Possible symptom - not sure

Hello doc, hope all is well.

Here is my situation.  My girlfriend of 3 years (on and off) has been experiencing fevers over the last six months or so that come on rather quickly and leave just as fast (she has had about seven or eight such episodes in that time).  These fevers usually begin at about bed time and will last through the night, but will be gone by the next morning. She will usually get very warm and will have to change clothes during the night because she is sweating profusely. She can feel these fevers coming on before she goes to bed so they would not really be characterized as night sweats.  This is the only symptom that she presents, but it is concerning because they are happening so frequently.  I would not say that either of us would be in the "at risk" category.  We are both heterosexuals, i have had unprotected sex with partners in the past, but they were either one night stands with people i knew very well and would not consider at risk or relationships.  Neither of us are iv drug users either.  

Finally, i must point out that i suffer from the occasional cold sore and accidentally passed the herpes 1 virus on to her during oral sex (this happened about a year and half ago). I am not sure if there is any connection between the herpes and the fevers, but i just wanted you to know the full situation.  

My question then is this.  What are the chances that the frequent fevers are attributed to hiv infection?  I know it is only one symptom, but it seems like this type of fever is a common symptom in hiv sufferers.  Do you know of any other illness that would cause such a pattern of fever?

My girlfriend is going to the doctor tomorrow, but i am so concerned that i was hoping to get some info as soon as i could. Thank you so much for your help. God Bless  

[Edward W Hook, MD]

From what you tell me, both you and your GF are low risk for HIV and, as explained below, the odds of her night sweats being due to HIV are close to zero.  Use of symptoms to gauge one's risk for HIV is incredibly unreliable.  Night sweats are a non-specific symptoms which can be caused by any number of things including heartburn, thyroid problems, and infections, only one of which is HIV (and among persons with night sweats due to HIV, HIV is causes only a very small proportion).  In addition, some people just have night sweats for other, as yet undefined reasons.  If your GF feels otherwise fine and has not lost weight or had other health problems, I would guess that there is a fair chance that her doctor will not find a cause for her symptom and she should not worry further beyond the evaluation that is provided unless new symptoms arrise.

As for what her doctor will do, that will be determined by her/his complete history and physical examination and will likely lead to some testing.  For me to guess more than I have already would be  improper.  

Bottom  line. the chance that her night sweats are related to HIV are very, very low.  Her interaction with her own doctor tomorrow is the next appropriate step in evaluation.  EWH

p.s.   this is not related to her HSV-1 infection.  EWH