Confirmed Swollen Glands and HIV

I have been concerned about swollen glands in my armpit groin and neck for about a month.  My friend, who is a family practice physician confirmed that my glands were swollen in my neck and armpits..I did not have him check my groin but I know they are.  He seemed scared for me and mentioned cancer in passing.  After doing research on the web everything is leaning to HIV.  Now I am scared too.  I have had unprotected sex with 4 women in the past year.  Casusal encounters. Prior to that I was married for 5 years and monogamous.  The first encounter was about a year ago and the last was a little over a 4 months ago. I have done some reading on ARS.  The question I have is about the timing.  I see that ARS is in the 3-6 week range.  My swollen glands appeared much later like week 10 or 11.  1. In your experience ,does this seem typical for HIV?  2. Early or Late HIV?  3.  Have you seen patients with no other symptoms but overall swollen glands at this stage?  4.  Do patients with HIV maintain swollen glands for long periods throughout the disease?I have scheduled an appointment when I get back home.  Any insight would be helpful.  Thanks.

PS.  Its pretty bad when your choices are Aids or cancer.

[H. Hunter Handsfield, M.D.]

OK, taking at face value that you have generalized lymphadenopathy (enlarged lymph nodes in several anatomic areass), what is range of possibilities?  (In medical terms, 'What is the differential diagnosis?')  HIV infection is one possibility, but it is low on the list for persons with with sexual histories like yours.  Other possibilities are infectious mononucleosis ("mono"), probably the most likely cause; other mono-like illnesses (sometimes called "heterophile negative mononucleosis") such as infection with cytomegalovirus; various immunologic disorders (although usually in conjunction with other symptoms, such as arthritis); syphilis (also a long shot with your sexual history); and various malignancies, such as Hodgkin's disease, other kinds of lymphoma, and others.  (There probably are other possibilities; these are off the top of my head.)

As that list implies, you need to see a health care provider.  The odds are that you have neither HIV, cancer, nor any other serious threat to your health.  Mono or a related infection is the best bet, and if so, will clear up on its own.  But even mono has its complications and should be evaluated by a health care provider.  And you don't want to risk delayed diagnosis of the other things that are unlikely but potentialy serious.  The provider who examines you will be in a better position than me to decide what tests to do and when to do them.

So to answer your specific questions:  1) Lymphadenopathy is typical for HIV, but also for other things, and HIV is a low risk given the sexual exposures you describe.  
But you should have an HIV test.  2) If HIV, it is more likely early than late infection. 3) Most people with HIV would have symptoms in addition to lymphadenopathy.  But I don't personally see very many patients with early HIV infection, so my personal experience isn't helpful.  4) HIV-related lymphadenopathy typically resolves over a few weeks.

All of this may be smoke and mirrors.  Docs can be good friends or good health care providers, but often not both at once.  There is a powerful psychology that often leads someone providing casual health care to a friend or family member to find things that support what s/he believes or fears.  So unless your lymphadenopathy is quite dramatic (e.g., olive-size or larger lumps), it may be nothing is wrong at all.

So see your (real) health care provider as soon as practical, but stay calm in the meantime.  Good luck--

HHH, MD

[Lutheran122]

You may have neither , swollen glands can be from a lot of different issues. And ARS is almost always within the first 2 to 4 weeks or so and don't even bother to try and think of your symptoms and equate them with HIV as people get colds and sore throats all the time especially during winter and also if you keep touching your glands they may react and enlarge just from that alone. Just get tested , its the best and only real way to know. I hope you will be fine.

[unluckyoral]

I will see a dr. asap.  The woman I am seeing now has been having mono like symptoms too.  Sore throat with white spots in her throat white coating on tongue etc.  She has had them on and off for about two months. We have not had unprotected sex.

Follow up from your answers.

1. Does the 11 weeks from last exposure and lack of other symptoms at this time lead you to feel that is not likely HIV?  2.Is lymph node swelling longer than 4 weeks atypical for HIV?  3. Would there be other symptoms if it was mono?

Lutheran.  This did all start when I poked my armpit gland.  It hurt then it seemed to move to my groin then into my neck.

Thanks

[H. Hunter Handsfield, M.D.]

SS:  Eleven weeks is longer than usual for onset of HIV symptoms, but I cannot speculate further on HIV vs other diagnoses.  Mono is transmitted by kissing, so protected vs unprotected intercourse is irrelevant; and your partner's symptoms are consistent with that possibility.

WAL:  You probably can find a friend whose credit card can be charged; you can pay him/her back.  But unfortunately thread-jumps are a no-no on this forum and I deleted your message.  If you can't find a friend with a credit card, you can search the forum; answers to your exact questions are there.  Look for "HIV anxiety", "HIV transmission risk", "HIV symptoms", and "time to positive HIV test".

HHH, MD

[wwarrior]

Please keep us posted of your test results.

Take care & good luck

[welcomemark]

Any update?