[Question #1027] HIV and scared and tired of symptoms.. don't know where to go from here.

49 months ago
Hi Dr.

I would like to get your scientific medical opinion on critical situation that I'm going through. No one is able to explain me "Why" should I not worry about this situation.

My exposure : May 1, 2016. Receptive unprotected anal sex and later found out that person tested positive which makes it even high risk situation. 

I was totally unaware of the risk that I took but started realizing 2 weeks after when I got symptoms (some mild, some life threatening). I FULLY understand that symptoms are non specific to determine if person has HIV or not. I understand that some of the symptoms could be related to anxiety/stress but I firmly believe that some of them are genuinely related to virus.

The symptoms that I'm concerned about because on top of all the ARS like symptoms I'm also having these:
1) From last month, I do have chronic loose stool (sorry to be graphical but it's like getting ice cream in a cone). 
2) My GUMS has been turned almost white since last month and from last 3-4 days I have THRUSH (genuine thrush and not just white color) on my tongue.
3) Severe ear issues related to tinnitus started month ago and I can't even sleep because of it.

Recent CBC does not sound great but don't know how to interpret this as I got that done online. Based on some values it seems like some viral thing going on.

Lymphs (Absolute) 3.3 (HIGH) Range  0.7-3.1 x10E3/uL 01
BUN/Creatinine Ratio 20 (HIGH) Range 8-19
Alkaline Phosphatase, S 118 (HIGH) Range 39-117 IU/L
Urinalysis - Specific Gravity     <=1.005 (ABNORMAL) Range  1.005-1.030

I have had following symptoms during ARS:
All started with cold sore, Night sweats, Worst Flu ever, dry mouth, dehydration, Peripheral Neuropathy, red rashes and additional dots on face, joint and back pain... Also, My lymph node gave me so much pain (some are swollen already) under neck, behind ears and under my armpits for about 2-3 week.

Results:
40 days - 4th gen Ab/Ag -ve
- RNA TMA method, 10 STD Panel, -ve 
84 days - 4th gen Ab/Ag  -ve
88 days - No HIV Test but others were negative including Chlamydia,gonorrhoeae,Trich,RPR,HEP ABC,HSV 1/2
94 days - HIV1 HOME ACCESS -VE


1) I have read numerous articles from med community that late seroconversion is totally possible and in some cases people end up in hospital after several -ve ELISA tests. Can quantity, strain or transmission mode of virus makes any difference in window period ? 

2) What other virus causes this type of things and what should i get tested for if this is not HIV? 

2)  I definitely don't want to find this out at 4 month, 6 month or year later that I was HIV positive and ignored the signs of HIV at the same time I want to preserve my immune system if this is related to virus.  What are the proactive thing that I can do to put this behind me if this is not related to HIV ? or related to HIV ? 

3) Importantly, Can I RESUME my unprotected sex life ? I definitely don't want to be the cause of infecting someone else with this virus if I have it. Specially, I would like to have baby and don't want to infect partner and baby.

Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago
Welcome to our Forum. I will do my best to help.  From the lab tesst that you mention is clear that despite your symptoms you did not acquire HIV or any of the other STIs that you tested for and thus you can be sure that your symptoms are not due to any of these problems.  When symptoms and lab tests performed in a reputable lab disagree, the lab tests are virtually always right. 
that you were not infected does not surprise me- Even with unprotected receptive rectal intercourse with an HIV infected partner, less than 1% (1 in 100) persons become infected and your tests prove that you were not the one.  There are many other non-STI viral infections (including the flu) which cause ARS like symptoms and I suspect this is what has happened to you. further, the lab tests you describe are only borderline abnormal and non-specific.  If I were seeing you as my patient, I would dismiss them as not concerning. 

1) I have read numerous articles from med community that late seroconversion is totally possible and in some cases people end up in hospital after several -ve ELISA tests. Can quantity, strain or transmission mode of virus makes any difference in window period ? 
The articles you have read (perhaps on the internet where most such misinformation comes from) are either out of date or incorrect.  "Late sero-conversion" in persons who are not taking anti-HIV medications is a myth. 
Neither quantity, type, or mode of transmission lead to late seroconversions

2) What other virus causes this type of things and what should i get tested for if this is not HIV? 
You should see a good internal medicine specialist for a complete check up which should include examination of your lymph nodes, evaluation of what you believe is thrush, and evaluation of other infections, particularly viruses like CMV or EBV

2)  I definitely don't want to find this out at 4 month, 6 month or year later that I was HIV positive and ignored the signs of HIV at the same time I want to preserve my immune system if this is related to virus.  What are the proactive thing that I can do to put this behind me if this is not related to HIV ? or related to HIV ? 
You need to believe your test results, you have been tested multiple times and your results will not change- you did not get infected from the exposure that you describe.  There is no need for further testing related to the exposure you mention above.

