Positive Mono and HIV infection

Hi, Doctor. I am worrying about the relationship between mono and HIV. I went to an asian massage parlor in mid April. I had protected vaginal sex and received unprotected hand-job from the massage girl. After browsing this forum, I know the chance for HIV infection is low. But two weeks after that incident, I began to have low fever, headache, fatigue, diarrhea and running nose. I went to see my doctor and had the mono test. The result is positive. 18 days after the incident, I had an oral HIV test. The result was negative.

Recently I got to know that the symptoms of acute HIV infection resemble the symptoms of mono. And the result of the HIV test is usually negative in this period. ( I am not sure if this is true. )

My question is about the two tests.
1. Is the mono test (blood test) designed exclusively to detect the antibodies of EBV or the result can be false-positive due to HIV?
2. Is it true that in the acute HIV infection period, the HIV antibody test is usually negative?
3. For me, positive in mono test, if I want to have a re-test in HIV, can I do it in the near future of I need to wait until the mono symptoms is over to get an accurate result?

Thank you very much.

[H. Hunter Handsfield, M.D.]

Mononucleosis is an unlikely explanation for your symptoms, which do not particularly suggest either mono or HIV.  Some other garden-variety virus is more likely.

1) The mononucleosis tests and HIV tests to not cross-react in any way.  Even if you have mono or some other virus, it would not make your HIV test negative.

2) You tested too soon for a reliable HIV antibody test.  At 18 days, probably around 30-50% of infected people have positive results.

3) Unless your doctor advises otherwise, you do not need further testing for mono.  It is not a realistic possibility for your symptoms.  Neither is HIV, but since you seem to be anxious about it, have another HIV antibody test 6-8 weeks after exposure.

Good luck--  HHH, MD

[HHH,MD]

Oops--I misread your question, didn't realize your mono test was positive.  Sorry!

I'm not sure you caught it during the sexual exposure you describe, but it's possible, especially if kissing was involved.  Ebstein Barr virus (EBV), the cause of infectious mononucleosis, is transmitted primarily mouth-to-mouth through saliva.  Although the symptoms you describe are not typical for mono, you can rely on that result.

The rest of my responses are accurate.  The chance of HIV remains essentially zero from the encounter you describe (although I don't know what other risky exposures you might have had).  Follow your provider's advice about follow-up HIV testing.

HHH, MD

[toda]

Thank you very much. No kissing was involved in the encounter. Also I have not kissed anybody for a long time. Anyway, I will take mono as the cause of my symptoms. I will have a retest for HIV according to your advice.