[Question #12223] Is it HIV?

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9 months ago
I am M had sex with F on Oct 5th (Protected vaginal and unprotected oral from her), 2 weeks later, I started feeling muscle pain in thighs and knee pain, and frequent urination (every 45 min or so) and some itching in genital area and constant pressure/burning feeling at the tip of my penis and pressure in the pelvic area, this lasted for a few days during which time I also developed mild sore throat, chills, low fever, random muscle twitches in legs, back and arms night-sweats, nausea and loss of appetite while all this was happening I also got really stressed, panicking and very anxious about STDs, I took STD panel (incl. 4th gen test)panel 16 days post exposure, all negative, then I had other symptoms such as stiff neck, back pain and pain under armpits, slight pain in testicle (left testicle seemed to be slightly enlarged), and once for a few sec I had a ringing sort of noise in my right ear, I also had some tingling/warming under the soles of both feet. Further tests: HIV-1 RNA --22 days post exposure, STD Panel (incl. 4th gen also HSV-1, HSV-2)--25 days post exp,  HIV1/HIV-2 RNA test--26 days post exp, another full STD panel (incl. 4th gen)--29 days post exp. Everything has come up negative except for HSV-1 ab, which I probably had it for a already. I also tested for EBV 33 days, negative. Q: 1.Is it HIV?. 2. Could it be that all these tests are false negatives, as it might be within window period
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9 months ago
My original post is shorter than most post I have seen but for some reason I wasn't able to submit without having to trim it down, So, I just want to add what I couldn't in original post: I also did a couple of urine culture, everything was normal, also did an oral swap for Raspiratory panel 24 days post exp, and the only thing that came back positive was Rhinovirus/Etenovirus, (negative for Covid, flu and etc)
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H. Hunter Handsfield, MD
9 months ago
Welcome to the forum. Thanks for your confidence in our services.

There are many details in your question that don't matter. The HIV RNA PCR tests are 100% conclusive any time 11 days or more after exposure. Your negative results at 20 and 26 days show you do not have HIV. Nothing else matters -- not the amount of risk at the time of exposure (which in any case was near zero risk for HIV), not your symptoms, not any of your other test results.

Those comments pretty well cover both your numbered questions, but to be explicit:  1) "Is it HIV?" Nope. 2) "Could it be that all these tests are false negatives, as it might be within window period." No; and both your PCR RNA tests were well beyond the 11 day "window period".

Your symptoms do not fit with any known STD. It's good the rest of your STD tests were negative, but even if positive for something, it would not have explained the symptoms you describe. That also applies to the additional tests you had. All in all, you were WAY over tested. Most if not all your symptoms are  consistent with anxiety, magnifying minor symptoms or even normal body sensations that otherwise would not be bothersome and maybe not even noticed.

I hope these comments are helpful. Let me know if anything isn't clear. (And by the way, there is a character limit for the initial question window, intended to limit some users' tendency to write over-long essays!)

HHH, MD 
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9 months ago
Thank you very much for replying Dr Hunter, and apologies for not reading the rules/guidance for initial posting before actually posting.
I had never had this type of anxiety in my 34 years of life, so I hope it was all because of that anxiety. Except for maybe the pain in my thighs, fatigue and frequent urination which I was NOT even thinking about STDs when I started experiencing them.
And I do also feel a huge relief when a Doctor says my PCR tests were conclusive, so thank you very much for that! But I still have to ask, I hope you don't mind:
1. When you say "Your symptoms do not fit with any known STD.",  do you mean all of them? Because, every time I google my symptoms (I know it's not a good idea), first thing that pops up is HIV.
2. Is there a chance that this is HIV-2, which might have low viral load and go undetected by the RNA test I did (sorry if I am still overthinking this)
3. Could Rhinovirus (Common cold) that I got tested positive for be the culprit here and then my anxiety just made it seem 100 times more terrible?
4. My doctor also suggested to do the HSV-2 test one more time in 3 months along with hiv 4th gen test, does this mean there is a possibility of HSV-2 test (blood test) being a false negative after 25 days and should I still do hiv tests?
5. I also would love to know, if you think I should consider testing for Hepatitis diseases, and maybe do syphilis test in 90 days?


And thank you in advance for your patience with my questions.

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H. Hunter Handsfield, MD
9 months ago
1. Yes, I mean all STDs and also all of your symptoms. Not one of them fits any STD. As for HIV, almost any symptom associated with a hundred different infections can occur in HIV. It is the pattern of symptoms that can give clues about HIV infection; no individual symptoms ever point to HIV in particular. And your pattern of symptoms isn't even close. And even if you had the most typical HIV symptoms, the test results overrule. It is simply impossible HIV is the cause.

2. Some of the RNA PCR tests now include HIV2 and well as HIV1. But your antibody tests also have been negative, and they cover HIV2 -- and prove HIV2 is not he cause of your symptoms. And again, you had a zero risk exposure for HIV.

3. I missed your positive rhinovirus test. It could be causing some of your symptoms, yes.

4. I disagree with any advice to test for HSV2 in this situation. There is absolutely nothing in your symptoms or the nature of your exposure that fits with herpes.

5. You were not at risk for hepatitis. Sexually transmitted hepatitis B virus (HBV) is now rare because of widespread immunization (and you are immune if you were vaccinated). And contrary to popular belief, hepatitis C is not a heterosexually transmitted STD. 
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9 months ago
I believe I have one more follow up to use, so here it goes.
A few days after that exposure, while I didn't have any symptoms and was unaware I had contracted something, I had a protected sex with another girl, who I just talked to again and she said she had developed some flu-like symptoms, pain in thigh muscles, and now has some pimple/foleculitis/acne looking things showing up on her body in arms and legs mostly that don't itch initially but dry up and shed slightly in 2-3 days and then get slightly itchy. She had also tested HIV-1 RNA 12-13 days post our encounter negative. But I am now very scared that I might have given her HIV, please help! I can live if I have it but if I passed it to someone else, it will be unbearable for me. Could her symptoms be Syphilis, HSV or something else? What else should we test for?
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H. Hunter Handsfield, MD
9 months ago
It is 100% certain you do not have HIV and neither does this other partner. Her symptoms don't fit at al, and of course neither does her negative RNA test. They also do not fit with syphilis, herpes, or any other STD.

Perhaps you would also like to know this:  In the 21 years of this and our previous forum, with thousands of questions from persons concerned about exposure and infection with HIV, nobody has yet turned out to be infected. You will not be the first. If and when it finally happens, it will be from a genuine high risk exposure, which you did not have. (Think unprotected anal between two men.) And it also will not include impossible false negative test results!

As you expected, that concludes this thread. I hope you're finally able to accept the professional, expert, reasoned, science-based advice you have had, probably from your own doctor(s) as well as this forum. Move on without further worry. You're fine.

Best wishes and good luck.
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H. Hunter Handsfield, MD
9 months ago
I see you have started a new thread with the same question, and with a new username and account -- both against forum rules. There is nothing to add and you can be sure Dr. Hook's response will be no different than what you have heard here.---