Possible HIV exposure, Acute symptoms

[J_Con]

Hello,

I had unprotected vaginal sex with a female 2 weeks ago.  The contact lasted for about 5 minutes and I did not ejaculate.  I heard a rumor that she had AIDS.  I confronted her about the situation and she had papers to show me which were 2 months old(could not tell if they were fabricated).  I have tested negative for all STDs prior to this partner.  Because of my poor decision I am now having some anxiety about the situation.

I've experienced minor throat irration,  a temperature of between 98.5 and as high as 99.5, and today I had enlarged lymph nodes in my under arm area.  I saw a doctor today and they did a rapid strep throat test which turned out negative.  The doctor also examined my lymph nodes and did acknowledge they were a little swollen.  I experienced minor pain when the doctor was pressing on my lymph nodes.  I have not experience any other symptoms after the exposure.  

1) If I do have strep throat, does a fever and enlarged lymph nodes under the arm pits usually accompany it?

2) Can all of this be a result of my anxiety(including enlarged lymph nodes)?

3) I have been smoking cigarrettes excessively for the past week or so.  Can smoking cause all of the symptoms I am experiencing?

4) How accurate would a pcr by dna test be at this point(2 weeks)?  Are there any other tests I can do this early?

5) I would consider my symptoms to be minor, if this were a case of acute hiv symptoms, would this symptoms be a lot worse or not necessarily(i.e. higher fever)?

Any help would really help me out.  Thank you for your time and any answers.

J

[H. Hunter Handsfield, M.D.]

Please read other forum threads about how low your risk is.  Symptoms mean nothing.  Undoubtedly the doctor you saw reassured you.  There is no need fo rhIV testing.

1) Symptoms are meaningless as an indicator of new HIV infection.  Search the threads for "ARS symptoms" and/or "HIV symptoms".

2) Many of your symptoms are due to anxiety.  None are due to HIV.

3) I don't know.  Maybe some of your symptoms are due to smoking.

4) You do not need testing.  PCR testing in this situation would be irresponsible.  But if done and negative, it would be reassuring.

5) See no. 1.

You are badly overreacting.  Mellow out.   HHH, MD

[J_Con]

I also forgot to ask.  Is folliculitis any kind of acute hiv indicator?  Thanks, J

[skerdstraght68]

I had all your symptoms and tested neg out to 10 weeks.  The chance you aquired anything is slim to none.  BTW.  what kind of papers did she show you?  I doubt she had AIDS in any case.  If she had AIDS I very much doubt she would decide to have sex with you.

Extreeme stress does indeed drop the immune system.  Just about every symptom of HIV lines up with stress.  99.5 isnt worth taking note of.  Sounds more like a fluctuation.  I know you feel like your doomed but it's your mind screwing with you.  Trust me, it screws with all of us convincing us were all doomed.

Your minor throat irritation is probably GERD which flares with anxiety..   I would advise you sticking to this board soley and not searching the net.  It will show you stuff you will get with all your stress.

[J_Con]

Thanks for the reply skerdstraght68.  The papers she showed me from what I recall indicated that the test for HIV was non-reactive.  It looked like a lab form, with her name, date etc.  I am not certain if the papers were real though.  Thanks again.

[skerdstraght68]

I think I would trust the paper you saw more than someone running around saying she has AIDS.  

The mind is powerful.  If you look to be sick it WILL make u sick.

[skerdstraght68]

in any case you know the drill.. get a test 6-8 weeks and put it behind u.

[brambles26]

Hi Guys,

I have replied to some comments in the HIV support forum, and made some comments about the DUO ( antigen and antibody blood test) test being 99.7% at 28 days based on other forum question i have read.  Is this correct?  And when would the DUO be 100%, surely it would be before 84 days (12 weeks) if it is 99.7% at 28 days.

I dont want to be giving people in the HIV support forum false information, especially since many are awaiting test results.  

Could you clarify this for me and others in the forums please ?

I got my initial info from  http://www.medhelp.org/forums/HIV/messages/277.html
if that helps.

