't really suggest HIV anyway, and they came on too late to be due to ARS.  The timing is only a coincidence; your test results make it almost 100% certain you did not catch HIV.  Your doctor might suggest another antibody test at 6-8 weeks to be even more certain, but you can relax; any additional tests will also be negative.

For the future, please get into the condom habit for future unsafe sexual encounters.

Regards--   HHH, MD

[Guy1975]

Thanks doctor.

To follow up, post 28 day test did not have any fever on subsequent days (self measured).

I did have aching body/limbs/back & some headache like coming down with a flu which came & went over the next 3 days (days 29-32) however this didn't progress to any flu or symptoms such as congestion or stomach upset which my doctor suggested it might. I have intermittently been getting tension-like headaches where my scalp is sore to touch & feel like I have a slight cough/throat irritation.

Today is 34 days post exposure - what continues to cause me the most concern is the enlarged node under my jaw - it is quite large and tender & I can manipulate it (move it around) when I put my chin down - I am feeling quite anxious as I understand it is a sign of infection but I don't have any typical virus/flu symptoms - and the first time I can recall having such an enlarged node.

Should I be concerned? Does any of this suggest ARS? I am getting quite anxious.

Thank you.

[H. Hunter Handsfield, M.D.]

No, none of this suggests ARS.  Lymph node inflammation in ARS is body-wide.  Enlargement of a single lymph node (if that's what the lump near your jaw is) virtually always means a localized inflammation, not a systemic illness; and lack of other symptoms (fever etc) also is evidence against ARS.  Please accept the reassurance you have been given and work with your own doctor or clinic about lump near your jaw.  It isn't due to ARS.

[Guy1975]

Thanks Dr.

I was feeling calmer until started fixating on the enlarged, tender, movable node.

I saw the doctor again Friday and tested -ve (day 36).

To his surprise he said I a mild fever at 38.2C measured via the ear - I had been measuring orally not realising that above 37.5C was considered fever - I had just measured orally 37.7C before the  appointment which would be supportive of mild fever.

He said to come back early next week to check on the status of the fever and depending on the result undertake a CBC.

I am less concerned about HIV now however have convinced myself I have leukemia or lymphoma.

My symptoms are:

*Over the weekend I have been measuring my temperature orally - Normal temperature (under 37.5C) except short period Saturdy night it measured 37.7C orally - I understand a low/mild fever is symptomatic
*The enlarged/tender node mentioned earlier.
*I have had general aches and pains but tend to be diffuse and not everyday.
*General itchiness sometimes - but only consciously realised this after I saw it as a listed symptom.
*I thought I had a moderate night sweat Friday evening after seeing the doctor.
*I have an extremely tender right calf muscle, not sure of the significance but timing seems strange.
* I don't feel weak or fatigued but am extremely stressed and preoccupied as I have been stressed with the initial HIV fear and now this for several weeks.

I am feeling extremely anxious where I am finding it difficult to function - I know my anxiety can make it hard to be rational & may contribute to symptoms but the symptoms seem real (esp the node) and combined with my doctor's concern on the mild fever.

I know this is deviating outside the HIV forum but would appreciate any advice you may have given my initial concerns presented were around contracting HIV.

Many thanks.

[H. Hunter Handsfield, M.D.]

With apology, this forum only deals with HIV, which you do not have.  You are under the care of a doctor.  Any additional questions should go to him, not to this or any other online source.  But be assured that the vast majority of people with symptoms like yours do not have leukemia, lymphoma, or any other life-threatening illness.

That will have to end this thread.  Take care.