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Help! In a panic!
Hi, I'm a male who has sex with men, and I have an HIV-related concern. My last negative HIV test was on 4/7/08, which was 45 days after an unprotected encounter with another guy who I know fairly well and who claims to be HIV-. (I was both the penetrative and receptive partner then - i.e., we switched.) I had sex with him again around 4/3/08, and this time we briefly did the same thing without a condom before we realized it was stupid and stopped. On both occasions, nobody came inside of anyone, although there obviously could have been pre-*** exposure for whoever was on bottom at the moment.
Other than that, my only unprotected encounters have been oral sex, and I've not allowed anyone to ejaculate into my mouth.
On 5/2/08, about four weeks after my last brief unprotected encounter with the guy, I developed a fever, ranging anywhere between about 99.5 and 101.8, a fever that has continued for a week. I also have had slightly swollen lymph nodes in the neck and groin (which I get whenever I have a cold), fatigue, and night sweats (which I always get with fever). I also have a lot of nasal congestion and drip down the back of my throat, something that I don't think is common with ARS. A little bit of nausea and loss of appetite, but no vomiting or diarrhea. Some very slight muscle pain, some very, very slight sore throat. And lots of fatigue - I just feel tired all the time, although it doesn't keep me from getting my work done each day. And maybe a small rash with reddish dots about the size of the head of a pin on my upper right arm, basically on top of the bicep. But nothing too noticeable.
I went to the doctor today and had them run a CBC, and it revealed thrombocytenia (low red blood platelets) and lymphocytosis (high lymphocyte counts). The first is consistent with ARS, while the second is not so common - more common to see lymphocytes drop in ARS, not go up. The doctor said that a mono test came back negative, but that mono tests often take up to two weeks after symptoms start to become positive, but that the CBC results were consistent with either mono or CMV, and not as much with HIV. Still, I am debating doing a (very expensive) viral load RNA test just for my peace of mind.
I know no one can diagnose HIV based on the symptoms I am describing and that it's quite likely I have something else, but I thought I'd look for some reassurance on here. Or if I have real reason for concern, that would be good to know too. I don't know much about interpreting the CBC results, but the doctor said it's clear that whatever I have is viral, which I kinda knew already.
Based on the high lymphocytes and congested nose with lots of drip down my throat, along with some sinus pressure, I'm inclined to think it's not ARS. But there is still the low red platelets, the fever that has lasted about a week, and slightly swollen lymph nodes, and the slight rash on my upper arm (although I know ARS rash is usually face, neck, and torso). But if anyone here has any ideas, I'd appreciate it.
I'm taking anti-anxiety medication but find it hard to function due to my paranoia. So let me know - does it look like I'm totally screwed.
Other than that, my only unprotected encounters have been oral sex, and I've not allowed anyone to ejaculate into my mouth.
On 5/2/08, about four weeks after my last brief unprotected encounter with the guy, I developed a fever, ranging anywhere between about 99.5 and 101.8, a fever that has continued for a week. I also have had slightly swollen lymph nodes in the neck and groin (which I get whenever I have a cold), fatigue, and night sweats (which I always get with fever). I also have a lot of nasal congestion and drip down the back of my throat, something that I don't think is common with ARS. A little bit of nausea and loss of appetite, but no vomiting or diarrhea. Some very slight muscle pain, some very, very slight sore throat. And lots of fatigue - I just feel tired all the time, although it doesn't keep me from getting my work done each day. And maybe a small rash with reddish dots about the size of the head of a pin on my upper right arm, basically on top of the bicep. But nothing too noticeable.
I went to the doctor today and had them run a CBC, and it revealed thrombocytenia (low red blood platelets) and lymphocytosis (high lymphocyte counts). The first is consistent with ARS, while the second is not so common - more common to see lymphocytes drop in ARS, not go up. The doctor said that a mono test came back negative, but that mono tests often take up to two weeks after symptoms start to become positive, but that the CBC results were consistent with either mono or CMV, and not as much with HIV. Still, I am debating doing a (very expensive) viral load RNA test just for my peace of mind.
I know no one can diagnose HIV based on the symptoms I am describing and that it's quite likely I have something else, but I thought I'd look for some reassurance on here. Or if I have real reason for concern, that would be good to know too. I don't know much about interpreting the CBC results, but the doctor said it's clear that whatever I have is viral, which I kinda knew already.
Based on the high lymphocytes and congested nose with lots of drip down my throat, along with some sinus pressure, I'm inclined to think it's not ARS. But there is still the low red platelets, the fever that has lasted about a week, and slightly swollen lymph nodes, and the slight rash on my upper arm (although I know ARS rash is usually face, neck, and torso). But if anyone here has any ideas, I'd appreciate it.