Thanks

[skerdstraght68]

The first part of the duo test which looks for the actual HIV virus itself becomes useless after 3-4 weeks as antibodies are targeting the virus.  This is however when the antibody segment of the test becomes reliable.  The antibody portion of the test is the same as a standard HIV test.  So theoretically after 28 days the tests become equally reactive.  

Look at this graphic. (bottom left graphic) It shows how long the P24 is active.  it also shows when the antibodys build.

http://www.retroconference.org/2001/posters/415.pdf

[J_Con]

skerdstraght68, thanks again for helping me through this.  I was wandering, did you have enlarged lymph nodes as well?  I seem to have them in the armpits, possibly throat region, and right groin region.  Please let me know if you can offer any help.

Thanks,
J

[skerdstraght68]

I've turned the internet upside down and have yet to see it.  Obviously we all think we're going to be the first.  I like to post this from time to time.  Its a good chunk of what's out there reguarding 6 weeks.

http://www.medhelp.org/forums/STD/messages/524.html

http://www.medhelp.org/forums/HIV/messages/258.html

http://huhs.harvard.edu/HealthInformation/HIVTesting.htm

http://www.aegis.com/askdoc/ASKD040318.html

http://www.aegis.com/askdoc/ASKD040617.html

http://www.sfaf.org/aboutsfaf/outreach/index.html?april00/two_tests.html~frontpage

http://peds.wustl.edu/labmed/retrovirus/

http://experts.about.com/q/Immunology-including-AIDS-973/ELiSA-6-Weeks.htm

http://www.thebody.com/Forums/AIDS/Women/Archive/WomenInfected/Q159734.html

http://www.areuatrisk.com/Learn/aids_hiv.php

http://liam.gnn.tv/print/1775/HIV_Antibody_Assays_Overview

http://www.retroconference.org/2001/posters/415.pdf  (Figure1)

http://www.health24.com/medical/Condition_centres/777-792-814-1753,33966.asp

http://www.aac.org/site/PageServer?pagename=basics_home

http://forums.poz.com/index.php?topic=2523.0

http://www.aegis.com/askdoc/ASKD040318.html

http://www.hopkins-aids.edu/publications/book/03MMHIV1to3.pdf  (page 7)

http://www.unaids.org/en/MediaCentre/References/default.asp#begin (q:32)

http://www.thebody.com/Forums/AIDS/SideEffects/Archive/Testing/Q142661.html

http://depts.washington.edu/hivaids/initial/case1/discussion.html (figure 7)

http://experts.about.com/q/Immunology-including-AIDS-973/u.htm

[H. Hunter Handsfield, M.D.]

OK, Folks, listen up.  I have said this before, but here it is again:  There are no precise data on the window period.  Twenty years from now, we still will not have precise data.  Therefore, there still will be differences in advice about the timing of testing, and their still will be anxious persons wondering whether they are the exception to the rule.

Why no precision?  Because you would have to study several hundred persons (maybe 1000 or more) infected with HIV (not just exposed) at a precisely known moment.  (To have several hundred infected, you would actually have to study thousands of exposed persons.)  Then those people would have to be tested every day for 3-6 months.  That research never will be done.

In the absence of definitive data, some experts and health agencies err on the side of total safety.  If they tell someone s/he is negative, they want 100% assurance it is true.  These are the ones who say 3 months.  Other experts (an increasing number, but maybe still a minority) go with something like 6 weeks, because the exceptions are rare and there is great benefit to most exposed people in getting the answer sooner rather than later.  These providers, and most of their patients, recognize that if the risk of exposure is low anyway, 6 weeks is plenty reassuring.

All of this is entirely unrelated to antibody test "generation", which makes a difference primarily in the proportion positive by 3-4 weeks, not later. HIV experts have stopped characterizing HIV tests by "generation"; that terminology remains only an artifact of the anxious.

Bottom line:  Live with the uncertainty.  Put things in perspective.  Go on with life.

