[Question #10367] Follow up #10201
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23 months ago
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Dear Doctors,
First of all let me thank you so much for all the help you gave me 2 months ago regarding this situation. I felt the need to comeback to ask additional questions regarding my exposure because, although your advice was amazing, i still have a few more doubts to clear in my head.Like I've mentioned, my exposure was a unprotected insertive vaginal sex with CSW in April of this year.
2 weeks after that, I started having some symptoms:
- diarrhea
- night sweats
- sore throat
- white tongueI
never had fever, any body pain, fatigue or rash. The symptoms went away after a week.
Since then, I took the following tests:
22 day Alere 4th gen rapid test
35 day HIV 1 and HIV 2 PCR
45 day Alere 4th gen rapid test
62 day 4th gen Lab test CMIA
92 day 4th gen Lab test CMIA
118 day Alere 4th gen rapid test
147 day Alere 4th gen rapid test
All of these were negative. I want to believe both my tests and your assurance that I'm clear of HIV, but I just can't shake the fact that I had those symptoms, and that they happened exactly 2 weeks after the exposure which fits the timeline for ARS.
1 - Does ARS mean Seroconvertion? I understand that some people don't even have ARS symptoms, but does ARS mean that your body is starting to produce antibodies?
2- In case of ARS at 14-20 days, would the PCR test at 35 days be positive if those were really symptoms of ARS?
3- After all the tests that I've done, would it be possible for those symptoms still be ARS and I'm going to be positive at a later time?
4 - Where I'm located, the window period is 3 months for all tests, no difference between lab tests and rapid tests or 3rd gen or 4th gen. My doctor told me that after 3 months I don't need more testing, but a different doctor told me 6 months. I'm 30 days away from the 6 month mark, but these additional 30 days are killing me inside. Will I turn positive?
First of all let me thank you so much for all the help you gave me 2 months ago regarding this situation. I felt the need to comeback to ask additional questions regarding my exposure because, although your advice was amazing, i still have a few more doubts to clear in my head.Like I've mentioned, my exposure was a unprotected insertive vaginal sex with CSW in April of this year.
2 weeks after that, I started having some symptoms:
- diarrhea
- night sweats
- sore throat
- white tongueI
never had fever, any body pain, fatigue or rash. The symptoms went away after a week.
Since then, I took the following tests:
22 day Alere 4th gen rapid test
35 day HIV 1 and HIV 2 PCR
45 day Alere 4th gen rapid test
62 day 4th gen Lab test CMIA
92 day 4th gen Lab test CMIA
118 day Alere 4th gen rapid test
147 day Alere 4th gen rapid test
All of these were negative. I want to believe both my tests and your assurance that I'm clear of HIV, but I just can't shake the fact that I had those symptoms, and that they happened exactly 2 weeks after the exposure which fits the timeline for ARS.
1 - Does ARS mean Seroconvertion? I understand that some people don't even have ARS symptoms, but does ARS mean that your body is starting to produce antibodies?
2- In case of ARS at 14-20 days, would the PCR test at 35 days be positive if those were really symptoms of ARS?
3- After all the tests that I've done, would it be possible for those symptoms still be ARS and I'm going to be positive at a later time?
4 - Where I'm located, the window period is 3 months for all tests, no difference between lab tests and rapid tests or 3rd gen or 4th gen. My doctor told me that after 3 months I don't need more testing, but a different doctor told me 6 months. I'm 30 days away from the 6 month mark, but these additional 30 days are killing me inside. Will I turn positive?
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Edward W. Hook M.D.
23 months ago
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Welcome back to the Forum. I'm sorry you are having so much trouble moving forward since your April encounter. I'll go directly to your follow-up questions:
1 - Does ARS mean Seroconvertion? I understand that some people don't even have ARS symptoms, but does ARS mean that your body is starting to produce antibodies?
1 - Does ARS mean Seroconvertion? I understand that some people don't even have ARS symptoms, but does ARS mean that your body is starting to produce antibodies?
Yes, the ARS is a seroconversion reaction which occurs when virus present in the body reacts with antibodies which are beginning to be formed due to a recent infection. You are correct that not everyone who acquired HIV but when it occurs, it means that the body is developing antibodies to the infection. People with the ARS always have positive tests for HIV
2- In case of ARS at 14-20 days, would the PCR test at 35 days be positive if those were really symptoms of ARS?
2- In case of ARS at 14-20 days, would the PCR test at 35 days be positive if those were really symptoms of ARS?
Yes, unless an infected person is on effective anti-HIV therapy, the PCR test for HIV will always be positive following the ARS and/or the appearance of the virus in the blood for persons who do not experience the ARS.
3- After all the tests that I've done, would it be possible for those symptoms still be ARS and I'm going to be positive at a later time?
3- After all the tests that I've done, would it be possible for those symptoms still be ARS and I'm going to be positive at a later time?