I'm taking anti-anxiety medication but find it hard to function due to my paranoia. So let me know - does it look like I'm totally screwed.
sad ... VERY sad, Teak. I can relate, and all I can say is that you shouldn't allow your ego to take over here.
Giving out false information is worse. By the way PCR tests are known to give false positive results
I think it's sad that you've allowed your ego to become so involved in this. I don't think you're serving ANYONE with this kind of attitude.
What you think and what is fact is two different things. Go post your PCR BS in the doctors forum and see what they tell you.
Very good point, Teak - that is a direct quote from me. However, I keep repeating that this "in the clear" should be followed up with the 12 week. And yes, I'm convinced that a 28 day neg and undetectable on both are conclusive ... and yet, I'd say to confirm what has already been confirmed at 12 weeks. Let's not split hairs here - we're both knowledgeable about HIV - and I certainly hope our goal is the same: for people to play safe and to test after a risky encounter. The rest is all gravy, my friend - I'm not going to change your mind, and you aren't going to change mine.
Go reread your posts you did not say get a conclusive test result at 12 weeks.
Regarding the combined Elisa with an PCR RNA test ... if it's negative AND non-detectable at four weeks (I'd even say three weeks, and probably even two weeks) then you're in the clear. The PCR is one of THE most sensitive tests in science - in fact, it's SO sensitive that it sometimes will give false negative
Regarding the combined Elisa with an PCR RNA test ... if it's negative AND non-detectable at four weeks (I'd even say three weeks, and probably even two weeks) then you're in the clear. The PCR is one of THE most sensitive tests in science - in fact, it's SO sensitive that it sometimes will give false negative
Again, I tend to agree with Teak that oral sex is only a risk in theory. But, Teak, you're all over the place when it comes to providing factual information - and it all seems to boil down to what YOU'RE comfortable with - what resonates with YOU, as opposed to scientific facts and evidence. I just sense another agenda here - and not one which is dealing with HIV transmission, testing, and infection facts.
I've seen it SO many times before - pure manipulation: You'll report me, and then if other people see truth in what I'm saying, you'll "huff and puff" and leave the forum (to get everyone to post how great you are), or something to the effect. Why go there? Heck, ALL of us get caught up in our egos and backed up into a corner. I can relate to that. However, why not just put it all down? Why become agitated or hostile when we can just as well "agree to disagree".
The gold standard 12 week Elisa should be taken by everyone who has had a risky exposure. We ALL agree on that. However, we disagree on tests, which I believe, can give a TRUE result in four weeks. As for me, I've been through the emotional ringer when it comes to certain risky episodes. And, even though I was told I was definitely negative after a 28 day Elisa and viral load, I still followed up with my 3 month Elisa ... just to put the cherry on top of the sundae.
Again, if I was telling people to get an Elisa at 28 days and that's it, I would agree with you that my advice would be incorrect and even dangerous. However, my stance is to get the Elisa and PCR done at 28 days and then follow up with the 12 week (just to confirm what was already confirmed).
I've seen it SO many times before - pure manipulation: You'll report me, and then if other people see truth in what I'm saying, you'll "huff and puff" and leave the forum (to get everyone to post how great you are), or something to the effect. Why go there? Heck, ALL of us get caught up in our egos and backed up into a corner. I can relate to that. However, why not just put it all down? Why become agitated or hostile when we can just as well "agree to disagree".
The gold standard 12 week Elisa should be taken by everyone who has had a risky exposure. We ALL agree on that. However, we disagree on tests, which I believe, can give a TRUE result in four weeks. As for me, I've been through the emotional ringer when it comes to certain risky episodes. And, even though I was told I was definitely negative after a 28 day Elisa and viral load, I still followed up with my 3 month Elisa ... just to put the cherry on top of the sundae.
Again, if I was telling people to get an Elisa at 28 days and that's it, I would agree with you that my advice would be incorrect and even dangerous. However, my stance is to get the Elisa and PCR done at 28 days and then follow up with the 12 week (just to confirm what was already confirmed).
So when the CDC says that oral sex is a risk (however minimal) you disagree with them. When they say that the viral load spikes in the first weeks after infection, you disagree. Yet you use their teaching materials and cite them as an authority here, when you feel they support whatever point of view you want to advance. I'm not trying to start a fight, but that seems terribly inconsistent to me.
No that is not what it said at all. There was no verified documentation that those that did turn positive was from oral sex. Their truthfulness about there risks were questionable.
