Condom break/Heavy symptoms

[terrified0878]

I recently had unprotected oral, and protected vaginal sex w/a sex worker.  The condom broke unknowingly during the vaginal sex.  I wasn't aware of the break until after I pulled out.  This happened about 3 months ago.

About 8 days later later I experienced heavy symptoms of ARS.  Fever, swollen lymph nodes, sore throat, extreme fatigue, lack of appetite, dry cough, extremely dry mouth, etc etc.  At the time I just assumed it was a nasty flu.  The symptoms persisted for approximately 10 days-2weeks.

I felt fine for about 3 weeks, and then I began to experience extreme night sweats EVERY NIGHT for the next month and a half.  Just about every night I have waken up drenched in sweat, and it continues to this very day.  

Also, I had some sort of infection in my mouth.  My tounge became very sensitive, and whenever I had eaten food I would have bumps/growths pop up on the roof of my mouth.  My tounge was very white.  Also, it became very difficult to swallow.  In fact it got so bad that I went to the ER, and the Dr. told me to see a HIV specialist after hearing my story.

I finally dragged myself to an HIV specialist to get the bad news.  He said my symptoms looked like classic acute HIV infection and the night sweats worried him heavily.  Also he said my mouth issues could have been candida(?).  

He gave me an oraquick test and it was negative.  This was a shock to me and gave me a little hope, however the Dr. didn't seem to be as pleased.  I told him "wow this is a suprise I was already in the mindset that I was positive."  And he said that I shouldn't get excited and I should stay in that mindset until I get the blood tests back.

How accurate are these oraquick tests?  I still believe I am positive, because there are no other explanations for my night sweats/oral issues and the ars symptoms I had after infection.  Do I have any chance at all?

Thanks

[Edward W Hook, MD]

Your symptoms are most likely related to some other viral infection which was not sexually acquired but acquired in the course of daily life, on the street, at work, on a bus, etc.  Many of these viruses are not routinely tested for.  See your regular doctor and he/she will likely prescribe symptomatic treatment to help you out till the infection passes (like a cold).

The odds that your body is not yet producing antibodies--ZERO


EWH

[Edward W Hook, MD]

I understand your concerns.  On the basis of the information you have provided however, I think it is almost certain that you are not HIV infected.  let's review your risks, then your test results and finally your symptoms.

Risk.  Your risk from the exposure is low.  Odds are that your partner was not HIV infected - if your exposure was in the U.S., less than 10% (probably far less and dependent on what sort of CSW she was) of commercial sex workers are HIV infected.  Then, IF SHE WAS INFECTED (unlikely), your odds of infection are about 1 in 1000 per exposure, thus, on the basis of these numbers your odds of infection are less than 1 in 10,000 (1 in 1000 X 10% chance she was infected).

Now your test results.  At 3 months (12 weeks) over 99% of infections that are going to be positive will be--strong evidence that you are not infected, particularly when you think if the odds of getting infected from your exposure.  The tests are very good and should be believed.

Now your symptoms. Indeed they are compatible with the ARS but if you study a large group of people with symptoms of ARS, most of them are due to other, community acquired viral infections (not sexually transmitted-most are respiratory tract infections).  In fact only 1-3 of them will be found to have HIV.  Putting this in context with your test results and risks, there is likely to be another cause of your symptoms.

Finally, the doctor's advice.  His job is to be conservative.   He is right, to be sure you should wait for the blood tests.  My job is to put things into context.  Based on the information you've provided, your blood tests will be negative.  You can relax and look forward to them as confirmation that you are not infected, not that you are.  Hope this helps.  Please let us know of your blood test results when they come back.  EWH

[terrified0878]

I am very aware of the low risk nature of my exposure.  Unfortunately, with all these symptoms it appears I was the "unlucky" one so to say.  My Dr. also told me that in his 10 yrs as a HIV specialist he had never seen anyone contract HIV from one low risk exposure such as this.  However, he also said it was certainly a possibility.

Could you give me any other possible medical explanations for my symptoms?  (both the early ones and the persistent night sweats/oral infection I had)

My Dr. went through a couple scenarios, although he seemed kind of unsure about them...probably why he didn't seem very optimistic even after my negative oraquick.

Are these oraquick exams very accurate and are there many times when they fail for various reasons?  Could it be possible I obtained a strain that wasn't detectable by the oraquick?  (sorry if this is a silly question)

To be completely frank I am fairly certain I am HIV +.  There are just too many telltale signs imo.    The thing I am most worried about at this point is having a Hep C co-infection.  I know there are great HIV drugs currently avail and in the pipeline,  but w/ Hep C co-infection the future looks very bleak.....I hope I didn't get unlucky in another way.

[Naseeb]

Following study suggests that OraQuick has sensitivity of almost 100%.

http://www.hivtestingconference.org/hivtesting2005/PA15.htm

According to their manual, their accuracy is 99.6%.

http://www.dhmh.state.md.us/AIDS/ProviderResources/CTR/OraQuick%20Self%20Assessment%201-05.pdf

It is FDA approved.

Trust in Doctor's judgement and in God. Your results were accurate.

[terrified0878]

My Dr. just called me and informed me that all my tests were negative!!!!!!!!!!!!!!!  He took blood for the HIV, viral load, cd4 and other things.  He said everything checked out great!!!

WOW WHAT A FEELING

The questions I still have for you are:

What could my symptoms be related to?  Specifically the night sweats that are continuing and the oral issues I was having.

Also, what are the odds that my body just isn't producing antibodies yet?  It has been 91 days since the possible exposure.  

Thanks!

[joggen]

You are CONCLUSIVELY negative because 1. you are beyond the 3 month window period 2. they did a viral load (PCR) test, which would have picked up this virus even if somehow you weren't producing antibodies

[Edward W Hook, MD]

The odds of you being HIV infected from the exposure you describe are ZERO!

As for your persistent symptoms- you need to work with your doctor on that.  The evaluation should be guided by your doctor's physical examination of you and are beyond the scope of this forum  there will be no further discussion of your concerns here.  To do so whould fuel what is clearly becoming pathologic anxiety. EWH

[AZ69]

I thought ARS Night sweats are only due to high fever breaking during the night. So why the HIV specialist was so worried about "Terrified" sweats?