[Question #4904] Hiv

27 months ago
I am 45 yr old woman that lives in Chicago, on the 5th of October I had a All out RISKY unprotected anal and oral on both parts (no pententration)  with a  man who's HIV status is unknown. Three days after the encounter I developed dark urine, terrible sore throat with nagging body aches including  stomach ache just a sick feeling. I went to the Doctor had a panel done comes back Herpes 1. But not herpes 2 (interesting)? HIV Antigen/Antibody negative but was literally days after encounter so that doesn't count... I'm officially depressed, ate nothing for 6 weeks straight, only nibbling. My body is changing feel like I've been hit by a train. Still feeling sick now I can't sleep, headaches, swollen lymph in jaws and groin. Skin peeled of my  palms and bottoms of my feet and they also itch and ache. My joints ache wrists shoulders, knees.. Muscles ache all over like I move boxes for a living. The pain is miserable but the guilt is worse! I go back to the Doctor WBC dropped from 5.8 to 3.7 in 2 mos! Take the WBC again it's a 5.0. Neutrophils only a 2.1. 
I've taken the HIV Antigen/Antibody  test every thirty days since Oct  last one taken Jan 15 all negative... Can I take another kind of test to test the blood directly for HIV?  Can I just not have enough antibodies to pick up the virus? 
I've had a MRI,  Bone Density, Ultrasound of the liver pancreas and gallbladder and nothing explains this pain... Please help! 



Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Welcome to our Forum.  I'll try to help.  In the 1rst sentence of your post, you stated "no penetration" - is this correct? If so, there was no risk of any STI, including HIV, from the outset - HIV is transmitted only through penetrative sex.   I would add that while your partner's HIV status is unknown, the odds are very, very good that he is HIV negative unless he has also had sex with other men or uses needles to take drags. 

Irrespective of the risk however, if you have taken combination HIV antigen/antibody tests at any time more than 6 weeks after the exposure, you can be completely confident that you did not get HIV.  It does sound like you have had one or more tests beyond 6 weeks since your exposure and thus you can be confident that HIV is not he source of your symptoms.  Currently available tests for HIV are among the most reliable tests in all of medicine.

Related to other parts of your post, I would also add that about 60% of U.S. adults have blood tests which would be positive for HSV-1, most often due to acquisition of infection during childhood. It is unrelated to your symptoms.  Further, I would add that the symptoms you experienced 3 days after the encounter you described occurred too quickly to be due to an STI acquired during the encounter- symptoms typically take longer to occur.

It also sounds to me like you are quite worried and focusing on any possible sign of infection.  Each of the WBC counts you list are in the normal range and fluctuation of the sort you describe is normal as well.  My advice is to work with your own doctor to seek other possible causes for your symptoms.  There are any number of non-STI illnesses which might cause the sorts of symptoms you are describing but the one thing you can be confident of is that your symptoms are not due to HIV.

i hope these comments are helpful to you.  EWH
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27 months ago
Hi Doctor 
I am trying to work with my doctors and figure this out and I'm trying to understand it all... I didn't feel any sickness until this encounter..  I have been diagnosed with Herpes 4.3 mono 8.0, gerd and a bacterial vaginosis that won't clear up all at one time... Now my gallbladder has is acting up all of which I read that are signs of HIV I'm only wondering if this  is a cover up for a underlying disease... I'm not looking any for signs of infection my body has changed significantly.  My throat hurts daily, lymph nodes hurt and body aches daily, my stomach  and back literally aches, skin itches etc..it's completely miserable.. I wish I could take those five min back.. I'm trying to be proactive.. My anxiety is high, can't Eatnmuch  and my quality of life is going downhill...
Let's discuss the exposure..
Unprotected oral and Unprotected oral anal on both ends... I developed herpes from him I had just been tested 6 mos prior. I'm completely sure he gave it to me..
The 4th generation test HIV test that took in December and January came back negative but I was wondering is there a test to see if it's in my blood.. Everything I read leads back to HIV.. I need some relief if I'm negative and some help if I'm positive.
Is there something else I can ask my doctor to test for?  Something is swelling my nodes and having this terrible body ache? 
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Thanks for the additional information.   From the sound of things, you are going to the internet looking for information and this is raising concerns about HIV for you.  Bad idea- please stay off the internet as much of what is said there is incorrect, out of date, or taken out of context.  Many of the clients we interact with on this Forum have been misled by things they have read on the internet.  For instance, gall bladder diseases is quite rare in HIV and when it occurs, it is in persons with advanced infection, not those who were recently infected.  If you have gall bladder problems, it is unrelated to the sexual contacts you have described.  Sometimes persons with gall bladder problems have itchy skin.

