ARS symptoms

[exhausted1981]

Dr.

i have questions regarding ARS symptoms and timelines.

On December 4, 2008 i had brief unprotected vaginal sex with a CSW. I'd estimate the unprotected portion was less than 5 minutes (it started out protected). As I was highly intoxicated at the time I did not ask her about HIV or any other STD's. Exactly 6 weeks later (Jan 16, 2009) I encountered a bad flu like illness. It lasted for a solid 2 days where i ran a high fever and suffered other flu like symptoms. Recently, however, I've started to encounter many of the ARS symptoms stated on many health sites and become quite anxious to the point where symptom searching has begun to control my life. About a month after this flu like illness, starting approximately February 25, I've had night sweats, never "drenched" but definitely noticeable on the back of my neck and back of my legs. I've also developed a couple "lie bumps" on my tongue. The most distressing symptom, however, is a rash on my forehead that resembles a sunburn. It is pretty dry and painful to the touch. I've basically diagnosed myself with Seborrheic Dermatitis. i've also had a potential flare up of a case of genital warts that was diagnosed about 2 years ago. None of these symptoms were apparent during the initial flu. I should also point out that I'm circumcised. I was tested today at a health clinic and expect results in the next week. This has only increased my anxiety. To my questions:

1. Do ARS symptoms occur simultaneously or can they be drawn out like my case?
2. Is Seborrheic Dermatitis common during ARS infection?
3. Is a genital wart recurrence common during ARS infection?
4. Does history of genital warts increase chance of hiv transmission during unprotected vaginal sex?

[Edward W Hook, MD]

Before I address your specific questions, let me make a general comment about "ARS" symptoms and  your situation.  The risk of the exposure you describe is very low.  Even in the unlikely situation that your partner had HIV (most unusual), the odds of your getting HIV from a single unprotected sexual encounter are less than 1 infection per 1000 exposures.  In addition, in your searches for the cause of your symptoms you have seemed to missed our repeated statements on this site  that the symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  In addition, it is also important to realize that many persons who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.  Now on to your specific questions:

1.  Usually they occur all at the same time, not drawn out.
2.  Seborrheic dermatitis is VERY common in persons who do not have HIV and when it occurs in HIV, it is most common in persons who have long stnadig, relatively established, not recent, infection.
3.  No.  In general, genital warts recur about 20-25% of the time following initially effective treatment.
4.  No.

So, here is my advice. This is clearly on your mind.  Go get tested.,  You are now more than 6 weeks beyond the exposure of concern.  When your test comes back negative, as I am confident it will, please accept this as definitive evidence that you did not get HIV from the exposure you are concerned about.

I hope this is helpful to you.  EWH

[exhausted1981]

Dr. Hook and Dr. Hansfield

Took a rapid test today and it came up negative! I really appreciate both of your work and honestly can say your comments and advice throughout gave me the courage to move on and get tested.

Thank you