ARS, Guillain Barre and HIV

[NickM82]

On May 6 I had brief unprotected vaginal sex with a women I do not know (used a condom but lost it inside her at some point), I developed neurological problems consistent with Guillan Barre Syndrome (twitching, slight paralysis), according to a neurologist. Symptoms came on about 10 days after contact, got worse for about 14 days, then gradually started getting better.

I was feeling much better, until about 12 days ago (6 weeks after exposure), at which point I came down with a sore throat/tender neck (lymphs?) that developed into more flu-like symptoms: severe muscle soreness/fatigue, sore groin, cold sweats, nausea, loss of appetite, one small white canker inside my mouth, shedding skin from the head of my penis (I'm uncircumsized), extreme sensitivity to light (both eyes and skin), dry nose/mouth.

I got blood tested for HIV two days ago (about 8 weeks post exposure). It will take two weeks to hear back. In the meantime, the flu-like symptoms are getting worse. The nausea, sweats, and malaise are keeping me from sleeping at night. I have seen my GP who insists I have nothing to worry about; my sexual exposure is considered low risk (brief contact, maybe 5-10 seconds unprotected with a 20 year old female student).  Still, the barrage of symptoms and the timing of it all has me gravely concerned.

My question: Does this sound like any known HIV experience? HIV is known to be a cause of Guillain Barre, and obviously the other symptoms fit with ARS as well.

Thanks,

[Edward W Hook, MD]

Welcome to the Forum.  there are two questions here- are you at risk for HIV and secondly, is there an association of Guillian Barre Syndrome with HIV.  Let's deal with them separately, they try to put things together.

The exposure you describe is very, very low risk for HIV.  In the U.S. less than 1 in 10,000 heterosexual women have HIV and the risk for getting HIV from a single act of unprotected intercourse is less than 1 infection in 1000 exposure. Thus your mathematical risk of HIV is less than 1 in 10 million - far lower than your risk for getting struck by lightning or, for that matter of getting Guillian Barre syndrome.   In your case, as you note, your partner was low risk making the likelihood of infection still lower.  As for your current, flu-like illness, while such symptoms can be caused by HIV as persons develop a positive test, your timing is too late- these symptoms, when they are related to HIV occur 2-4 weeks after exposure, not more than 6 weeks afterward.  The likelihood that your current symptoms, like your overall risk for HIV is very, very low.

What about Guillian Barre and HIV.  there are a handful of cases of Guillian Barre which have occurred in person who have HIV.  In some cases this has occurred with recently acquired HIV and in others it has occurred in person with advanced infection (i.e. AIDS).   There is no solid information to suggest that the relationship is causal or more than a coincidence.

So, could it be related- unlikely.  Is testing reasonable, sure.  Should you be worried while you wait for your results, no.

BTW, for it to take 2 weeks for an HIV test result to come back seems quite excessive. In the lab the test takes just a few hours and most labs run the test regularly.  I would check this out with your doctor- there is no reason for you to be worried about this for two weeks.  EWH

[NickM82]

Thank you Dr. Hook.

I understand my risk is extremely low, mathematically speaking.  And ordinarily I wouldn't be concerned, given that I already tested neg. for other STDs at the 10 day mark.  Still, between the Guillain Barre and now these flu-like symptoms, I can't help but worry. If the HIV test comes back negative, and these symptoms persist, I may have to ask for a specialist referral.

Thank you again, I will post again if there are more concerns.