The information you provide on HSV and mononucleosis is a bit unclear.  Are 4.3 and 8.0 your laboratory values for mononucleosis ]?  do you know what tests you have had?  Mononucleosis is relatively common and can certainly cause sore throat, swollen glands and muscle aches.  I won't debate whether of not you got HSV-1 from the encounter you have described although again.  If your test results have changed, you may have gotten HSV-1.  

As I also said earlier,  if you have taken 4th generation, combination HIV antigen/antibody tests at any time more than 6 weeks after the exposure, you can be completely, 100% confident that you did not get HIV.  These tests are among the most reliable tests in all of medicine.  You do not have HIV from the encounter you have described.  

It sounds like you are working with your doctor regarding what is going on,  Is he/she an internal medicine specialist?  Does she/he have a unifying diagnosis.  this  really sounds like something that your doctor should be able to help explain.   Your body aches, sore throat and swollen glands sound like a mononucleosis-like illness of the sort that can be caused by a number of viruses, including CMV or EBV as well as some hepatitis viruses.  I suspect your doctor is considering these.  These may not be sexually acquired.  

Please note, there is only one further follow-up exchange available, as per Forum guidelines.  EWH
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26 months ago
Hi Doctor 
Thank you for your help with me understanding HIV results but I'm still a bit confused about the other test results. Nothing against my Dr. But let's just say she is not as anxious as I am to get to the bottom of this sickness!!! You said the internet Has outdated  info and I just want to learn about this as much as possible...
As in the earlier Post I was hsv 1 positive and IGG is 4.21 to be exact but I  was tested for mono and the test result was an 8.0 super high 
I was tested for gential herpes 2 IGG which was negative 0.57 but I'm starting to feel irratated  in the genital area.. I was swabbed and blood test for herpes 2 and they were negative...Forgive me for the question but can it not be picking up because of the type of herpes infectious mono is?? What exactly does the test results mean??  What do I have???
Can you have herpes 1 orally and herpes 6 in the gential area I'm confused... 
does the symptoms for mono ever end?
 (Sore  throat aches and pains)
Are there special meds for this particular strand of disease? Should I be asking for a specific test?

Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
I will provide brief follow-up comments but your questions are now, in part, beginning to get off the focus of this forum and my area of expertise.  Further I had a bit of trouble following your most recent post as it seems to be dealing with several unrelated topics- your test results for HSV-1 and -2, mononucleosis and now your first mention of herpes virus type 6 (HHV-6).  I will have some brief comments but as I have already said, I would suggest you discuss this with your own doctor, preferable an internist.  If your current doctor is not answering your questions, then I suggest that you consider seeking another opinion, telling that person that you have had trouble getting clarity from your first doctor.

Responses:
HSV-1 is a very common infection, impacting more than 60% of American adults.  It is the case of cold sores in some but many people have the infection and do not get cold sores.   In fact, most people with HSV-1, which they most typically acquired in childhood, are asymptomatic and untroubled by the infection. Blood tests for HSV-1 are nor particularly reliable as they can be both falsely positive and falsely negative.  In your case, although you may have HSV-1, the complaints you have reported above are unlikely to be due to HSV-1.

HSV-2.  Your blood test for HSV-2 is negative.  This tests, although not perfect is better than the test for HSV-1.  Your symptoms do not suggest typical HSV-2.  I would not worry about HSV-2.

Mono.  I am not familiar with the "mono test" you mention and unlike for HSV, there are many tests for mononucleosis.  Mononucleosis refers to a syndrome which can give people a sore throat, muscle aches, and then a run down feeling. The run-down feeling can last several weeks.  The mononucleosis syndrome can be causes by a number of viruses including some which are related to herpes viruses, the Epstein-Barr virus (EBV) and the cytomegalovirus (CMV).  Other viruses which are more difficult to test for may also cause the mononucleosis syndrome.  There is typically no specific treatment for the mononucleosis syndrome other than rest and symptomatic support.  Typically the mono syndrome can take a month or more to resolve and occasionally takes longer with a gradual recovery.

Herpes virus-6 (HHV-6) is a virus in the herpes family that was discovered in the 1980s which causes a childhood illness called roseola.  Roseola typically causes a few days of fever, followed by a rash as the fever goes away.  Most people acquire roseola in childhood long before they even go to kindergarten.

I hope this information is some help to you.  Despite the risk you perceive related to your sexual encounter in October, there is no clear suggestion other than possibly coincidental timing that the concerns you mention are related to that encounter.  As I mentioned, I think your next step should be working through this with a doctor who can examine you, discuss things with you and possibly evaluate you more than once.  As per forum guidelines and as I have little more to offer, this thread will now be closed.  Take care and good luck.  EWH
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