Exposure/Symptoms

[Bucky1584]

I had an unprotected sexual encounter with a sex worker.  Two days after exposure I had thrush in my mouth and at day 22 I had a fever that got up to 103-104 and lasted 4 days.  I took my latest antibody test at 50 days post exposure.  All tests including the latest test have come back negative (10, 25, and 50 day tests).  I'm again worried as Im now developing a sore throat which is about 70 days post exposure..  I'm also not sure if I'm imagining my lymph nodes being swollen or if they are.  You can't see any raised swelling but I have a general swollen feeling.  When should I schedule my next test?  I'm worried maybe my body developed the antibodies slowly.  Is this possible in a generally healthy individual?  Can thrush come on within two days of exposure?  Is there something else I need to be asking my primary care physician?  What are the chances my negative test turns positive?

[Edward W Hook, MD]

1.  At 50 days (79 weeks) a home test is likey to detect most infections but not all, if this is a rapid test.  

2.  Correct,

Time to end this thread.  you and I both need to move forward.   EWH

[Bucky1584]

Sorry, it was comment #7 in this dialogue.

Hi Dr. Hook,

Couple quick follow up questions just for my understanding.

1.  Can I take an at home HIV test at this point to confirm the 50 day negative I already received or would you suggest going back to my primary care physician?  Is there a big difference?

2.  Just to clarify when a person has ARS symptoms (in my case a fever at 22 days) the antibodies are produced shortly thereafter if the two were related and that is what lead you to the conclusion that my 50 day negative and fever were not related to HIV.

Thanks!!

[Edward W Hook, MD]

Not sure what you mean by "Comment 6".  EWH

[Bucky1584]

Thanks Dr. Hook.  Also any thoughts on my two questions in comment #6?

Thanks,

Tim

[Edward W Hook, MD]

No. EWH

[Bucky1584]

One last thought as I will be heading to the doc soon for my last test.

Can thrush slow down antibody production?

[Bucky1584]

Hi Dr. Hook,

Couple quick follow up questions just for my understanding.

1.  Can I take an at home HIV test at this point to confirm the 50 day negative I already received or would you suggest going back to my primary care physician?  Is there a big difference?

2.  Just to clarify when a person has ARS symptoms (in my case a fever at 22 days) the antibodies are produced shortly thereafter if the two were related and that is what lead you to the conclusion that my 50 day negative and fever were not related to HIV.

Thanks!!

[Edward W Hook, MD]

Glad I could help.Take care. EWH

[Bucky1584]

Thanks Dr. Hook for the advice and your service to this community.  I didn't mention that I was itchy after the fever but did not see a rash and the itchy spots seemed to be moving around.  I'm wondering if a lot of this was just based on worrying and overreacting to this situation.  I was a nervous wreck after this incident.  My head itched at times, my arms, legs, back, etc.  This experience has definitely been a learning one and I look forward to the taking my final test since we are now post 56 days and getting on with life and stop worrying.  Thanks again!!

[Edward W Hook, MD]

No, thrush due to HIV would not develop two days after a sexual exposure. EWH

[Edward W Hook, MD]

Welcome to the Forum.  the chances of getting HIV from any single sexual encounter, even with a commercial sex worker is low.  Most CSWs do not have HIV and the risk of infection if your partner did happen to be infected is less than 1 infection is 2000 exposures, on average.  Further, while not completely conclusive, a negative test 7 weeks (50 days after an exposure) is very strong evidence that you were not infected and would have detected well over 95% or recent infections.  Tests for HIV antibodies are conclusive at 8 weeks (56 days after exposure).  

What your tests so far do prove is that none of your earlier symptoms were due to HIV.  not only did they occur too soon after exposure to be the ARS (the ARS would not begin two days after an exposure) but if your symptoms had been the ARS, your test afterwards would have been positive.  

I am confident you did not get HIV form the exposure that you describe.  if you wish to have a conclusive test to prove to yourself that you were not infected, get an HIV antibody test at any time more than 8 weeks after your exposure. When the test is negative, know that the results are conclusive.

I hope this comment is helpful. Please do not worry. EWH

[Bucky1584]

Also can you comment on if thrush can develop this quickly after exposure.  

Thanks Docs!!