Negative at 5 and 6 weeks. Should i worry?

[anonymous741]

Hi Doctor, I had protected vaginal sex and unprotected oral sex (cunnilingus) with a female of unknown HIV status. It was winter and i had dry chapped lips. The condom did not break during the vaginal sex. At 5 weeks i was down with sore throat and cold and went and got tested . The HIV test was negative. The sore throat lasted for a week. I read on the internet that todays test are almost 100 % accurate after 6 weeks. So i went and got tested at the 6 week mark and i was HIV negative. However after 7 weeks, i developed a sore throat again. It started as a lump in my throat and moved up the throat. I have no other symptoms like cold, fever etc.
1) What are the HIV transmission risks from the exposure i described?
2) Could ARS start at 5-7 weeks after exposure?
3) Is sore throat, without any other symptoms indicative of HIV? Could my symptoms be related to stress?
4) When does the body start producing antibodies, is it immediately after being infected or after onset of symptoms?
5) Should i consider my 6 week negative test as definitive and move on with my life?
Please help

[Edward W Hook, MD]

You can relax, your risk is about zero (in science we never say never).  

You were protected for your vaginal sex and there are no good reports of HIV being tranmitted through oral sex, irrespective of chapped lips, gum disease, mouth sores, etc.  In addition, you do not know that your partner was infected (and odds are that she was not) and you have negative tests at a time when well over 95% of tests that are going to be positive will be.  Putting all of this together, you are not at risk.  As for your questions:

1.  See above.  zero
2.  Given your information, no way
3.  You have had the bad luck to get two sore throats.  This is not HIV.  You anxiety is making things worse but there is no denying that you have a sore throat, it's just not due to HIV.
4.  Immediately after infection.  Many peole who become infected have positive tests as early as 2 weeks.  We use longer intervals to make sure that more people are encompassed by the information we give.
5.  It is definitive. Time to move on.  EWH

[anonymous741]

Thank you doctor. I will take your word on the 6 weeks being definitive and move on with my life.

[Edward W Hook, MD]

!.  Current understanding of the ARS is that it is a single, not recurring event.
2.  Typically
3.  I agree with that.  Realize that all recommendations are based on probabilities.  For low risk persons such as yourself (and your are low risk, no doubt about it) after six weeks more  than 95% of tests that are going to be positive.  When that's 95% after starting with a less than 1 in 10,000 probability., the risk is effectively zero.  Your results are definitive.  
4.  While the average time to positivity is about two weeks, that means that for 50% of folks, it takes longer.  We incorporate these figures in the probabilities we give

EWH

[anonymous741]

Hi Doctor, can you please comment on my questions above. Thank you.

[anonymous741]

Hi Doctor. Thanks for your response. I am currently being prescribed antibiotics for my throat infection. Lets see how it goes. Couple of more questions
1) Are ARS symptoms recurrent, or do they go away after some time?
2) Is ARS almost always accompanied by fever?
3) Some sites claim that with modern tests, it is not really necessary for an average healthy person to test again if he has tested negative at 6 weeks (http://www.aac.org/site/PageServer?pagename=basics_home).
Some sites claim that the average time from infection to positive EIA is 10-14 days. (http://www.medscape.com/viewarticle/421053_3). how authentic is this information?

Thank you.