[Question #296] HIV Symptoms/Test Accuracy

35 months ago
Hello and thank you for this service.

In July, I had strep throat, confirmed with a test.  I experienced symptoms, mainly sore throat and fatigue, non stop since then, but with diminishing severity.  I did not think i had any risks, but the symptoms have made me quite paranoid, and I can only imagine one hypothetical scenario in which I maybe had vaginal unprotected sex, a week before my symptoms began.  2 months after the onset of symptoms, I began feeling neck stiffness and suspected i had swollen lymph nodes.  The lymphnodes are not obvious to the touch, but were confirmed to be benign but enlarged on an ultrasound a couple weeks ago.  The sore throat, larynx swelling, and fatigue come and go, the lymphnodes seem tobe getting larger, and my neck stiffer.  

I had a gen 3 antibody test at 7 weeks.  Also had a rapid oraquick test at this time.
I had another oraquick test at 4.5 months 
I had a rapid clearview blood test at 5 months and one week.
All negative, fortunately.

1) will I benefit from further testing, maybe gen 4?  How much accuracy will this add?
2) is it possible i could have theses ymptoms without antibodies for this long?
3) i am having trouble finding any alternatives as to whit this might be.  What can i do?

Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Welcome to the Forum.  I'll try to help.  Let's start with my most important message for you- you do not have HIV.  Wile some persons with recently acquired HIV have severe sore,throats and lymph node swelling, only a small(1
%) of,persons with these symptoms turn out to have HIV.  The remainder have community acquired viral infections, most of which are hard to specifically diagnose.  

Your 7 week test would have detected over 95% of recent HIV infections and the timing of the two subsequent tests is definitive since these tests are reliable after 8 weeks in the vast majority of recent infections and after 12 weeks in all cases.  Currently available HIV tests are amongst the most reliable tests in all of medicine.  Believe the results.  There is absolutely no medical reason to repeat your tests related to your exposure over five months ago.  Further testing will be of no benefit with any test, 4th generation or otherwise (the advantage of 4th generation tests is how quickly they become positive and there is no advantage to you of testing with another test.

As far as where to go from here, you need to work with your doctor on this.  There are many viral infections (mono is one of them but there are many others) which can cause lasting lymph node swelling and run down feelings.  Typically, the best thing one can do is to work with the same doctor to first make sure there is nothing serious present and then to be followed by that same person over time.

I hope this comment is helpful.  Please do not worry further about HIV.  EWH
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35 months ago
Thanks very much doctor.  As a secondary confirmation, is it the case that I could not have symptoms this long (5 months) without making antibodies?  
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
No, you would certainly could not have 5 months of symptoms due to HIV and not have a positive test. 
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