3) Importantly, Can I RESUME my unprotected sex life ? I definitely don't want to be the cause of infecting someone else with this virus if I have it. Specially, I would like to have baby and don't want to infect partner and baby
Based on your test results, I see no reason for you to worry about transmitting HIV or any of the other STIs that you tested for through unprotected intercourse. 

I hope these comments are helpful to you. I see no need for further testing. My only additional advice is to stay off of the internet.  Searching for answers there will only mislead you and raise your anxieties.  EWH
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49 months ago
Hi Dr.,

I can't seem to put this behind me and I'm going to get colonoscopy done soon due to my severe growling sound in stomach and loose stool. However, as I had all typical symptoms my mind still has following questions as no one seem to answer root cause of my symptoms for 3 months.

1.What's the difference between ARS and sero conversion ? Do they occur in sequence one after another ?

2.Is it customary for any ID specialist to not to tell patient that he or she is about to going to test positive ? I recently came across this RECENT (http://www.thebody.com/Forums/AIDS/SafeSex/Q243899.html) story and I feel like I may be in similar boat as I swear I had all the ARS symptoms and my GP can't explain root cause of symptoms.

3.As you can see in above person, Initial viral load was only 297 copies/ml, Does it make sense for me to get NAAT or RNA test and put this behind me ?  I'm also going to ask my Dr. to get me tested for all other virus even though some symptoms does not make sense.

4.Is it possible that in initial ARS virus damages your immune system so much that your body can't produce antibodies efficiently and thus delay conversion?

5.This question is specific to autoimmune disorder vs immunodeficiency. I heard on several sites that one of this causes people to be test positive by 6 month. Is that autoimmune disorder or compromised immunodeficiency ? I do have Thyroid, Anemia, Arthritis and diabetes in our family history.
Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago

Your case in no way resembles the case you refer to as the result of your internet explorations (which will just fuel your anxieties).  You need to stay off the internet as you will find all too much misinformation there and mis-interpret what you see.  The case you refer to was exposure and had multiple positive tests.  You were exposed, did not get infected as is the case for most exposed persons and have PROVEN this with your multiple negative tests yet, because you had an everyday flu-like illness cannot get over the idea that you acquired HIV.  You need to move on and if you cannot yourself, you need to get some help.  Seaching the internet will not help.

1.What's the difference between ARS and sero conversion ? Do they occur in sequence one after another ?
Seroconversion is the term that described having an HIV blood test go from negative to positive.  The ARS is a set of symptoms that some but not all people who acquired HIV experience at about the time they seroconvert.  It can be mimicked by any number of everyday viral illnesses and other processes.

2.Is it customary for any ID specialist to not to tell patient that he or she is about to going to test positive ? I recently came across this RECENT (http://www.thebody.com/Forums/AIDS/SafeSex/Q243899.html) story and I feel like I may be in similar boat as I swear I had all the ARS symptoms and my GP can't explain root cause of symptoms.
I have explained your symptoms, you have not listened or accepted the fact that you were not infected.

3.As you can see in above person, Initial viral load was only 297 copies/ml, Does it make sense for me to get NAAT or RNA test and put this behind me ?  I'm also going to ask my Dr. to get me tested for all other virus even though some symptoms does not make sense.
Getting a NAAT/RNA test is a waste of time and money. 

4.Is it possible that in initial ARS virus damages your immune system so much that your body can't produce antibodies efficiently and thus delay conversion?
No, as I informed you earlier, "delayed seroconversion" is  myth which is perpetuated on the internet.

5.This question is specific to autoimmune disorder vs immunodeficiency. I heard on several sites that one of this causes people to be test positive by 6 month. Is that autoimmune disorder or compromised immunodeficiency ? I do have Thyroid, Anemia, Arthritis and diabetes in our family history.
More internet fueled mythology which has no relevance to your family history of diseases you do not have.  EWH


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