[Question #1988] HIV & Symptoms

46 months ago

Dear Dr Hook or HHH,

I’m a male,23, from London. 11 weeks ago I had an exposure with a girl of unknown status who I met in a club, I was very drunk and I remember the condom broke inside her but realized early so I wore a new one. Since day 1 after that even, my life completely changed to the level of destruction and have been very anxious. Let’s start with the symptoms first, two weeks after the exposure I did catch a flu-like illness which included high fever and runny nose for two days, a week later I developed a severe sore throat, I know it is terrifying.  However I was good until 6th week when I started feeling burning sensations behind my back but the temperature was normal. 8 weeks after exposure, I started having runny nose, muscle ,joint paints and night sweats but no fever. It stayed a week but the muscle and joint pains still comes and goes, although I thought I had lymph nodes swollen in my neck but my doctor checked them and said they were fine, I had no rash, no oral thrush but now I do have a ulcer in mouth which scares me to death.

Tests

HIV 4th Gen Duo, syphilis at 2 weeks=Negative

HIV 4th Gen Duo&syphilis at 25 days=Neg

HIV 4th Gen Duo at 31 days=Neg

HIV 4th Gen Duo at 42 days=Neg

HIV 3rd Gen at 49 days=Neg

HIV 4th Gen Duo 55 days=Neg

HIV 4th Gen Duo 72 day=Neg

So, reading my symptoms, do you still believe that the tests I have taken are conclusive?

What if I haven’t produced antibodies yet? I’m planning to retest on 12 weeks, Do I need further testing if that was negative? Based on the long experience you have in this field, do you consider me HIV negative?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question. I happened to log in a few minutes after you posted it; most users shouldn't expect nearly real-time replies!

My first reaction is to congratulate you on having (intended) safe sex in this situation. Too bad the condom failed, but the intent was there. Good show.

One of the most consistent themes on this forum, and among HIV experts in general, is that the HIV blood tests (especially the 4th generation or "duo" tests) are among the most accurate diagnostic tests ever developed, for any medical condition; and therefore, assuming enough time has passed after exposure (4 weeks for the duo tests), the results always overrule all other considerations:  no matter how high the risk of HIV at the time of exposure and no matter how typical symptoms may seem to be for a new HIV infection, the test results rule. Your exposure probably wasn't very high risk, since HIV remains rare in women like your partner (sexually acquired HIV is very uncommon in London women), and your symptoms are not typical for a new HIV infection and started much too long after the exposure. But even if they had been high risk and typical, your test results prove without doubt that you do not have HIV. Indeed, you were rather seriously overtested:  the 25 day result was close to 100% reliable and the 31 day test definitely conclusive. All others were superfluous. There is no such thing as "haven't produced antibodies yet"; but even if that happened, the duo test not only evaluates antibodies, but also detects HIV itself. It is impossible to have HIV and have a negative duo test more than about 4 weeks after infection.

So for sure you are not infected (assuming no more recent exposures you haven't mentioned). You do not need any further testing at 12 weeks or any other time. Previous advice about waiting 3 months was based on older antibody-only tests that haven't been in use for almost 20 years. If you want to confirm this, call and discuss with an expert clinic, such as a nearby NHS GUM clinics, or London's excellent Freedom Health private sexual health clinics.

The only other issue, it seems to me, is whether you were also tested for other STDs that are much more common than HIV, in particular a urine DNA test for gonorrhea and chlamydia. You could also have a syphilis blood test, although syphilis is almost as rare in London as heterosexually transmitted HIV, so that's optional. A GUM clinic or Freedom Health could take care of these if not yet done.

I hope this information is helpful. Best wishes and stay safe.

HHH, MD
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
To clarify symptom onset time, 2 weeks is consistent with HIV; but the 8 week onset of other symptoms is not. But still the test results rule.

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46 months ago
Dear Dr HHH,
many thanks for your quick response, it was very relieving.
I have done tests for Gonorrhea and Chlamydia, they were negative after 25 days, syphilis after 6 weeks was negative.
I have visited Freedom health and met Dr Sean Cummings, he tested me 3 times and reassured that I'm %100 HIV negative but I don't know how to accept this when my body gives me signals that there is something wrong.
One more thing to mention, I have done two blood cell counts at 6 and 11 weeks, they were normal to the doctor but what concerns me is my WBC count has dropped from 6.6 to 5 during these times.  Does that indicate to anything in your point of view ?
SO you reaaly think I should close the doors to HIV and move on ?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Glad to hear of your negative STD tests and that you are already linked with Freedom Health. Dr. Cummings is an internationally reknowned HIV/AIDS expert; you can rely on his expertise and reassurance. Glad to hear your blood counts are normal as well. That amount of variation in WBC count is entirely normal. Your body's "signals" are much less reliable than the test results. You deifinitely can "close the doors to HIV and move on".

If you see Dr. Cummings again, for still more reassurance you could print out this thread as a framework for discussion. If so, give him my greetings.

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46 months ago
Dear Dr HHH,
Thanks again for your answer. 
As a joke Dr Sean said that he does not want to see my face again because of overreacting, but will send him your greetings when I go back for my 12 week and final test. 
Thanks again, will do my best to go on with life. 

46 months ago
Dear Dr HHH,
Last question!
I forgot to mention that I also have a white tongue, and sometimes I feel pain in my arm muscles and back. 
You have been answering questions on forums for a long time, do you believe anxiety can lead to symptoms very similar to HIV ? 

46 months ago
Doctor HHH,
I promise this will be my last question and you can close the thread, I have been keeping my self away from my girl friend for around 3 months. I mean I don't want to sleep with her and she finds it very strange and she almost broke up with me as she thinks I'm ignoring her but the fact is I'm trying to protect her but can't tell her now.
Do you think it would be safe if I perform sex with her before my 12 weeks result ? Or you prefer if I wait ? 

Many thanks and you all are really doing a great job here, I appreciate it.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
White tongue happens all the time in entirely healthy people; it's not a significant health indicator. Your muscle and back pains also are not of concern. Please trust me (and Sean) on this:  you cannot possibly have HIV. And yes indeed, the physical symptoms of anxiety include all the sorts of aches, pains, etc that you describe. Many symptoms that occur in people with HIV are common to literally hundreds of other medical disorders, and the vast majority of people with them are HIV free.

There is and has been no valid reason to avoid sex with your girlfriend. For sure you should have resumed sex with her after your negative HIV test at 31 days and negative STD tests. And for sure you should resume a normal sex life now.

Thanks for the thanks about our services. As you know, that completes the two follow-ups included with each question and so ends this thread. I hope it was helpful. Best wishes and stay safe.

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