No, you are now far, far beyond when a person would develop the ARS or, for that matter, beyond when a test would become positive. You can be 100% confident you did not acquire HIV from the encounter of concern in April
4 - Where I'm located, the window period is 3 months for all tests, no difference between lab tests and rapid tests or 3rd gen or 4th gen. My doctor told me that after 3 months I don't need more testing, but a different doctor told me 6 months. I'm 30 days away from the 6 month mark, but these additional 30 days are killing me inside. Will I turn positive?
4 - Where I'm located, the window period is 3 months for all tests, no difference between lab tests and rapid tests or 3rd gen or 4th gen. My doctor told me that after 3 months I don't need more testing, but a different doctor told me 6 months. I'm 30 days away from the 6 month mark, but these additional 30 days are killing me inside. Will I turn positive?
This window is overly conservative and scientifically inaccurate. The doctor who told you you need to be tested out to 6 months is far out of date and incorrect. You do not need further testing.
EWH
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23 months ago
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Thank you so much for your answer Doctor.
Just a couple follow up questions:
1 - You told me 2 months ago that my symptoms didn't sound like ARS, but the per my search at least Diarrhea and Sore throat are common in ARS correct? I forgot to mention that I lost my voice for a few days and I also had loss of taste and smell. I won't say that some of these wouldn't be explained by anxiety since I was very scared at the time. Now, I'm less scared but still on high alert.
2- I will obviously take your word for it, and try to believe my results. I think that for piece of mind I will still be going back for the 6 month test, but at this moment I believe a rapid test would be enough. But, per your words, should I disregard the symptoms that I had at 2 weeks post-exposure or any other symptoms that might appear in the future as sign of HIV or ARS?
3- I made a mistake, my last test was indeed at 147 days (21 weeks) but it was the Abbot 4th gen rapid. At this time it would be enough to detect all infections correct?
Once again doctor I will take your advise, and I will leave my last response to give an update on my last test 3 weeks from now even if, according to you, the result wont change.
Thank you so much
Just a couple follow up questions:
1 - You told me 2 months ago that my symptoms didn't sound like ARS, but the per my search at least Diarrhea and Sore throat are common in ARS correct? I forgot to mention that I lost my voice for a few days and I also had loss of taste and smell. I won't say that some of these wouldn't be explained by anxiety since I was very scared at the time. Now, I'm less scared but still on high alert.
2- I will obviously take your word for it, and try to believe my results. I think that for piece of mind I will still be going back for the 6 month test, but at this moment I believe a rapid test would be enough. But, per your words, should I disregard the symptoms that I had at 2 weeks post-exposure or any other symptoms that might appear in the future as sign of HIV or ARS?
3- I made a mistake, my last test was indeed at 147 days (21 weeks) but it was the Abbot 4th gen rapid. At this time it would be enough to detect all infections correct?
Once again doctor I will take your advise, and I will leave my last response to give an update on my last test 3 weeks from now even if, according to you, the result wont change.
Thank you so much
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Edward W. Hook M.D.
23 months ago
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1. Severe sore throat, ALONG WITH high fever, widespread muscle or joint aches is part of the ARS. Diarrhea is present sometimes but not particularly commonly. Laryngitis is a different process than pharyngitis, the latter of which is part of the ARS- the former is not. Remember as well, if these symptoms were part of the ARS, your tests would have been positive.
2. I would disregard those symptoms. AS I've said on several occasions, you have PROVEN that your symptoms were not due to HIV. any test that you do at 6 months will provide further prrof that you were not infected with HIV.
3. Correct
I look forward to your final response which, I am confident, will once again show that you were not infected with HIV back in April. EWH
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22 months ago
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Dear Dr. Edward W. Hook,
As promised, I underwent my 6-month (181 days) HIV test at the local screening facility today. The test administered was a 4th gen Abbot Rapid finger test, yielding a negative result.
Following this outcome, I have a few remaining inquiries to conclude this discussion:
1 - Considering all the tests I have undergone (PCR HIV 1/2 at 35 days, 4th gen lab test 62 days, 4th gen lab test 92 days, and 4th gen rapid tests at 118, 147 and 181 days), can I confidently assert with 100% certainty that I did not acquire HIV in April and thus conclude this chapter?
2 - Can I be reassured that the symptoms I experienced two weeks after a potential exposure (diarrhea, night sweats, sore throat, white tongue, loss of voice, taste and smell) were unrelated to HIV?
3 - Do you recommend any further testing, either at a later date or using a different test (such as a lab test)?
I want to express my gratitude for your invaluable guidance and the time you have generously devoted to addressing my inquiries. Upon receiving your responses, I plan to proceed with my life and put this matter behind me, following your expert advice.
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Edward W. Hook M.D.
22 months ago
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Final responses.
1. You were told previously that your negative test results were conclusive. You have another negative result. Why would the answer change. Further testing is a waste of time and resources.
2. Absolutely
3. See above.
I’m pleased to hear that you plan to move forward. There should be no need for further testing and no need for any additional questions. The thread will be closed shortly. EWH
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