[Question #10475] HIV or CMV?
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22 months ago
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On Aug 17 I met an escort. After 1-2mins of rough sex I pulled out and saw the condom had broke. Its base was still on but its top came off separately as I pulled out. She said she tests monthly. Her agency said her last tests were 10 days ago and all were clear. A few days later I saw 2-3 small surface-level scrapes on my shaft; unsure if it increased risk.
On Sep 12 I saw that my neck and ear lymph nodes were swollen. On Sep 13 (27 days after) I went to the hospital.They noticed the swollen nodes and a sore throat. They did a 4th gen test.It was neg. They diagnosed a cold. Symptoms seemed over but on Sep 24 (38 days after) throat went sore again and tonsils swelled. On Oct 2 I saw a doc.By then I'd also a few chills and rare low fever (37.2).COVID, bacterial, flu and EBV were neg. Doc suspects CMV. Symptoms persist.
1) Am I at significant risk of having caught HIV based on the above?
2) Tomorrow (50 days after) I'll retest for a 4th gen test. If neg, do I need to retest?
On Sep 12 I saw that my neck and ear lymph nodes were swollen. On Sep 13 (27 days after) I went to the hospital.They noticed the swollen nodes and a sore throat. They did a 4th gen test.It was neg. They diagnosed a cold. Symptoms seemed over but on Sep 24 (38 days after) throat went sore again and tonsils swelled. On Oct 2 I saw a doc.By then I'd also a few chills and rare low fever (37.2).COVID, bacterial, flu and EBV were neg. Doc suspects CMV. Symptoms persist.
1) Am I at significant risk of having caught HIV based on the above?
2) Tomorrow (50 days after) I'll retest for a 4th gen test. If neg, do I need to retest?
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22 months ago
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I apologize for the abbreviations, but space was limited. I should add that the escort mentioned she had been in South Africa in the past and had multiple clients there daily. (I know that's the HIV capital of the world sadly.)
3) Also, assuming her agency was truthful, isn't there a period in which a test won't show up as positive and that is also the period someone is most contagious?
4) Finally, is it true that if someone has indeed ARS HIV and displays symptoms, then a 4th gen test will always be accurate even if taken within the window period?
Thank you for your attention and time. I deeply appreciate it!
3) Also, assuming her agency was truthful, isn't there a period in which a test won't show up as positive and that is also the period someone is most contagious?
4) Finally, is it true that if someone has indeed ARS HIV and displays symptoms, then a 4th gen test will always be accurate even if taken within the window period?
Thank you for your attention and time. I deeply appreciate it!
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Edward W. Hook M.D.
22 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment.
2) Tomorrow (50 days after) I'll retest for a 4th gen test. If neg, do I need to retest?
4) Finally, is it true that if someone has indeed ARS HIV and displays symptoms, then a 4th gen test will always be accurate even if taken within the window period?
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Your exposure. I understand your concern regarding your condom failure but will also point out that most commercial sex workers, even those from South Africa, do not have HIV. This is particularly true for CSWs working in brothels as it would be bad for business to have customers becoming infected. The fact that her agency was able to assure you that she tests regularly and had a negative test 10 days prior to your encounter all suggests that it is unlikely that she had HIV. Even if she did, the risk of HIV infection from a single unprotected sexual encounter is substantially less than 1 in 1000 making infection unlikely. The scrapes you noted on your penis do not change this.
Your sore throat and swollen glands were not due to HIV or any of the other viruses you tested for. What you describe is often referred to as a mononucleosis syndrome which can be caused by Epstein Barr virus, CMV, or, occasionally a few other viruses. Mono can be acquired through sexual contact or through non-sexual activities of daily living. CMV could certainly be causing your swollen glands. If so, I would not worry and, in fact, from a medical perspective see no need to pursue what is causing your swollen glands. There is no treatment for CMV other than rest and it sounds as though you are improving.