HHH, MD

[skerdstraght68]

Well i thought I had some under my jaw.  The glands were tender.  My doc said those were normal and I need to stop screwing with them.  I didnt have anything noticable in the armpit/neck etc.   In any case your lympnodes "if you do have them" mean 0. Only blood tests do.

[skerdstraght68]

the lack of a fever is evidence against ars.  That's one thing I never remember having is a fever or at least anything over 99.1

[J_Con]

I apologize, I forgot to add one more thing which I forgot to mention earlier.  About 6 days or so after the contact I felt like my liver was enlarged.  No pain or anything, just a little pressure on the upper right side of my abdomen.  Would this be indicative of anything after 6 days?

Thanks,
J

[brambles26]

thanks skerd,

do you know about the reliability during this time... i just want to make sure i have not said something incorrect in the other forum.

Would this protein always show up before subconversion?

After the protein has showed up would antibodies ALWAYS be detected.  (ie: would someone always subconvert about a week later, or could there still be delayed conversion)

[J_Con]

Hello Doctor,

Thank you for the reassurance.  I am simply over-reacting because I have good reason to believe the person in question has AIDS through a reliable source.  Was wandering if you could please help me with a few more questions just to help me sleep better.  I do apologize but am grateful and really appreciate your time.

1) So a fever of 99.5 or so is definetly nothing to worry about?

2) The enlarged lymph nodes I have(confirmed by the doctor) neck, armpits and groin area could be caused by my stress then?

3) The enlarged liver I felt after 5-6 days would definetly not be associated with acute hiv?  Too soon perhaps?

Thanks again doctor, and this will be my only other post.

J

[brambles26]

Hi Guys

I am looking for opinions on the mass. and now some parts of australia guidelines for 6 week window period.

As said previously 6 weeks is the window period in the CYA statements on Mass. and some Australian HIV test results - in australia usually ag/ab tests.

do you all agree?  Like what if people do walk around with the 6 week piece of paper and are positive, i know the doc has said inemerable times 6 weeks is close to 100% but what is close... 95%, 98%, 99% or 99.999% ?

could this be in fact contributing to the spread of HIV ?  Im not trying to highten anyones fears but im am trying to be realistic...

maybe it should be 8 or 10 weeks or even 3 months.

I know i git tested at 11 weeks and although most of you (including the doc think that is conclusive) and the peice of paper does say 6 weeks.. what if people like me  do convert within 11-12 weeks....

does this open up legal avenues for people who become infected.. does this give people false reassurance.

Any reply or comments (as long as they dont call me insane) are encouraged.

I think this is a legitimate question.  

[skerdstraght68]

First of all p24 testing which is the first segment of a duo is not as accurate as the antibody test.  A duo at 4 weeks is highly reliable and a standard antibody test is accurate  at 6 weeks.  Mass concludes all tests including home access are conclusive by week 6 not 4 not 5 but 6.  The vast population will be reactive by 28 days which gives a couple weeks to cover all the basis.  If massachusetts was wrong in this matter we'd know about it.  Its the medical capital of the free world.

[broncos27]

I dont know bro...I asked myself the same question about the 6 week window period.  BUT...why would MASS say this if it was not true.  We/Mass/America doesnt want HIV/AIDS to spread any more than it has.  Has anyone heard of anyone being neg at 6 weeks and then later turning pos??  Why would MASS state something soooo important if it was not true???

[brambles26]

Thanks for your response dr HHH

So in brief this is how it is.

with all tests no matter of generation or risk associated with exposure the majority of HIV positive people will test positive by 6-8 weeks.

With those that do have high risk exposures would also be positve in the 6-8 weeks timeframe.  However just to be safe it is recomended they test as say 10-11 weeks to ensure that they are negative.

No one takes 3 months to turn positive (or ever has) apart from those on chemotherapy, organ transplant and maybe PEP.

As long as someone tests at leat say 70 days (10 weeks) after exposure, they are 100% conclusive HIV negative unless they have one of the conditions noted above.  

The CDC guidelines  are a CYA thing but based on actual medical research and practice no one really ever turns positive later than 6 or 7 weeks.


