[Question #2908] ARS!?

42 months ago

Hi Doctors,


Appreciate your help here. 


I had a potential exposure 19 days ago - unprotected vaginal sex - with what is on the face of it a low risk female. 


As of about 3 days ago I have developed the following symptoms which are really scaring the life out of me:


  • stomach upset - it started by making me feel a little nauseous and as if I need to go toilet, but do not actually need to. Alternatively I have found that I have cramps, wind and slight weakness. I don’t think it is full blown fever as I am not bed ridden nor do I have a temperature. This feeling has been fluctuating. At times I don’t feel it, at others I feel really uncomfortable. 
  • Sore throat that keeps coming and going. 
  • Slight rash on my face. It started out looking like a spot, but when I looked closer, it looks like a light rash. I understand they are usually mascopapilar and I think this might be - slightly raised, non itchy with little see-through parts. It is a little less than a cm in diameter. I have not seen it anywhere else and it is right beside a spot. 

Does this sound like ARS to you?


Thanks 






Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum.  I'll try to help.  If your female sex partner had HIV your risk for acquiring HIV is less than 1 infection in 2000.  If your partner did not have HIV, you are not at risk for HIV although there are other STIs which might be tested for.

The symptoms you describe do not suggest the ARS.  While the ARS is most common in the 1-3 weeks following acquisition of HIV, the symptoms of this syndrome tend to be dramatic and more severe than what you report.  These symptoms include a high fever, severe muscle aches and a painful sore throat an, on occasion diarrhea or a generalized skin rash..  An isolated rash on your face does not suggest the ARS and the absence of a fever likewise suggests that this may be a regular non-HIV sore throat of the sort that most people get from time to time...If you test with a combination HIV antigen/antibody test at this time, this will prove that your symptoms are not due to HIV as these tests are virtually always positive in persons with the ARS.  Results of this test for HIV in persons do not experience the ARS are not definitive until 6 weeks after exposure although over 98% of infections are detectable at 4 weeks.  If you choose to test, I would suggest you might wish to test for other, far more common STIs such as chlamydia and gonorrhea which can be tested for at this time with a voided urine specimen.

I hope these comments are helpful to you.  Nothing you have said at this time suggests you should be worried about HIV.  EWH
---
42 months ago
Thank you doctor. 

That is both helpful and reassuring. 

Understanding that the chance of infection is statistically unlikely, has helped a great deal, but want to clarify a few things that might help me lower my anxiety over this. 

1. Is it the case that the rash would have to appear in multiple places around the body? I have also noticed other smaller looming rashes, but these resemble usual rashes that are not flat by any means. 

2 in terms of my stomach issues. These worry me the most. If not typical ARS? Any idea what they could be? I have noticed that I either have wind or burp a bit the last few days, but no diarrhoea at all, nor any noticeable increase or decrease of frequency in going toilet. To describe it, my stomach sometimes feels like it has cramps and other times like I’ve eaten something hot. 
Are gastrointestinal issues ever seen with ARS?

In terms of the sore throat, I agree in that there is not yet enough in it for me to know either way. It is a little intermittent as yet. In order for it to be possible, would it have to be quite severe?

Lastly I am due to travel on my 28th day.  Would there by any difference in getting the test done on the 27th day? Also, would a 4th generation Instant test be as good for a quick result? I think it’s the Alere Combine. 

Many Thanks 




Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
1.  Yes, the rash of the ARS, when it occurs, is generalized, not localized.  Mostly they occur on the chest and back.
2.  Nausea is a non-specific problem with many possible causes.  When the ARS causes GI tract problems, it causes mild diarrhea. 
3.  Sore throat- intermittent symptoms again, do not suggest the ARS.
4.  Testing on the 27th day will be highly predictive of your HIV infection status and, I anticipate, will be negative.
EWH
---
42 months ago
Hi Doctor,

Thank you for your reply.  I have since sought help and have been advised that I do, in fact, have light diarrhoea. Albeit very light. 

Does this change your assessment?

His leaves me with recurrent sore throat, stomach discomfort/cramps, and very light diarrhoea. I am now incredibly worried and anxious about this. 

The stomach issues started about 4 days ago now and have hardly abated. I am not vomiting or anything, and as far as fever, I am unsure if this can be classified as such. My temperature has not been very high and I am able to go to work in the morning, but for the discomfort. 

I have not been able to speak with my partner since. At the time she suggested she tested and was clear some months before and I am circumcised (I understand this makes a difference)

I still intend to test next week, but am so so worried that I know the answer now despite being made to believe that under my circumstances it is hardly ever seen (one off, circumcised and heterosexual encounter)

So so scared now.  

Appreciate your thoughts and comments. 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
No, light ( or heavy) diarrhea does not change my assessment.  I really think you are worrying more than you need to.  EWH---