[Question #15] HIV symptomes on week 11.5 (For Dr. Handsfield or Dr. Hook)

42 months ago

Dear Doctor, 

I had a trip to Frankfurt and I went to a massage salon. 
The masseuse was an African lady and she was completely naked 
She applied oil all over my body and gave me a hand massage: 

  • During this time, I feel her vagina might have slipped into my penis I was not wearing a condom….(I am not sure about this, my eyes were closed) .
  • Then she fingered my anus during the massage. I didn't checked if she had cuts\blood on her finger….
 I did 4 COMBO TESTS(hiv1,12+P2): 

14 days after - NEGATIVE - in a well know private lab in israel 
28 days after - NEGATIVE - in a well know private lab in israel 
41 days after - NEGATIVE - in the same lab. 
50 days after - NEGATIVE - in the same lab. 
11.5weeks after the exposure I started to have similar symptoms to ARS which continued for 1.5 weeks as follows :

1. 48 hours of high FEVER around 38 
2. 24 hours after the fever came i started to develop mouth ulcers:very pain white spots on the inner bottom lips
3. Than low fever (around 30-37.5) and for three days at every night I woke up with extreme pain muscles in my legs and arm-fingers- I could barely open a bottle of water…
4. After 5 days weakness in my arms –finger, no fever and the mouth ulcers started to disappear everything went away and came back to normal... 

My doctor said it was probably a viral infection, but I searched on the internet and couldn’t find any symptoms like I had that cause by a viral infection in the summer. Also my wife and daughter didn’t  get those  symptoms(my 2 years old daughter had mouth ulcers but different from mine without fever and pain muscles)

My questions:
1:Is there a second window time after 2-6 weeks symptoms? Could ARS symptoms start at 11 week?
2:Do I need to test again – maybe because of my risk to hiv type 2 ??

Best regards

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago

Welcome to Ask the Expert. Thanks for your question.

 

You describe a zero risk exposure for HIV. Without insertive sex – penile entry into vagina or rectum, with no condom – HIV is not sexually transmitted. Even oral sex, without a condom, carries little or no risk. It is not possible to be exposed to enough virus for transmission to occur from hand-genital contact, kissing, or with the possible fleeting contact of your penis with your massage partner’s genital area.

 

Second, your symptoms: First, 38C is barely elevated, not a “high fever”; and 37-37.5C is normal. (37C is not the maximum normal temperature, but the average temperature in healthy people or, in any individual, over the course of a day.) Second, no HIV symptoms can start sooner than 7-10 days after catching the virus. And although oral ulcers often accompany acute HIV, that symptom also was too soon. Weakness etc isn’t an HIV symptom, and those symptoms also were too early. As for your symptoms at 11+ weeks, that’s much too late for ARS. And anyway, none of your symptoms in fact were highly suggestive of HIV. The vast majority have not only fever and sometimes mouth ulcers, but also sore throat, enlarged lymph nodes, and/or skin rash – none of which you mention.

 

Third and most important, you HIV test results are conclusive. The combo test is 100% reliable after 4 weeks, so your 41 and 58 day tests were superfluous and unnecessary. HIV test results always overrule both exposure history and symptoms. Even if you had had a high risk exposure, and even if your symptoms were typical, the test results tell the truth: you don’t have HIV. I think your personal physician was right:  you had a minor viral infection, probably the same one as your 2 year old child.

 

To your specific closing questions: 1) There is no such thing as a “second window time”. 2) HIV2 is detected by the combo test. Also, HIV2 is rare outside parts of Africa. I don’t know the specific situation in Israel, but I’ll bet they have had few if any HIV2 infections there. You could contact local or national health authorities to check, but it’s really nothing to be worried about.

 

Bottom line: You were at no risk; had no symptoms to suggest a new HIV infection; and your test results prove you don’t have it. All is well!

 

I hope this has helped. Best wishes--  HHH, MD    

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42 months ago

Hi,

Thanks a lot for the quick respond, I really appreciate it :)

Just 2 comments:

1: All my symptoms began after 11.5 weeks.

2: My exposure was in Germany, Frankfurt city and  the lady was an immigrant from Africa

 

Soo basically, I have only two more questions left for closure:

 

1. Does my result also conclusive for hiv2?

2. Could ARS symptoms start after 11 week?

 

Best regards and  again Thanks a lot for helping me

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Thanks for the thanks. I'm glad to have helped.

Sorry I misunderstood the timing of your symptoms. But neither that nor the other information changes my opinions and advice. I was aware of your location (Frankfurt) and the African origin of your partner.

I already covered your these additional questions. I wrote "As for your symptoms at 11+ weeks, that’s much too late for ARS", and "HIV2 is detected by the combo test. Also, HIV2 is rare outside parts of Africa." I mistakenly referred to Israel, where you were tested, instead of Frankfurt, where the massage took place. But I'm pretty sure HIV2 is just as rare in Germany as in Israel or anywhere else outside equatorial Africa. Anyway, the combo test does detect it, so your negative test results are valid for both HIV1 and HIV2.
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42 months ago

Great!!

You helped me a lot, again I appreciate your help.

Your detail answers definitely closed the case for me

Best Regards