possible ARS

[andresgirl]

Hi there,
I posted this on patient-to-patient forum yesterday, but wanted an opinion from a doctor.  I was sexually assaulted 9 months ago.  The HIV status of my assailant is unknown.  The night of my assualt, I went to the ER and they did a rapid HIV test there, but i've heard that's not accurate unless i had HIV antibodies prior to assault.  Anyway, last tuesday is when i started getting sick..it began with a rash that started on my feet and spread to rest of legs and arms and a little on my back.  I also had muscle aches and my temp. fluctuated between 99.8 and 101.4 degrees for a few days.  I went to the hospital and the doc there told me I had erythremia mutliforme(sp?) and the rash was caused by simply a "viral infection," that he didn't know exactly what it was.  I started reading online about ARS and the rash thing scared me. what does ARS rash look like?  Can you develop ARS 9 months after possible exposure?  I'm also a clinical social worker and work primarily with cihldren, so it may be more likely i picked up a bug from one of them.  I made an appt. with my doc for an hiv test tomorrow, just to put my mind at ease (should've had one awhile ago).  Also, i'm already feeling better and rash started to go away a few days ago.  I just want to know what your thoughts are.  Thanks in advance.

[H. Hunter Handsfield, M.D.]

Since the event you are concerend about occurred 9  months ago, if you acquired HIV, an HIV blood test wouild be positive.  You are right in getting another test.  It is useless and unnecessarily anxiety-provoking to try to figure out any other way whether or not you might be infected, and judging symptoms is the worst of all ways.

Erythema multiforme is a pretty classical rash and that diagnosis probably is reliable, especially if your provider is experienced in recognizing it, and it would not usually be confused with the rash associated with ARS.  And as you say, 9 months is much too late for ARS anyway.

But a word of caution (and not to alarm you):  It is correct that a viral infection is the usual trigger of EM, but what your provider apparently didn't tell you is that the virus most commonly responsible is herpes simplex virus (HSV) type 1 or 2.  EM sometimes is the first evidence someone has genital herpes, and every person with new EM should be tested for HSV infection.  Absence of recognized herpes (genital or oral sores) doesn't rule it out; the initial HSV infection can be asymptomatic and still trigger EM.  Other viruses certainly can do it as well (but HIV is unlikely).  When you have your HIV test, consider asking your provider to also do a type specific HSV blood test.

Best wishes--  HHH, MD

[andresgirl]

thanks for your response.  deep down i know i am probably ok...the rash thing concerned me though and i wanted to know from the doc what an ARS rash looks like.  Anyway, i'm also sorry you had the experience that you had.  I know it's scary to get tested, but I already feel better and I just made the appt.  I think if you got tested, you could put your mind at ease and stop all the "what if(s)" that you keep thinking, which is enough to drive anyone crazy.  Have you had some counseling after your experience?  I went briefly to a sexual assault counselor and it helped me alot.  Just a suggestion...even if you're not sure you were assaulted,since you can't remember the night in question, it might help you a little bit, and a counselor ( a good one anyway) won't think you're crazy or stupid for going.  Best wishes to you.

[andresgirl]

Thanks for the info. doc!  I am of course freaked by the thought of having HSV, but i suppose that's better than HIV...at least to me it is. I will request an HSV blood test be done tomorrow as well.

[tnx4listening]

I just wanted to say that I will be praying for you, and that I am going through some very similar concerns.  I have read on this forum that a one time exposure has a 1/2000 chance of getting infected even if the person has HIV.  Those odds are very reassuring.  And, the chance the person who assaulted you had Hiv was also probably low.  My exposure was that I am not entirely sure what happened that night because I had too much to drink.  I don't know if he could have raped me while I was passed out, but I woke up with only my underwear on.  It has been 3 years ago, and I am so afraid to get tested.  I know that your test results will be fine, and you will be so relieved.  I hope I can gain enough courage to make an appointment for my test.  I am married, and worried sick about the what ifs.  It is literally consuming my mind.