[Question #10743] HIV or Covid
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20 months ago
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Hi,
I had a very risky event wherein I had unprotected insertive vaginal sex with a csw in Mumbai redlight area.
2 days later, I got the chills and fever, sight sore throat, cough, congestion, rash on my left calf (and a few spots on the right calf), and pain in the cervical lymph node area. I tested positive for covid
Most symptoms including fever went away in 3 days and by day 5 from the exposure I was feeling good. But later in the evening, I suddenly got a very painful lower back (felt more like bone pain than muscle pain). The next day I got muscle pain in the upper/mid back. This is continuing and it is day 9 now from exposure. The lower back pain is always there but not severe. The upper back pain comes and goes. There is no fever or any other noticeable symptoms except occasional neck pain in the cervical node area but no enlargement that I can feel.
Is it possible that covid symptoms resolved and muscle and bone pain is HIV related? I have read that covid can cause muscle pain later but this seems like a long shot?
Would muscle/bone pain have to be accompanied by fever in the case of HIV or is it possible the covid induced an immune reaction already and hence it’s possible to have HIV symptoms without fever now? I mean what could logically cause this pain?
Thanks.
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Edward W. Hook M.D.
20 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment. You are correct that the exposure you describe was rather risky. COVID could certainly cause the flu-like symptoms you describe and it would be most unusual for recently acquired HIV to cause symptoms just 2 days after an exposure. More typically when persons develop the ARS symptoms begin a 7-10 days following the exposure. I suspect that your symptoms are due to COVID. You can prove this be having a test for HIV at this time- when symptoms are due to HIV, the tests are always positive.
I hope that this information is helpful. EWH
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20 months ago
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Hi Dr. Hook,
Thank you for your reply. I was also under the impression that the symptoms were too soon for HIV, but am having doubts now with the new muscle/bone pain and the nature of the symptoms I thought were due to covid.
Will the Duo suffice or is an RNA test better in this case?
Would also appreciate your thoughts on the following.
1. If it was Covid, I can’t understand how I could get additional symptoms of muscle/bone pain after the main symptoms of Covid had resolved (fever, sore throat, etc)? Is this normal in covid?
2. Have you come across HIV presenting with primarily muscle/bone pain and in the absence of fever (assuming the initial symptoms were due to covid and the latter ones not).
3. Is the rash on one calf (and almighty on the other) typical of ARS or would it be more widespread?
4. Do you feel there is a good chance the symptoms are not related to HIV and the test result may be negative? Or am I honestly looking down the barrel on this one?
Thanks
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Edward W. Hook M.D.
20 months ago
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Thanks for your follow-up questions.
Yes, a DUO test is totally adequate to determine if your symptoms are due to the ARS.
1. COVID is a highly variable disease. I do not have a better explanation. As I said earlier however, testing using a DUO test will rule out any possibility that your symptoms are due to HIV.
2. No, persons with the ARS typically have high fever. Presentation solely as muscle/bone pain is not described.
3. The rash of the ARS is widespread and generalized, not localized
4. Yes, I anticipate that your test will be negative.
EWH
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19 months ago
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Hi Dr. Hook,
Merry Christmas!
My 11 day Duo test result was non reactive.
I also did a 15 day qualitative PCR RNA test which came back as not detectable. It was done by Taqman and sensitive to 20 copies.
For all practical purposes do I need to test anymore? Or can I safely assume I am HIV negative and have unprotected sex with my partner.
Thanks!
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Edward W. Hook M.D.
19 months ago
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Thank you for the additional information and congratulations on the results of your test results.
Your 11 day duo test provides reliable information that your symptoms were not due to HIV. Your HIVRNAPCR test results are strong evidence that you were not infected at all. Manufacturers state that results after more than 11 days are conclusive however most experts conservatively recommend that a follow-up DUO test be done at 4 to 6 weeks to confirm the PCR results. FYI, we have never seen or heard of a person with a negative HIV RNA PCR test at 11 days or beyond who went on to turn positive.
In my opinion, based on your results, you can be confident that you did not acquire HIV from the encounter you described above. Also, in my opinion, whether or not you choose to retest at 4 to 6 weeks is a personal choice and I am confident that you did not acquire HIV.
---As you know, we provide up to three responses to each clients questions. Therefore this thread will be closed shortly without additional responses. Happy holidays. Stay safe. EWH.