[Question #13469] HIV ARS?

9 hours ago

Hello Doctors

I would greatly appreciate your assistance. I am a tad freaked out at the moment.

I will start off by saying that I have not engaged in any sexual intercourse, open mouth kissing etc with anyone, nor have I been exposed to huge traumatic amounts of blood. I say this as I understand unprotected sex and blood exposure are the only ways in which adults can become infected with HIV.

About a week ago (maybe longer) I picked at a scab on my arm and it bled for a while. I do not recall washing my hands prior to this and I am conscious that I had been touching door handles at work, in the parking lot and bathroom; and posts on public transport.

A few days after I came down with terrible flu-like symptoms (feeling hot, chesty/phlegmy cough and overall exhaustion). I spent 4 days in bed pretty much.

I went back to work yesterday, and in the last 2-3 days I have noticed almost a tic-tac-like shape under my skin on my jaw bone near my mouth. It is very tender to touch.

I do not know if this is a potential cyst or swollen lymph node. It has no yellow head like a pimple and is skin colour.

My symptoms over the last week of course have me fearing of ARS. Please can you help me?

Edward W. Hook M.D.

5 hours ago

Welcome to our Forum. Thanks for your questions and your implied confidence in our service. I'll be glad to comment. Your symptoms suggest one of the occasional, community acquired viral illnesses that most of us get from time-to-time. They are not the HIV ARS however. I say this with complete confidence for the following reasons, including:

1. You have do ne nothing that would potentially expose you to HIV. An open scab is not a potential site of entry for the virus and the virus is not acquired though transfer on a person's hands, trugh touching contaminated surfaces such as door knobs, or through other activities of normal living.

2. Cough and sputum production are not part of the ARS.

3. While the cyst may be a lymph node related to your viral infection, it is non-specific and certainly does not suggest the ARS

From a medical/scientific perspective, I see no need for testing or concern. Having said that, I also know that sometimes our clients take additional comfort from getting a negative test. If you chose to test, the results will be negative and, in that way, prove that your symptoms are NOT due to HIV since when ARS symptoms are present, 4th generation, combination HIV antigen/antibody tests are always positive.

I hope you find this information helpful. Please don't worry. EWH

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5 hours ago

Thank you for your reply, Dr Hook and for your assurance.

I had an HIV blood test a month ago as part of my VISA renewal (I live and work in MENA).

I wanted to get the opinion of yourself and/or Dr Handsfield as I have seen too many conflicting comments from medical professionals (including on Healthtap), where some have said an actively bleeding cut (no matter the size) would warrant an HIV test if the person had genital fluids or blood on their hands and touched it. Naturally this concerned me as I wiped away the blood with my finger when I noticed the peeled scab was bleeding (it was 3-4cm in size); and I thought about fluids potentially being on handles etc.

I note that this forum is particularly unique as you have not had one positive HIV infection in 20+ years (?) of the forum’s existence. I am therefore taking your word as gospel.

My follow up questions are:

1. I move on with my life with zero concern regarding the peeling scab event (even though it was bleeding and my finger touched it to wipe away the blood)?

2. Am I correct that I will NEVER be at risk of HIV unless I have unprotected intercourse or I am exposed to huge amounts of infected blood (i.e gunshot victim and/or shared needles)?

3. When you say ‘activities of normal living’, does that include things like licking fingers, drinking from the same glass and eating food without washing hands prior? (i.e zero risk events for all?)

4. Are my fears regarding this event unwarranted since I have read that HIV dies instantly when outside the body? (I only ask this because, again, I have seen other medical pros providing differing verdicts, and in my case MENA is hot and humid, so not sure if the virus would die in this climate).

Thank you for your help.

Edward W. Hook M.D.

2 hours ago

Thanks for your follow-up questions. I have no experience with Healthtap although when I looked on line I see it has mixed reviews. I suppose that in theory an opencut could provide an entry way to HIV if DIRECTLY exposed in the same way that in theory you could be struck by meteorite falling from space while reading this reply. That said, there are no cases reported in which HIV has been acquired through transfer of virus from an inanimate object such as a handle, etc. The situation you describe was associated with no realistic risk for infection. In response to your specific questions:

1. I continue to encourage you to move on with no concerns about HIV from the situation you have described'

2. Correct

3. Yes. Each of the situations you describe are zero risk.

4. There are reports of viable HIV being detected soon after exposure to the environment outside of the body but there is no evidence that that virus is infectious (organisms become non-infectios before they die)

Please don't worry. EWH

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