[Question #11130] Hiv Hepatitis exposure? Worried.

16 months ago

Caucasian female 54 years old. Husband and I are swingers. Incident on January 10 where the condom came completely off of my partner. He ejaculated in me. I do not know his sexual history. Washed myself out with warm water many many times. no other exposures since then.
Fatigue last 2-3 weeks. Sleeping 12 hours/day and taking a 1-2 hour nap and I'm still sleepy. Tender glands/lymph nodes in my throat and diarrhea. Comes and goes in severity but stool is consistently loose. Nausea comes and goes. No fever or vomiting.
Went to my doctor for bad breast pain. Capsular contracture in my implants. Prescribed Hydrocodone and flexeril for the breast pain. Liver enzymes came back elevated. Test was March 21. AST was 103 u/l. ALT was 258 u/l. Bilirubin was .29 mg/dl. Then ordered Hep C antibody test and a Hep B surface antigen. Both non reactive. March 26 test again AST and ALT had both come down. AST was 82 ALT was 228. Bilirubin went up to .33. He then ordered an "acute hep panel" and I don't have those results yet.
Sonogram showed gall stones and sludge. He said he's "not convinced the gall bladder is causing these symptoms." I have no other symptoms. Nothing vaginal at all. No problems down there. My questions are, could I be in seroconversion for HIV with my symptoms?Does HIV cause elevated LFT? Hepatitis? Thank you

16 months ago

Update just now. My acute hep panel is back.
Hep A IGM Antibody Negative
Hep B surface antigen (2) Negative
Hep B Core IGM Antibody Negative
Hep C Antibody Negative.

Does this change anything? Could I have HIV or is this all related to the gall bladder and breast pain? Thank you Dr's Hook and Hansfield. What a service you provide here. Wonderful.

Edward W. Hook M.D.

16 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment on several aspects of your post

First, your test results prove that the current illness is not viral hepatitis related to the condom mishap you experienced.

Second, your symptoms are NOT those of recently acquired HIV and have occurred far too late to be the ARS of recently acquired HIV.

Third, the symptoms that you are experiencing are those of a viral infection of the sort that may occur from time to time. I doubt that the symptoms are in any way related to your gall bladder. These bothersome community acquired, no STI viral infections can certainly cause the sort of mild elevation in liver tests that you've experienced and which seem to be resolving. I'd suggest giving this a few days and then, if not better, work with your doctor to evaluate. I would not be worried about HIV.

I hope this perspective is helpful. EWH

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16 months ago

Thank you Dr. Hook.

It was my understanding that HIV infection causes flu like symptoms. So the nausea, runny stool, fatigue etc had me worried. I also thought the timing was around 8 weeks post exposure for symptoms to show up. That's when my symptoms got really bad.

Anyway, can you please clarify that I am understanding your position on this? 8 weeks post exposure is too late for acute HIV infection symptoms to start? And even if they did, mine are not indicative of HIV at all? Am I understanding correctly? The reason I asked for clarity on this, is that I'm curious what the literature means when stating "flu like symptoms"? Thank you Dr. I won't reply to you or bump this thread again. I appreciate your help. :)

Edward W. Hook M.D.

16 months ago

The ARS does not occur more than 30 days after an exposure. Severe sore throat and high temperatures are characteristic of it, as well as some of the other symptoms such as diarrhea that you mention. If you wish to prove that this is not recently acquired HIV, you can test since persons with symptoms of HIV ALWAYS have positive tests. I am confident that if you test, it will be negative.

All too often the internet is misleading on the symptoms of recently acquired HIV.

Also, FYI, when persons with flu-like symptoms seeking evaluation have been tested for HIV, less than 1% have HIV. The remainder have other viral illnesses such as influenza, COVID-19 or mononucleosis. Your symptoms are more characteristic of mono, which can be sexually acquired and tends to be self limited than anything else. The mononucleosis syndrome can be causes by the EB virus or CMV, both of which can be tested for.

Please don't hesitate to follow-up if there are additional questions. you have one follow-up remaining and I'll be happy to reply

EWH

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16 months ago

Thank you Dr. Hook. I guess I will respond since you brought up mono.

First, I completely forgot to mention that my blood pressure has been very low off and on as well for the past couple weeks. I didn't think of that this morning because I felt good. But I came home from my salon because it dropped to 90/71. I took a little salt and got it up to 111/80. This is happening almost daily. My heart rate jumps up to around 110bpm when my bp drops. Is this related to these other viruses you mention? Or a possibility with them?

Second, I had mono 40 years or more ago. In my early teens. Could I get it again?

Thank you again Dr. Hook.

Edward W. Hook M.D.

16 months ago

Thanks for your response. People can get mono twice because it's caused by two unrelated viruses. It sounds like your low BP this morning reflected the totality of your illness and the likelihood that, between the illness itself and feeling poorly, you are a little bit dehydrated.

Regarding the concerns that brought you to our Forum. I'm confident that your current illness is unrelated to the HIV. As to what it might be, I'll once again encourage you to work through it with your doctor whom has already started thinking about it. I anticipate that your illness will be self-limited. I hope that it improves sooner than later.

This will complete this thread. Take care. EWH

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