[Question #11941] Follow up to q. 11812 HIV - PLEASE

11 months ago

Dear Docs

As per my previous question, I only deep- and intensely kissed with another male back on 10th August, not being on PrEP. Then, 14.5 days later, I had both a PCR test (Cepheid GeneXpert Qual) and 4th gen test (Determine HIV Early Detect Abbott), both negative. I kept on being anxious and having symptoms so I had two further 4th gen tests on 1st September and 8th September — both negative as well.

11 months ago

However, yesterday night (30 days post-exposure) I had really belly aches, nausea to the point I stayed in the bathroom, felt hot and today I have a bad headache, feel tired plus elbow, back and knees hurt. Also my skin is very, very itchy.

Dr Hook said that kissing is very very low risk and also that my tests are conclusive and I also read other comments of yours saying that once somebody has HIV/ARS symptoms a 4th gen will always be positive.

11 months ago

1. What happens if symptoms appear AFTER a 4th gen test?

2. Is it normal to have ARS symptoms sharp at 30 days?

11 months ago

3. I read a comment by Dr Handsfield saying that a PCR at or after 11 days PLUS a 4th gen at or after 28 days, are conclusive. Do you still think so even if symptoms are present?

4. How accurate is 4 gen at 28days?

11 months ago

4. I’ll test again on 27.09 (47/48 days) post exposure, do think the test can change? I’m super anxious.

Thanks and sorry for any errrors, I speak Spanish

Edward W. Hook M.D.

11 months ago

Welcome back to the forum, although I’m sorry to see that you continue to worry about the virtually no risk encounter on August 10 that we have discussed in the past I’ll go straight to your questions:

1. Theoretically, symptoms occurring after a -4th generation test could be due to the ARS however, the onset of symptoms does not occur 30 or more days after an exposure. Further, the gastrointestinal symptoms that you describe are not a typical part of the ARS. Finally, the combination of the HIV RNA’ PCR test and fourth generation test that you had four weeks following your exposure proof that you do not have HIV. You need to accept this. You do not have HIV.

2. See my comments above. Her symptoms do not occur 30 or more days following and encounter.

3. Yes

4. Aunt 28 days a single single fourth generation, combination, HIV antigen/antibody test with detect more than 98% of recent infections. In your case, this result, preceded by a negative PCR test is conclusive evidence that you were not infected with HIV by the virtually, no risk and counter that you remain concerned about.

I hope this information is helpful and allow you to put your unwarranted concerns aside.EWH

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11 months ago

Thanks a lot Dr Hook. Indeed, I do acknowledge that I am anxious. It’s just the physical symptoms, I note that it wasn’t only vomiting or nausea but also joint pain and muscle pain plus highest temperature yesterday in the last 30 days, even feeling worn out today. What could it be if not HIV?

I’m glad you still believe my results are conclusive. I wanted to be sure about the specific brand of the tests.

Last question for now and, if may, I can please leave room to share my results on 27.09.2024.

In what time period do ARS symptoms appear? And what would you say if more come up (eg a rash)?

Thanks!!!!!!

11 months ago

Sorry - only a correction: I met this guy on a Saturday so Sunday was 29 days, not 30. Don’t if this changes things. Thanks.

Edward W. Hook M.D.

11 months ago

These are the same sort of argumentative follow-ups you made during our last interaction. Let me start by stating that it is not that I "believe" that you don't have HIV but that you have PROVEN conclusively that you do not have HIV. Further argumentative, "what if..." or "could I be the 1rst ever..." questions serve no purpose. Thus, in follow-up to your questions:

Test brands make no difference. All tests within a class (i.e. 4th generation, PCR, etc.) are expected to perform to the same degree, proving equivalent results or they would not be approved.

As I have already told you, your nausea and vomiting are not typical ARS symptoms and have occurred AFTER you have conclusively proven that you do not have HIV. That they are now accompanied by muscle and joint pains is irrelevant- you do not have HIV!!!!

ARS symptoms occur most typically 10-21 days after acquistion of HIV and do not occur after a month. There is no meaningful difference between 29 and 30 days.

As you know, you have 1 follow-up remaining. After one more follow-up of any type, this thread will be closed without further replies. Please accept that you have proven that you do not have HIV. EWH

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11 months ago

Hi Dr Hook. Thanks for your last response. I was thinking about saving this final comment for after having the results of my future tests.

But I wanted to share with you that today, 35.5 days after this guy, I woke up all sweat. with muscle and joint pain, headache and fever. I also have a temperature of 38.2 right now. Do u think it can be HIV at all? Please please respond.

Edward W. Hook M.D.

11 months ago

I repeat, once again, the ARS does not occur more than 30 days after an exposure, nor are persons at risk for HIV from the exposure you have described.

You need to look for another cause of your symptoms- they are not due to HIV. When flu-like symptoms such as your have been studied in at risk persons (and you do not fufill the definition of "at risk"), over 99% have something other than HIV including COVID, influenza and other common everyday, non STI viral illnesses.

As you know, this will complete this thread. There should be no need to return regarding the exposure you have described. EWH

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