In answer to your specific questions:
1) Am I at significant risk of having caught HIV based on the above?
No. See my comments above. If you had HIV at the time you were checked for swollen lymph nodes, your test would be positive. Further, at 4 weeks (27 days is certainly close enough) more than 99% of recently infected persons will have positive tests.
2) Tomorrow (50 days after) I'll retest for a 4th gen test. If neg, do I need to retest?
Absolutely not. When you test is negative, as I am confident it will be, your results will be absolutely conclusive with no need for repeat testing.
3) Also, assuming her agency was truthful, isn't there a period in which a test won't show up as positive and that is also the period someone is most contagious?
Yes there is but you and she are well passed that period. Your symptoms are not due to HIV
4) Finally, is it true that if someone has indeed ARS HIV and displays symptoms, then a 4th gen test will always be accurate even if taken within the window period?
Yes, 4th generation tests are always positive if they are causing symptoms.
I hope that this information is helpful. Please don't worry. EWH
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22 months ago
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Dear Dr. Hook,
Thank you for your thorough and very swift reply! It was extremely helpful and it's a shame that your answer to my 4th question isn't widely mentioned online.
Yes, it does seem that my symptoms have been improving over these 3 weeks. My glands are back to normal. My tonsils are still swollen/inflamed and my throat sore, but I'll just have to wait it out then.
If I may ask a follow-up: Assuming it is indeed CMV – the Epstein Barr rapid came back negative and I'd already passed EBV mono in my teens (which was much worse!) – for how long do I have to be careful around parents, kids, and newborns after my symptoms completely pass? Some members of my close social circle have newborns and little kids and I've read that CMV can be dangerous for them.
Thank you for your thorough and very swift reply! It was extremely helpful and it's a shame that your answer to my 4th question isn't widely mentioned online.
Yes, it does seem that my symptoms have been improving over these 3 weeks. My glands are back to normal. My tonsils are still swollen/inflamed and my throat sore, but I'll just have to wait it out then.
If I may ask a follow-up: Assuming it is indeed CMV – the Epstein Barr rapid came back negative and I'd already passed EBV mono in my teens (which was much worse!) – for how long do I have to be careful around parents, kids, and newborns after my symptoms completely pass? Some members of my close social circle have newborns and little kids and I've read that CMV can be dangerous for them.
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Edward W. Hook M.D.
22 months ago
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The majority of health persons will acquire both CMV and/or EBV over the course of their lives and experience no lasting consequences. It sounds as though your symptoms have, in large part resolved and if that is the case, I would not worry about transmission to others. These viruses are transmitted in many ways but I would not worry.
EWH
p.s. The newborn form of CMV is most problematic when a pregnant woman becomes infected and the child is infected even before it is borne. EWH
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21 months ago
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I neglected closing the thread. As you said, doctor, my HIV blood work came negative. I also did blood work for EBV and CMV which also came back negative and my general blood test was all fine.
A thrush started developing on my tongue though, which didn't go away after a mouthwash of Nyatin and my tonsils are still swollen, so my PCP recommended I see an ENT for an endoscopy (in case it's esophageal thrush); she also tested me for oral gonorrhea and chlamydia and we're awaiting the results.
At least, it's nothing serious from the looks of it and I'm happy for that. Thank you once again for your attention and time, and may you have a great day!
A thrush started developing on my tongue though, which didn't go away after a mouthwash of Nyatin and my tonsils are still swollen, so my PCP recommended I see an ENT for an endoscopy (in case it's esophageal thrush); she also tested me for oral gonorrhea and chlamydia and we're awaiting the results.
At least, it's nothing serious from the looks of it and I'm happy for that. Thank you once again for your attention and time, and may you have a great day!
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Edward W. Hook M.D.
21 months ago
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Thank you for your follow up and your kind words. I'm confident that your tests for gonorrhea and chlamydia will be negative.
It sounds like your doctor is being very thorough- that's a good thing. Take care. EWH
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