[Question #2921] Further hiv information would be greatly appreciated

41 months ago
I would just like a little more information to help me out. Five days ago Dr. Hook and myself discussed a situation that he felt was a no risk. However, after reading some of your older posts I'm sure you both would agree no risk isn't actually no risk unless it involves abstaining from sexual activity. 
   The further  information I'm seeking is I've had a sore throats for about 8 weeks now. The sore throats got substantially worse seven days ago, this is what stemmed my initial question. Of course what went through my head was it is a different sore throat. I also had what I believe to be a mouth ulcer on the side of my tongue that lasted a day and now I have loose uncontrollable stools. The stools came eight days after the throats issues. 
     Touching on the nobody has seroconversion after eight weeks. Is this based on personal experience or case studies? I found on line Dr HHH referring to a conference of 300 doctors who unanimously agreed. 
      If you believed I had a risk would the symptoms listed above make you consider ARS?
     I cannot get to the clinic for at least two more weeks to take a blood test, would an oraquick test at 72 days be able to detect antibodies if the symptoms of Ars were only present for seven days? I also found some literature that DR HHH said he originally believed you would test positive right away with symptoms but after speaking with colleagues he now believes symptoms might have to be present 11-14 days before detection
   Hiv 2: could seroconversion happen a lot latter because it's not a very potent virus in the beginning? Could seroconversion happen at nine weeks with that virus?
  I need to keep this in perspective. I have had a negative fourth generation test at six weeks along with a negative rna pcr test. However, I need to make sure I'm not infected. 
   
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
I'm sorry that you continue to worry about the very, very low risk exposure that we discussed before.  I think your concerns are unrealistic.  You are correct that very, very low risk is not no risk but when your description of you exposure is considered in combination with your test results you should be entirely confident that you were not infected.  I say this with the same confidence that I say I am confident that you have not been infected with an alien life form from outer space, something that is equally likely with your possibility of having been infected by the encounters you have described.  Withthis perspective I will now address your questions, several of which are rather repetitive:

Sore throat.  An isolated sore throat at 8 weeks is simply not compatible with the ARS.  The ARS is not a single symptom but a collection of symptoms which typically include a severe sore throat, high fevers, and intense muscle or joint aches.  Some patients have a faint generalized skin rash and loose bowel movements as well.  Mouth ulcers are not part of the ARS.  The ARS occurs at the time antibodies are beginning to show up in the body.  Everyone has antibodies before 8 weeks- the ARS does not occur after 8 weeks, not matter what is said on the internet.  Your symptoms in NO way suggest the ARS.

Yes, an OraQuick assay at 72 days would be completely reliable for HIV diagnosis.  Including HIV-2

I think you are mistaken about ARS symptoms occurring 11-14 days after antibodies are detectable.  Combination HIV antigen/antibody tests are virtually always positive during ARS symptoms and antibodies are detectable within a few days of the onset of the ARS. 

HIV-2 (again)  See above. the time to seroconversion for HIV-2 is similar to the time for seroconversion for HIV-1.  Tests (including the oraquick) would be positive before 9 weeks had passed. 

I agree, you need to keep this in perspective.  You need to determine how to do this.  If you think an RNA test would do this, do it.  I already know what the test will show (it will be negative) but you need to reach a point where you understand that you did not acquire HIV form the exposures you have described.  I hope these comments will help you to get there.  EWH
---
41 months ago
Sorry if description was a little jumbled it's hard to get everything expressed in coherent fashion. 

First I do have a sore throat about 4-5 on pain scale along with loose uncontrollable stool. The stool came a week after the sore throat. Is this considered a collection of symptoms?

You did clarify this later in the post but I meant that you wouldn't have measurable antibodies until 11-14 days after ars symptoms began. You clarified that it would be a few days after symptoms

Lastly, I did have a pcr rna that was negative. 
I will hang onto my last comment just in case I've been infected by an alien and feel the need to tell you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
No, a sore throat (I would consider 4-5 moderate) and diarrhea has MANY causes.  Your negative test outweighs your symptoms. When symptoms and test results differ, the tests are virtually ALWAYS right. 

Measureable antibodies are present within a few days of the onset of ARS symptoms.

Your RNA PCR is further proof that you were not infected. Further testing is truly a waste of time and money.  You might as well take any money you are planning for further testing and burn it.  Seriously. EWH
---
41 months ago
Doctor Hook,
  I would like to start by thanking you for your advise and everything you have told me has been put to good use. They say knowledge is power. It helps in a situation where you feel powerless. I would like you to know I completely understand the improbability of being infected. I'm sure it's one with many many many zeros behind it. However I'm having a hard time completely ridding myself of these thoughts, especially since I find myself visiting the porcelain throne 10-15 times a day now for 5 days straight. I'm sure it's probably IBS Accompanied by stomach aches.This has me very concerned so I decided to take a rapid fourth generation finger poke test four days post "symptoms". This would be 74 days post exposure.
  Being rapid tests aren't quite as sensitive as laboratory tests would four days be enough time for Test to turn positive if in fact these where ARS symptoms? If not, how long would it take?  
   The sore throats comes and goes but is never there all day it's usually only partial days. So Ive concluded this isn't anything to worry about does the diarrhea in any way alarm you?
   Have you in you long career ever seen a negative 74 day test turn positive at 84
   
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
The problem of sensitivity of rapid HIV tests has to do with the time these tests take to become positive, nothing more.  I urge you to believe your test results.  This is not HIV and repeat testing is not going to change the result.

I think you need to look elsewhere for the cause of you diarrhea. There are many causes other than HIV and given the intensity of your symptoms, it is appropriate for you to seek medical care to look at other causes (and treatment for your ongoing gastrointestinal symptoms.

As you know, we provide up to three responses to client questions. This is my 3rd response to your questions and therefore this thread will be closed later today.  Take care.  Please do not worry further about HIV and there is no need for further testing.  EWH
---