But you know as well as I do about the study in San Francisco that showed that 8 out of 102 recently infected gay men in San Francisco had gotten it from oral sex, sometimes without ejaculation. The study was criticized for the small sample siz
That's what receptive oral is, when you're receiving something in your mouth. e, but there are certainly documented cases of people getting HIV from sucking a guy. The risk is tiny, but if it's 1/10,000 or 1/5,000 or whatever the doctors on the doctors forum say, that's still some sort of risk. Obviously, it's not a risk to really worry about, since your chances of getting in a car crash and dying this year are probably far higher.
Insertive oral sex, when someone is sucking you or (if you're a woman) eating you out - that's not a risk, unless you have open sores on your penis or something and the person servicing you had blood in their mouth, or something totally bizarre like that, which has probably never happened.
That's what receptive oral is, when you're receiving something in your mouth. e, but there are certainly documented cases of people getting HIV from sucking a guy. The risk is tiny, but if it's 1/10,000 or 1/5,000 or whatever the doctors on the doctors forum say, that's still some sort of risk. Obviously, it's not a risk to really worry about, since your chances of getting in a car crash and dying this year are probably far higher.
Insertive oral sex, when someone is sucking you or (if you're a woman) eating you out - that's not a risk, unless you have open sores on your penis or something and the person servicing you had blood in their mouth, or something totally bizarre like that, which has probably never happened.
I agree with you - yet, the CDC claims that giving head is a risk. I've seen the feedback you give on this forum which states that performing oral sex on an HIV positive person is not a risk. And again, I think it's sound feedback you're giving ... however, it is NOT in accordance with the CDC.
Teak, I don't want to argue this - especially if there's no end in sight. I commend what you're doing - you're fighting the good fight. However, in this case - and in line with this thread - lookin4answers is not infected with HIV. He's wise to follow-up with the 12 week Elisa, but it will confirm what he already knows.
Teak, I don't want to argue this - especially if there's no end in sight. I commend what you're doing - you're fighting the good fight. However, in this case - and in line with this thread - lookin4answers is not infected with HIV. He's wise to follow-up with the 12 week Elisa, but it will confirm what he already knows.
Receptive oral sex is not a risk, nor going down on a woman is a risk. If you would have read the studies that was done by the CDC and USFC you would know that information. The studies on discordant couples shows not one of the couple turn positive when using condoms for anal and vaginal sex and unprotected oral sex.
I get what you're saying, but from what I understand, the viral load stays high all during primary infection UP UNTIL ANTIBODIES DEVELOP AND THE VIRAL LOAD CORRESPONDINGLY BEGINS TO GO DOWN. Thus, a negative PCR RNA test at 4 weeks combined with a negative antibody test at 6 weeks would be a good indicator that someone (me, in this case) is not infected. Subsequent testing at 3 months would still be advisable, in my opinion, to confirm this, and that's what I plan on doing.
Oh, the SAME CDC that says oral sex is a risk? Again, I don't mean to be confrontational, but you are contradicting yourself.
There is a big difference between early HIV infection and being infected for 4 to 8 weeks. When the viral load starts to increase it means that your body is getting over whelmed with the infection and cannot no longer control it. That doesn't happen in the early stages of infection and by the way I get my training manuals from the CDC.
Very true. If you don't have a detectable viral load within 4 weeks (many say 72 hours, but let's play it safe), you don't have HIV.
So you know more than the CDC and everyone else who claims that viral load is highest at the earliest stages of infection? Viral load is through the roof in the beginning. It then drops rapidly once antibodies are produced. As the disease progresses, without medication, the viral load will go up again. Your viral load is undetectable, presumably, because you are on anti-retroviral medication.
Being infected and teaching the classes, while providing valuable life experience, do not mean that you know what you're talking about when you say that viral load is low in the beginning. If you're telling people in your classes this, I'd be interested to find out what teaching material you're using that tells you that viral load is low during primary HIV infection. That is, what sources are you using, beyond your own personal opinions and own undetectable viral load, for these assertions? I'm not asking how you know this. I'm asking specifically what your sources of information are. I provided a citation from The Body. I could provide hundreds more saying that viral load is incredibly high during primary HIV infection.
Being infected and teaching the classes, while providing valuable life experience, do not mean that you know what you're talking about when you say that viral load is low in the beginning. If you're telling people in your classes this, I'd be interested to find out what teaching material you're using that tells you that viral load is low during primary HIV infection. That is, what sources are you using, beyond your own personal opinions and own undetectable viral load, for these assertions? I'm not asking how you know this. I'm asking specifically what your sources of information are. I provided a citation from The Body. I could provide hundreds more saying that viral load is incredibly high during primary HIV infection.
