[Question #1350] F.A. [Question #1290] ---- ARS SYMPTOMS

46 months ago
Hello again, a few weeks ago I made you some questions concerning a possible infection of HIV via cunnilingus. Dr. HHH told me that the options were virtually zero, and really forgot about it. However this week (4th week) I had a persistent sore throat (with phlegm), runny nose and cough, any pain when eating. To get in context, several friends and family have had symptoms of a sore throat too, just that lasts more mine. I have not had fever (check it daily), or muscle pain, fatigue, mouth ulcers ... Another thing is that I have had intermittent diarrhea during this month.

My personal physician has told me I need not take the test because in their view, oral sex alone could be transmitted via giving fellation and that the symptoms are not interesting as there is no fever. I still have 3 weeks to test me, what worries me most is that I had sex with my girlfriend, I thought it was impossible to catch really well, but now back to doubt. My questions are:

1) my symptoms fit with ARS?

2) My doctor thinks my sore throat is due to a cold and lasts for smoking. What is your opinion?.

3) They've upped my options have HIV because these symptoms

4) The million dollar question, should do the test or forget the matter?

5) Regardless of what you recommend that I do. if you were in my situation (my risk exp, symptoms ...) would you do the test?

6) Yesterday I looked at my throat with a flashlight and pharynx saw that there were as grains, there were not ulcers, they were like orange blisters pharynx with different shapes. My feeling is itching and dryness. It could be an STD or HIV symptom?

Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago

Welcome back to the Forum.  I'm sorry that your recent sore throat has caused you to worry about the exposure you described again.  I, read your earlier interaction with Dr. Handsfield and  agree with all that he said.  This you have now heard from your own doctor, Dr. Handsfield and me that the exposures you describe did NOT put you at risk for HIV and that there was no reason for concern.  The recent sore throat that you experienced is a coincidence and unrelated to the exposure you mention.   If you had asked about the need for testing, I would have told you that there was no need for testing.  that your friends also had sore throats, that there was no fever and the timing of your symptoms all add to the evidence that your sore throat was not due to HIV- the symptoms of the ARS typically occur within two weeks of an exposure and DO OT occur at four weeks- that is too late to be HIV. 

In answer to your specific questions

1.  No they do not. These symptoms occurred too late for the ARS and when persons have the ARS, they typically have high fever and severe muscle aches as well as a sore throat.

2..  I agree.  And smoking will make a sore throat worse.

3.  No, your symptoms do not change your risk for HIV.  it is still essentially zero.

4.  I urge you to forget about HIV risk from the exposure you described. There is none.

5.  I would not test.  If you feel you must test, I would get a 4th generation, combination HIV antigen/antibody test 4 weeks after the exposure.  At that time the test results would be definitive and not need to be repeated.

6.  If anything what you saw is more suggestive of a viral sore throat than HIV or any other STI. 

I hope my comments, re-enforcing those that you received before will be helpful and allow you to move forward without further concern about the exposure you described.  EWH

---
46 months ago
Hello, I still have doubts about times ARS. My date of exposure was 07- October and my sore throat 28-29-October, about 21 to 22 days apart. I understand that this is not an exact science, my doctor says again that it is an irritation of the pharynx as he sees daily. He said that on Monday I'm going to do a test of all STDs to see if I can continue my life without regret. By the way, oranges things in my throat my doctor says it was just inflammation.

My questions are:

1) 21 days is too much to be ARS? You know of any case that comes only with a sore throat? I read that 80-90% of those who suffer ARS have also fever.. I do not have the fever or other symptoms. Does this indicate that it has nothing to do with ARS? are mucus and phlegm symptoms?

2) The test results are completely definitive (laboratory are 4ºG) in those dates (31 days)?

3) Any your patient or some other partner has been infected in this way?

4) This month I have not had any sexual relationship with my partner because it seemed too risky, but we've kissed, she caught myhand, sharing drinks and activities like this. Have I put on some risk?

5) In your opinion, I'm being a hypochondriac and all this is ridiculous?

5) It is not a question, but I ask you a word of relief so far to know the results, it will take 2-3 days starting Monday. Although if I think rationally know I could not have gotten infected, I'm still pretty nervous. I have only 25 years old, a beautiful girlfriend and a mistake that I know I will not commit.

Thank you very much for your kindness, do not close the thread until I know the results please
46 months ago
I forgot to say that my gums sometimes bleed when I brush my teeth, and I brushed my teeth a couple of hours before the incident.
Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago

None of these questions in any way change the message that Dr. Handsfield or I have told you about your NO RISK activity, nor does it change the message.  You are not at risk for HIV and ANY signs or symptoms that you are experiencing are NOT due to HIV.  As for your repetitive questions:


1) 21 days is too much to be ARS? You know of any case that comes only with a sore throat? I read that 80-90% of those who suffer ARS have also fever.. I do not have the fever or other symptoms. Does this indicate that it has nothing to do with ARS? are mucus and phlegm symptoms?
When persons experience the ARS. most experience symptoms within two weeks of exposure.  The symptoms are typically severe, include fever and como on all at once.  Your symptoms DO NOT suggest the ARS. 

2) The test results are completely definitive (laboratory are 4ºG) in those dates (31 days)?
Yes, test results with 4th generation tests are definitive at ANY time more than 28 days (4 weeks) after exposure.

3) Any your patient or some other partner has been infected in this way?
No, as I've already said- your exposure was no risk. 

4) This month I have not had any sexual relationship with my partner because it seemed too risky, but we've kissed, she caught myhand, sharing drinks and activities like this. Have I put on some risk?
No!

5) In your opinion, I'm being a hypochondriac and all this is ridiculous?
Yes, in my opinion you are over reacting and should resume normal activities with your partner. 

5) It is not a question, but I ask you a word of relief so far to know the results, it will take 2-3 days starting Monday. Although if I think rationally know I could not have gotten infected, I'm still pretty nervous. I have only 25 years old, a beautiful girlfriend and a mistake that I know I will not commit.
As you acknowledge above you are being irrational.

Brushing your teeth and having gums which bleed in no way change my opinion or advice.  EWH




---
46 months ago
My Combo results are 0.07, so No Reactive, for me it's time to forget. Thank you very much for the patience, it is difficult to be rational when speaking with HIV. If one day you are in Spain, I would be happy to help you in any case.
Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago
Thanks for the follow-up.  I'm pleased that you will now be able to move forward without continuing concern.  EWH
---