Would you agree with the above statement DOC ?

[skerdstraght68]

This is a quote from a great article from the body pro.

"In detecting HIV infection early, timing is everything. Standard antibody testing, such as ELISA and Western Blot, can be negative for up to six weeks after infection. In contrast, viral load tests, such as PCR and other amplification techniques, can detect the presence of virus within days of infection."

heres the link.  Its long but well written.  Maybe HHH has even read it.  

http://www.thebodypro.com/journalview/top10/top10.html#pub1

[J_Con]

Ok, this evening I am now getting very noticable red dots on my palms.  Sore throat still occuring but minor.  Lymph nodes enlarged still.  No signs of fever(but did measure 99.4 yesterday).  I did mention earlier that I felt pressure in my right upper abdominal quadrant(liver probably) 6 days after the exposre and never got any feed back on this as well.  I understand from the previous responses that my symptoms could be stress/anxiety related.  Can the red dots on my palms be from this as well? (accompanied with enlarged lymph nodes and sore throat).  Please let me know what you think at this point and if I should still skip the pcr by dna test.

Thanks,
J

[J_Con]

Ok, this evening I am now getting very noticable red dots on my palms.  Sore throat still occuring but minor.  Lymph nodes enlarged still.  No signs of fever(but did measure 99.4 yesterday).  I did mention earlier that I felt pressure in my right upper abdominal quadrant(liver probably) 6 days after the exposre and never got any feed back on this as well.  I understand from the previous responses that my symptoms could be stress/anxiety related.  Can the red dots on my palms be from this as well? (accompanied with enlarged lymph nodes and sore throat).  Please let me know what you think at this point and if I should still skip the pcr by dna test.

Thanks,
J

[J_Con]

Ok, this evening I am now getting very noticable red dots on my palms.  Sore throat still occuring but minor.  Lymph nodes enlarged still.  No signs of fever(but did measure 99.4 yesterday).  I did mention earlier that I felt pressure in my right upper abdominal quadrant(liver probably) 6 days after the exposre and never got any feed back on this as well.  I understand from the previous responses that my symptoms could be stress/anxiety related.  Can the red dots on my palms be from this as well? (accompanied with enlarged lymph nodes and sore throat).  Please let me know what you think at this point and if I should still skip the pcr by dna test.

Thanks,
J

[J_Con]

sorry, did not mean to post 3 times...

[who_dis]

There are other viruses that can cause a sore throat, enlarged nodes, and red dots on various body parts.  All much, much more common than HIV.  

I doubt you will believe it, though.  You seem pretty fixated on HIV as the cause.    Why on earth don't you simply go back to your doctor tomorrow and show him/her your dotty palms?  The rapid strep could have been wrong.   If you are feeling worse today, or the dots are spreading, go to an Urgent care to be seen today.  Or if you really feel bad, go to the ER though I don't advocate that unless you are really ill.  

[dumbguy12]

J

just curious how you are doing?

[J_Con]

Hello dumbguy12,

Thanks for the follow up.  I've been doing better these past few days.  My sore throat only lasted a few days.  Fever or what seemed to be a fever went away pretty fast as well.  The spots on my hands only lasted about a day or so.  I got tested today and results should be back in 3-5 days.  I'm praying that my symptoms were the cause of some other illness or anxiety related.  I really appreciate you following up though.  Just curious, have you seen cases like mine with similar symptoms which were caused by anxiety?  Also, do you know what temperature(when it is present) is usually indicative of acute hiv?  Thanks again, J

[dumbguy12]

j

I am going through a similar situation....Girl rumored to have HIV but produced papers that stated she did not...I too am suspect of the papers...I have all the symptoms but tested negative out to 3 months....I feel your pain bro

[H. Hunter Handsfield, M.D.]

Time to cut this off.  The past few days have been occupied by the sort of discussion that ought to be on the unmonitored HIV support forum, not here.  New forum rules soon will be posted on this.  This forum will be limited to direct questions, my responses, and a few comments about the specifics of the original question.

Thanks and happy holidays--  HHH, MD