Not true, Teak. During primary infection, it is a fact that the viral load is at one it's highest points (until one actually has AIDS). Primary infection is the time when one is most likely to transmit the virus. If you've been teaching this for 15 years, then surely you already know this.
Where do I get my information. 1. I've been infected with HIV for 23 years and 2. I've been teaching classes on HIV for 15 years. When one is first infected with HIV they don't have VL. A high VL is later with infection.
Wow, I didn't mean to start the debate of the century with this.
I don't know where you're getting your information that people don't have a high viral load immediately after infection. Most people immediately after infection have an absolutely massive viral load, in the hundreds of thousands, or even millions. Why? Because the body has not developed any antibodies to fight the virus. You can read this anywhere online, and any doctor will tell you this. Anyone who is in primary infection and experiencing ARS symptoms will have a viral load through the roof.
From the article on the issue from The Body, which I think is a fairly good site.
"Primary HIV Infection
By Dr. Shireesha Dhanireddy
Winter 2002/2003
Primary HIV infection (PHI) refers to the period of time immediately after initial infection, which is characterized by a prolific phase in viral replication (sometimes up to one million copies of virus) and an acute drop in the CD4 count. However, the HIV antibody is negative, because it has not yet had time to develop. (It usually takes 1-3 months for detectable levels of antibody to HIV to develop.) Identifying individuals during this initial phase of infection is important not only to the newly infected person, but to the community as well."
The way I understand that, "prolific phase in viral replication" means that one has an enormous viral load during this period. The fact that you have an undetectable viral load has nothing to do with the matter, as progression to AIDS is determined by the CD4 T-cell count falling below 200 and not by the amount of virus in the blood.
If I become the first person to test positive for antibodies after a negative PCR RNA test at 30 days, a negative antibody test at 34 days, and a negative antibody test at 41 days, I'll be sure to let you all know. I don't think it will happen, but, hey, there's a first time for everything.
I don't know where you're getting your information that people don't have a high viral load immediately after infection. Most people immediately after infection have an absolutely massive viral load, in the hundreds of thousands, or even millions. Why? Because the body has not developed any antibodies to fight the virus. You can read this anywhere online, and any doctor will tell you this. Anyone who is in primary infection and experiencing ARS symptoms will have a viral load through the roof.
From the article on the issue from The Body, which I think is a fairly good site.
"Primary HIV Infection
By Dr. Shireesha Dhanireddy
Winter 2002/2003
Primary HIV infection (PHI) refers to the period of time immediately after initial infection, which is characterized by a prolific phase in viral replication (sometimes up to one million copies of virus) and an acute drop in the CD4 count. However, the HIV antibody is negative, because it has not yet had time to develop. (It usually takes 1-3 months for detectable levels of antibody to HIV to develop.) Identifying individuals during this initial phase of infection is important not only to the newly infected person, but to the community as well."
The way I understand that, "prolific phase in viral replication" means that one has an enormous viral load during this period. The fact that you have an undetectable viral load has nothing to do with the matter, as progression to AIDS is determined by the CD4 T-cell count falling below 200 and not by the amount of virus in the blood.
If I become the first person to test positive for antibodies after a negative PCR RNA test at 30 days, a negative antibody test at 34 days, and a negative antibody test at 41 days, I'll be sure to let you all know. I don't think it will happen, but, hey, there's a first time for everything.
Teak - I find it interesting that you’re willing to say that oral sex carries NO risk, while most HIV specialists would actually say that, in theory, it could happen. Not to say I disagree with your stance; but it is nevertheless, a rather bold assertion on your behalf. However, when another bold assertion is made; in this case by me ... it doesn’t seem to fit with what you deem as stamped “official” or approved. I’m just pointing out an inconsistency with your line of reasoning; although, again, I do agree with you that oral sex isn’t a risk. Would you mind responding to this?
I hear you, my friend. And again, I don't disagree in regards to the gold standard at 12 weeks post exposure. But, as you know, since HIV has SO many variables which feed the "gray area" (a window period, questions on transmission, politics which make the CDC and the facts world's apart, etc) ... it therefore allows for the "perfect storm", if you will, for those who obsess after a risky encounter. With that said, I think it's wise for someone who has the financial means to get BOTH tests performed at 28 days. I mean, two extra months of pure worry and h e l l may be a mere blip on the space-time continuum, but it is an eternity for someone who's in the window period.
Viral load? Most people with early HIV infections don't even have a VL. I have AIDS and I have an undectable VL. So VL testing is not the route to take. It is used to monitor those that are positive. The only time a PCR test is approved for diagnostic is for infants up to 15 months of age.
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