Very worried, your thoughts

Hi Doc, let me start by giving you my sexual risks/behavior.  I am a heterosexual male.  I have unprotected sex 6 times within the past 5 years.  All of which were pretty much one night stands.  Very stupid, I know.  I really havent been sick within the past 5 years until now so I never been tested before.  My most recent episode with unprotected sex was on 3/12. Prior to that, it was in August of '05.  All encounters were minimal in time, ranging from 5-10 minutes within the vagina.  So let me get to whats freaking me out.  The last exposure/risk, which was on 3/12, I came down with flu like symptoms on 3/15, a possible fever (never checked), soar throat (with flegm), tiredness, dizziness, night sweats.  I kicked those symptoms to the side within 3-5 days but I sustained the fatigue and drowsiness.  I went to the doc and was diagnosed with a sinus infection.  I went on Antibiotics for 17 days, with no results, then went on a stronger dose with nasal spray and three days in, my head was clear.  My doc also took a normal blood test and checked for a thyroid problem but everything came back in normal fashion.  But I have still retained the fatigue.  Mostly, my legs dont feel under me.  I go to work and Im not tired there but its when I walk, I know Im not a 100%.  And just recently, I experienced 4 nights of consecutive night sweats, basically, a month later after the flu like symptoms, which has really freaked me out.  And I think there is small lymph node swelling in my right groin area, not too big.  Cant feel any enlargements under the armpits, behind the ear, or in the neck regarding lymph nodes.  I cant sleep, probably because Im worried beyond belief since Im getting my test back this coming week.  These are my symptoms and I would very much like your opinion.  And any other thoughts of what this might be other than a possible HIV infection.  Any other information you need from me, please ask.  Thanks.

[H. Hunter Handsfield, M.D.]

Sounds like you caught a cold, perhaps from your sex partner.  (Anybody close enough to have sex with someone is plenty close to catch a garden variety respiratory infection.)  HIV infection doesn't cause stuffy nose or sore thhroat with phlegm; symptoms never start in less than 7-10 days.  Fatigue, fever and night sweats can result from HIV, but much more often they are caused by otther things.  Add this to the rarity of HIV transmission by any single heterosexual exposure, plus the low likelihood your most recent partner had HIV, and the odds you are infected probably are no higher than 1 in a million.

The almost certainly negative HIV test result will tell the story.  Your provider might recommend another test ~3 months after exposure, but a negative test at 4-5 weeks is over 90% sensitive.   Any number of viruses or non-infectious inflammatory events could explain your symptoms--almost all of them non-serious.  Mononucleosis sounds possible, but that's only speculation.  The odds are you will never know for sure, because testing for all the potential causes isn't cost effective (and the specific causes simply are often unknown).

Bottom line:  Relax; await your test results; follow your provider's advice; and start using condoms for those future one-night stands!

Good luck--  HHH, MD

[redskin786]

Thanks for the quick response doc...I also had another question...Ive been feeling these muscle twitches all over my body recently for the past week...it feels weird but whats causing that to happen?  And if rashes appear on my body, what stage of HIV/AIDS does that happen in, if it were to happen at all?  Also, regarding a normal blood test, what indications, if there are any, can there be that HIV was present within the results given back?  Like if the White Cell count was low/high, CBC was low or high, etc...I had a normal blood test, so that is why Im asking...thanks again doc.

[H. Hunter Handsfield, M.D.]

In comparison with the blood test, all symptoms are irrelevant in assessing the likelihood of HIV infection.  The additional information doesn't change my opinion or advice.

HHH, MD

[redskin786]

Im sorry for asking a couple more questions doc but please let me know when you can on...

1)  Is it possible that I caught a real flu and kicked the flu symptoms away and then caught the ARS symptoms 7-10 days later?  So, my last risk was 3/12, caught the flu on 3/15 (which I did or it seems) from natural causes, and then ARS symptoms came into play...like fatigue...and a month later, night sweats and swollen lymph nodes?

2) I read somewhere that intermittent night sweats are a result of most likely a HIV infection.  Is that statement true?

3) Also, I dont believe that all my lymph nodes are swollen, only in my groin...do all relevant locations need to be swollen?  Like neck, ears, and armpits?

Thanks Doc, Im really nervous right now.

[H. Hunter Handsfield, M.D.]

1) Is it possible?  Yes, of course.  Is it probable?  No.  Do I think it happened to you?  No.

2) Night sweats are not a particularly common symptom of HIV.  They occur with any health problem that causes fever.  Night sweats by themselves, with no other symptoms, never are due to HIV.

3) Personal assessment of one's own lymph nodes is totally unreliable.  If a health care provider has diagnosed lymphadenopathy (enlarged lymph nodes), I will believe it.  Until then, I assume you don't have it.  When lymphadenopathy is due to HIV, it generally involves lymph nodes all over the body, not just in one or two locations.

Almost certainly you do not have HIV.  To repeat my original advice:  "Relax; await your test results; follow your provider's advice; and start using condoms for those future one-night stands!"  And from my second reply:  "In comparison with the blood test, all symptoms are irrelevant in assessing the likelihood of HIV infection. The additional information doesn't change my opinion or advice."  

This is my last response on this thread.

HHH, MD

[HHH,MD]

Do you somehow think I would have a different opinion when you asked the same question in the STD Forum?  And as a thread jump??  

HHH, MD

[detricja]

I JUST WANTED TO GIVE SOME ADVICE FOR ALL OF THOSE WHO ARE WORRIED ABOUT HIV SIGNS AND SYMPTOMS. THE ONLY WAT TO KNOW IS TO GET TESTED!!!!!!!SYMPTOMS CAN INDICATE SO MANY OTHER THINGS BESIDES HIV.I HAVE ORAL HAIRY LUEKAPLAKIA, AND I AM HIV NEGATIVE, SO IT IS NOT ONLY A SYPMTOM OF HIV, MORE RESEARCH NEEDS TO BE DONE ON OHL. WHEN I FIRST NOTICED THE OHL ON MY TONGUE, I THEN FELT ALL THESE OTHER "SYMPTOMS" COME ON TO ME, NIGHT SWEATS, TINGLING SENSATIONS IN MY EXTREMITIES, AND OTHER VARIOUS THINGS ASSOCIATED WITH AN HIV INFECTION. YOUR MIND CAN PLAY TERRIBLE TRICKS ON YOU AND HAVE YOU DIAGNOSING YOURSELF BEFORE YOU EVEN TAKE AND HIV TEST.GET TESTED, ITS THE ONLY WAY TO KONW!!!!!!!!