HIV Fears and Conflicting Info on Web - Need Expert Opinion

[scrdind]

I've had one night stand back in September on a drunken night and have been pretty stressed over it since I have no way of contacting her since.  Over that same month, I've had a tooth abscess which I found to be possibly due to a weakened immune system.  I was given some antibiotics and shortly got thrush.  I looked it up and found that thrush could've been caused by the antibiotic, but of course I first read that it was also possible that this was also one of the symptoms during initial exposure to HIV (including link below).

http://emedicine.medscape.com/article/211873-overview

I then found an article on your site later with conflicting info that this may not occur for possibly years after infection:

http://www.medhelp.org/posts/HIV-Prevention/Brown-tongue-HIV/show/748951

With both a tooth abscess, something I don't think I've gotten before, and thrush shortly after all within the acute period, I'm really concerned, especially after reading the first link I posted above.  When coincidences occur, tend to lean towards the worst case scenario.  

I'm shy of the 3 month period so haven't gotten tested yet but I plan on it but until then, I'm pretty stressed out and have been for quite a while now.  Can you please tell me whether or not my fears are warranted?

Thanks in advance for any info you can provide and I am really thankful that this site as a resource is around.

BTW, I posted this question in the public forums twice when attempting to post here, I apologize for that.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  There's no problem in posting your question in both this and the HIV community forum.

First, you have misinterpreted the emedicine article whose link you provide.  "Early symptomatic infection" does not mean the acute retroviral syndrome (ARS), i.e. symptoms associated with initial HIV.  It means symptoms in people who have been infected a long time and then start to develop symptoms of immune deficiency, before progressing to overt  AIDS.  Dr. Hook's information in the MedHelp thread you cite is accurate:  oral yeast infection (thrush) is not a common sign of ARS.  Second, you had an obvious predisposing factor to an oral yeast infection.  Third, as Dr. Hook said in the other thread, the large majority of oral thrush occurs in people without HIV or other causes of immune deficiency.  (I once had it myself.)

And I don't know where you heard that a dental abscess might be evidence of an HIV infection.  It certainly is not.  (Of course almost all infections occur more often in people with advanced HIV infection.  But not with acute/recent HIV infection; and of course the vast majority of the millions of dental abscesses that occur each year in the US do not happen in HIV infected people.

And in any case, the chance you caught HIV from a single episode of vaginal sex is extremely low.  Heterosexually transmitted HIV remains rare in the US and most industrialized countries, except in special circumstances.

But since you're worried, just have an HIV test.  All people who are sexually active outside mutually monogamous relationships ought to have an HIV test from time to time, like every 1-2 years.  If you haven't been tested recently, do it now -- but not because of this particular exposure and not because of your symptoms.  Assuming you haven't had any truly high risk exposures, you can expect a negative test result.  (While you're at it, have a urine test for gonorrhea and chlamydia and a syphlis blood test.)

In the meantime, stay mellow.  It is exceedingly unlikely you have HIV.

I hope this helps.  Regards--  HHH, MD

[H. Hunter Handsfield, M.D.]

Negative.  Apparently not a duo test, but as long as it was done 6 weeks or more after the september exposure, it's definitive.

[scrdind]

Hi Dr. Handsfield, I haven't written back since we first communicated to prevent being repetitive and annoying out of fears and thought it would be pointless until I got tested anyways.

I got the test online, which doesn't provide me with a doctor to speak with about results.  At this point, I'm a week shy of the 3 month mark (although I completely believe what you said about time passed for accuracy, this is just to stop me from thinking bout it again at a later time out of paranoia).  

I did ask about "DUO" / "COMBO" test as you suggested but the opearator didn't appear to understand so this is just the antibody test.  Would you say that this is conclusive and no other tests are required even though I didn't get the test for the p24 antigen?  I've retyped the results below, hope the formatting comes out ok


======================================================
TESTS                                  RESULT             REFERENCE INTERVAL
======================================================
Panel 083824 HIV1/0/2 Test Results

HIV 1/0/2 Abs-ICMA
HIV 1/0/2 Abs-index value    <1.00                  <1.00
          index value: specimen reactivity relative to the negative cutoff
HIV 1/0/2 Abs, QUAL          non reactive        non reactive

[H. Hunter Handsfield, M.D.]

The most commonly cited risks for transmission, if the vaginal or anal partner has HIV, are averages of once for every 2,000 vaginal sex events and 1 in 500 for anal.

Don't assume annual STD testing includes HIV. Usually it would, but it's best to ask to be certain.

The standard HIV antibody tests are virtually 100% accurate any time more than 6 weeks after exposure, even though official advice cites 3 months.  For even greater security, ask for a "combo" or "duo" test, which includes both HIV antibody and a test for p24 antigen.  This test is 100% reliable any time after 4 weeks since exposure.

[scrdind]

You don't know how those clarifications put my mind at ease in regards to that article from emedicine!  Guess I had a huge case of hypochondria brought on by fear, the all knowing interweb and my ignorance =).  If you were in the area I'd take you out for a few beers now!

I have some more questions for you if its OK.

With unprotected vaginal sex, do you know of any statistics with what chances are for getting HIV from an HIV or AIDS infected person?  Are chances higher to contract the virus through anal sex vs vaginal?

I will definitely get tested (normally get tested for STDs anually which I would assume would also test for HIV).  Do you have a recommendation for specific tests I should get that would put all my fears, 100%, to rest?  Question is for tests I can take anually and within 2 months (to relieve my current fear) of possible contact that after finding out results, won't need to take a follow-up test to ensure their accuracy.

Just want to get all the information from you so I don't start searching online and stumble onto something that would get me worked up again :)