hiv test, blood count, symptoms

Last June, I had a questionable encounter with another guy, involving receptive anal. We used a condom. He did not ejaculate inside me and I don't believe the condom broke. 6 weeks later,  my axillary lymph nodes began to swell. They've been swollen on and off since August. Sometimes they go back to normal for a few days, but the swelling then recurs.

I had three hiv ELISA tests done through Home Access: after 12 weeks, after 17 weeks, and after 21 weeks. They were all negative.

I also had additional blood work. A blood count showed that there was a slight elevation in eosinophils--around 8%. Everything else was normal, including the SED rate.

I know from reading your posts that symptoms do not mean much in the presence of negative HIV tests. But I still worry. Can I take the 21-week negative ELISA as conclusive and begin looking elsewhere for my recurring swollen lymph node problem? What are the odds that a 21-week negative test would turn positive in the future?

Thanks.

[H. Hunter Handsfield, M.D.]

Your multiple negative HIV tests prove without doubt that you were not infected with HIV last June.  For all practical purposes, it is not possible to catch HIV and have a negagive ELISA test after 21 weeks.  Your blood count results and symptoms, axillary nodes or anything else, are irrelevant.  You don't have HIV.

If you are convinced your axillary lymph nodes are inflamed, see a provider to confirm it and learn the cause.  It isn't HIV.

Regards--  HHH, MD

[rkeane212]

Thank you for your reply. Given your other statements in the forum that is what I expected to hear.

Just out of curiosity--and I promise that there will be no more reactions from me--what do you mean when you say that "for all practical purposes" it is not possible to catch HIV and have a negative ELISA at 21 weeks? is that simply to cover the fact that people using chemotherapy or something like that can have delayed seroconversion beyond the 21 week period?

Thanks--and a special thank you for the very useful service you provide.

[H. Hunter Handsfield, M.D.]

It only reflects the fact that there are few absolutes in biology or medicine.  In general, scientists are trained to rarely say "never" or "always" if there is a theoretical possibility.

Considering the low risk of the exposure plus the blood test result, the chance you have HIV has to be one in a billion or something like that, i.e. zero "for all practical purposes".  By contrast, the chance you'll be dead of an accident within 12 months, if you live in the US, is 1 in 1,756.  That's 600,000 times higher than 1 in a billion.  In other words, forget HIV.  And don't forget your seatbelt.

[rkeane212]

I'm sorry to bother you one last time. But I'm sure you've seen cases like me where the 1 in 1 billion chance is still not good enough--I am so scared over this. In any case, I'm going to get another Home Access test next week--at 23 weeks after exposure. Would the 23 week test meet the  "6 month" CDC guideline? Will I finally be in the clear then?

Thank you, Doctor. And, again, I'm sorry to bother you with something so petty--but the anxiety is just too much.

[H. Hunter Handsfield, M.D.]

No, I have never seen cases like yours where the chances "were not good enough".  In the history of the world, I'll be nobody ever had such a low risk exposure and then turned up with a positive HIV test after 21 weeks.  You aren't going to be the first.

Accept the reassurance.  You don't have it.  You are not welcome to continue to post any more such comments.  If you do, I will delete the entire thread without further comment or reply.