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Avatar universal

HSV2 + HIV co-infection delay seroconversion?

Thank you in advance for the support.

I had an oral sex exposure a little over 6 weeks ago (I am male and I gave oral to a women - we also had condom protected vaginal sex). I did not notice any sores in the genital area at the time. 2-3 days post the exposure I developed what an infectious disease doc said were white ulcers on my tonsils. My glands in the neck became swallon over the course of the week and then I developed a sore throat that lasted for 3 weeks. Also 2 weeks post event my leg muscles became very painful and I develop muscle spasms and tingling sensations on the feet/hands and face. These symptoms are with me today (6 weeks after the event). I tested negative for HIV at 43 days (6 weeks). But i'm not sure if what was on my tonsils area was HSV2 acquisition sores. I also get night sweats 2-3 times a week where the neck area is sweaty and the t-shirt and bed sheet is damp. Today is the first day my mouth has a metallic taste and my tongue looks white. I'm in the window period for HSV2 (and HIV) but will get that blood test soon to confirm. My bowel movements have been thrown off big time. I am severely constipated right now and have been pretty much since the event 6 weeks ago.

Can anyone give me feedback on my chances of acquiring HIV through oral sex (on a female) if my partner was shedding HSV2 (asymptomatically because I didnt see any sores at the time) and if my 43 day HIV negative test is at risk if that tonsil thingy was in fact HSV2 (i.e delayed seroconversion). Is it tough to get HSV2 on the tonsils only - didnt have any sores on my mouth, lips or tongue or inside of my cheeks. Thank you doctor.
8 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Answering the question as posed in the title you selected for this thread:  Neither HIV nor HSV-2 changes the seroconversion time for the other infection.  If your test results are negative a few weeks after your last possible exposure, then you can be sure you aren't infected.

Now looking at the rest of the question:  Your symptoms are not particularly suggestive of either herpes or HIV.  If you really had ulcers of the back of the throat, an HSV infection is possible, but as you suggest yourself, primary oral herpes usually would be associated with sores in the front part of the mouth as well, not just the tonsils.  This sounds like any number of garden variety respiratory infections, like a virus, strep throat, or perhaps even mononucleosis.

Most people with new HSV infections have positive blood tests by 6 weeks, but sometimes it takes longer -- so that result is reassuring but not definitive.  You are beyond the usual HIV window; that is, your negative test at 6 weeks shows you didn't catch HIV during the oral sex event.

As to the specific questions in the last paragraph:  Cunnilingus (oral sex on female genitalia) has never been implicated in HIV transmission, in either direction.  Undoubtedly it is possible, but very rare; you are unlikely to be the first known case!  And the chance your partner had HIV is near zero anyway, especially if she isn't an injection drug user or commercial sex worker.

If your symptoms persist, continue to work with your health care provider about the cause.  You can definitely put HIV to rest, and probably HSV as well --  but to be absolutely sure about herpes, you could have another HSV-2 blood test at 3-4 months.  Ask your provider about a test for infectious mono.

Whatever is going on, it isn't serious and is going to clear up.  There are no serious worries here.

Good luck--  HHH, MD
Avatar universal
I forgot to mention that I also had condom protected vaginal.
Avatar universal
Thank you doctor HHH. We did a test for mono and that was negative. I havent done a test for HSV (1or2) yet - the 43 day test was for HIV. But I will go for a HSV test this week since you mention that it could possibly show up at this point in the window. Very strange these symptoms though and it has increased the level of my anxiety.

It is reassuring to hear that neither delays seroconversion so my 6 week HIV test gives me some comfort. I have read some of your posts regarding HSV-2 and that if someone is co-infected inflammation cells can be loaded with HIV. If that were to enter my oral cavety it wouldnt increase my risks for either? I guess inoculation for HSV should typically occur in the front if it were going to because that would have a higher chance of contact (i think??). Not sure if I'm making any sense here as my first point of contact would have been my tongue. Appreciate the feedback dr. HHH.
Avatar universal
I also forgot to mention that the test I took was a rapid HIV test with finger *****. Not a fully blood draw. Does that make a difference in terms of window period? Thank you.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Sorry, I misunderstood and thought you had been tested for HSV-2.  But otherwise, you are seriously over-thinking this.  In 30+ years in a busy STD clinic, I have seen no more than 2-3 people with oral HSV-2 acquired by oral sex, and all those alo had typical first-episode genital herpes.

The biological mechanisms by which HSV-2 increase HIV transmission risk are irrelevant in assessing your situation, because your HIV test shows you weren't infected.  And as has been stated innumerable times on this forum, the rapid HIV tests have the same window period and are just as reliable as thea lab-based tests.

You don't have HIV and I doubt you have an oral HSV-2 infection.  Believe it, but feel free to follow through with HSV-2 blood testing.  If you have it, it won't matter much.  Oral HSV-2 recurs rarely and you would be unlikely to infect a future partner.  It really wouldn't be a significant issue in your long term health or your sex life.

Bottom line:  You really have no signficant health worries here.  Please accept that and stop losing sleep over it.

I won't have any further comments.

Avatar universal
Thank you doctor for the feedback. I know you are providing me with reassurance. I have an appointment with my doctor tomorrow to follow-up. I am unreal afraid that the muscle pain, twitches, tingling, warm/cold sensations on the skin are something like a Guillain-Barré syndrome spawned on by an infectious agent i.e. (HIV or whatever caused my tonsils). Strep test at that time on the tonsil infection was negative. If one were to get Guillain-Barré which is an autoimmune response to an infectious agent would that delay the body's ability to produce antibodies. Also GBS can cause constipation because of the lack of neuro movement and I have been constipated for a month now. Would greatly welcome your expertise.
Avatar universal
I know doctor you said no more comments. I dont know what to say, I am truly at lost with what is going on in my body and I would welcome your thoughts on my question. I know I have an appointment with my GP today but GP's dont know as nearly as much as a specialist like yourself. Please help.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Probably this has nothing to do with HSV, and it definitely is not HIV or any other STD. The truth lies elsewhere.  That means your GP is going to be a more reliable source of care and information than this forum.  I will delete any further comments/questions on this thread.
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