[Question #149] Worried I may have been infected with HIV

37 months ago
Hello,

93 days ago I had unprotected vaginal intercourse with a female of unknown status. The morning after i was experiencing discomfort in urethra (slight burning sensation). 
- I tested for complete STD Panel Including HIV-4th gen, one week later - all non reactive (with exception of HSV-1, already known)

Had other symptoms begin skin related (back of neck & forehead - acne type irritation) with some eye irritation (red, burning & itching)
Also experienced slight muscle and joint pain.
- I retested for complete STD Panel Including HIV - antibody 3 weeks post possible exposure - all non reactive (with exception of HSV-1, already known)

At week 6, I experienced extreme fatigue, upper and lower abdominal pain, kidney or back pain and slight diarrhea (not sure if it was diarrhea or if i just made myself believe it was)
- I retested for complete STD Panel Including HIV-4th gen & HIV RNA 8 weeks post possible exposure - all non reactive (with exception of HSV-1, already known)

At week 10, I was experiencing high anxiety and I noticed my veins were darkening in my wrists and arms so I went to the ER for basic bloodwork (thyroid, diabetes, etc.), urinalysis all came back fine.
-I also had an additional HIV-4th gen & HIV Rapid tests - Both non-reactive

It is now after 90 days and I have retested for antibodies outside the window period and awaiting results. Leading to my questions:

1) Are all of my test results leading up to now conclusive? Is there still chance that I have HIV?
  ***I do not have any immune disorders, illnesses that would effect the results (to my knowledge) and I did not take any medication or PEPs.

2)Would reactivation of HSV-1, cause similar symptoms to what is explained above? If not, what else do you think may be causing symptoms?

Thank you for your prompt reply,
JN


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

Welcome to the Forum.  I will be glad to comment.  You have now tested with STD panels on at least three occasions by my count and for HIV on four occasions, the most recent STD panel being more than 6 weeks following exposure and the most recent HIV panel being 10 weeks post exposure.  With these negative results you should be entirely confident that you did not acquire any of the STIs tested for, including HIV.  There is absolutely no reason for further testing or concern about STIs related to the exposure that you describe over two months ago.  Specifically, with 10 week test results you can be absolutely clear you did not get HIV from the exposure you have described. 

As for HSV-1, your symptoms are not consistent with an HSV reactivation either.  Regarding the source of your symptoms, it appears that you have not had any specific lasting or progressive symptoms and, rather, over the past 10 weeks you have had a variety of symptoms- eye and skin symptoms, loose stools, abdominal discomfort, fatigue but that none have been lasting.  Am I correct on this?  If so, my suggestion would be that, being understandably anxious about your exposure, you are now in a "hypersensitive state" in which you are on the lookout for symptoms and when the sort of passing aches and pains we all experience from time to time (i.e. we all have good days and bad), you tend to wonder if they could be HIV or STI related.  This is not at all unusual.  The best way to put them behind you is to believe me when I tell you that your test results are now definitive and should be believed.  Then try to focus your energy and attention on other things.  You were not infected by the exposure you describe (remember most people do not have STIs and even when they do, exposure usually does not lead to transmission).

I hope these comments are helpful to you.  EWH

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37 months ago
Dr. Hook, 

Thank you for your reply and I feel pretty confident that my test will be negative. Most symptoms other than fatigue have not been long lasting more than a few days. The one major concern is penile and testicle discomfort. That has been ongoing and may have been an issue prior to possible exposure 3 months ago, I just can't remember. 

I will wait for my results and reply when I get them. 

Thanks again,

JN
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Glad I could be of service.  EWH
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37 months ago
Dr. Hook,

My confidence has been superseded by worry within the past couple of hours. I still have a slight doubt that my test will come back positive. I know that your response will stand. Please reassure me explaining why my test results will remain negative. It would be greatly appreciated and I will leave it alone after your response. 

Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
You are correct, my answer will not change.  The tests that you have already have performed prove that further tests will also be negative and prove that you did not acquire HIV from the exposure that you have described. At this time further testing is a waste of time and money.  EWH
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37 months ago
One other early symptom that i forgot to mention and is the route cause for most of my anxiety and stress involved the palms of my hands. I experienced very small and sporadic bumps under the skin of my palms. they didnt hurt or itch at first but after they were there a day or two, they would begin to itch. After about a week they would peel off leaving small circles of broken skin. Is this something to be worried about in regard to sexual health. These symptoms began a couple weeks after the incident.

Thanks,
JN
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
While syphilis can cause a rash that occurs on the palms of the hands and soles of the feet, syphilis is quite rare and the rest of your description is not suggestive of syphilis which, in this day and age, is primarily an infection that occurs amongst men who have sex with other men.  Personally, the rash you describe does not raise any concern for me but if you are concerned, you could get a syphilis blood test (or another one if you have already had one).  Results would certainly be absolutely definitive at this time.  EWH
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37 months ago
I had the RPR test each time within panel testing - all non-reactive. Syphilis does not typically have a long window period does it?

Thanks,
Josh 
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago

No, it does not.  If your RPR is negative, you can be confident you do not have syphilis.

It is now time to close this thread.  We are beyond the three response level that our policy specifies as the appropriate length of interactions.  Take care.  EWH 

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