[Question #5509] Scared to death
74 months ago
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On May 26th, I had insertive anal sex and used a condom. It did not break or tear, I examined it carefully after withdrawing. No other contact was had.
On June 2nd, I had inservtive anal again (different) partner and again used a condom, it did not break or tear. I blew into the condom to insure it was solid.
On June 3rd, I rethought my actions and decided to get PEP (22 hours after exposure)
On June 5th I started feeling bad, lost my appetite and just felt bad for two-days days. No “flu” but I’ve never felt bad like this before where I didn’t want to eat and was overall wanting to stay in bed.
On June 6th, I did a 4th gen rapid test at the HIV clinic and it was negative, I also did blood work for a 4th lab test which came back negative.
On June 7th, I went back to the HIV clinic and did a rapid 4th gen test which was also negative.
Today, June 9th I’m feeling better but my mouth is very dry. I’m freaking out and not sure what to do. I went and bought a Ora Quick test and it’s also negative.
I’m going to go back to the HIV clinic tomorrow and do another rapid test.
My questions:
1) is dry mouth a symptom of an acute infection?
2) if I was symptomatic, would all the 4th gen tears likely have showed something from my 1st encounter?
3) would the three doses of PEP thrown off the test?
4) please be honest, I’m worried out of my mind, how scared should I be? I’m checking a number of boxes for symptoms.
5) if hiv could not pass and intact condom, could the fluids got onto my scrotum and gone in a sore from where I’ve been scratching it?
74 months ago
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I would like to add I've got one swollen lymph node that was noticed when I started to feel bad.
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Edward W. Hook M.D.
74 months ago
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Welcome to the Forum. I'll do my best to help. I think you are over reacting. You do not know if your partners had HIV and, no matter who they were, it is unlikely that they were infected. In addition, you practiced safe sex and your condoms did not break. Nothing in your history suggests any need for PEP and the symptoms you describe may well be symptoms of your PEP, combined and amplified by your anxiety. Please relax, stop testing, finish your PEP now that you have started it and plan to test using a 4th generation, combination HIV antigen/antibody test 4-6 weeks after completion of the medication. In answer to your specific questions:
1. No! Dry mouth is a sign of anxiety or perhaps medication side effect. It is NOT a sign of recently acquired HIV.
2. Yes, if your symptoms were due to HIV, the 4th generation test would have been positive.
3. No- seem my comment above
4..See my comment above. I see NO reason for concern.
5. No, I see no reason for concern
I hope that this information is helpful. Please don't worry, please hold of for further testing until you finish your PEP. EWH
74 months ago
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I've been holding out hope that I didn't contract HIV., thank you for your response Dr Hook!
Couple of follow up questions.
Couple of follow up questions.
1.) Why do I read about so many people that receive false negative 4th Gen tests during the acute phase of the virus? If someone is symptomatic, would they likely test positive? (ie since I was having the symptoms I'm describing had I contracted HIV would I likely test positive at 11 & 12 days?
2.) Literally, while I was typing this message I got a test the HIV RNA results were back. They are:
HIV-1 RNA Qualitative Negative NORMAL Negative 02
Negative for HIV-1 RNA
How sure can I be in the RNA Results since I'm on PEP and that blood was drawn day 12 from the first encounter but 3 days after starting PEP for the first encounter.
74 months ago
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Just wanted to give a quick timeline so I can understand what results I can start to rely on:
1) May 26th Encounter
2) June 2nd Encounter
3) June 3rd Started PEP
3) June 5th Feeling Bad & Swollen Lymph Node
4) June 6th HIV 4th Gen Rapid, 4th Blood Draw 4th Gen, HIV RNA (All Negative)
5.) June 7th HIV 4th Gen Rapid Test (Negative)
6.) June 9th HIV Ora Quick (Negative)
If I had been positive from my May 26th Encounter, would the tests done on the 6th or 7th have shown me anything? Should I put any weight in them?
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Edward W. Hook M.D.
74 months ago
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My guess is that when you say "when I read about so many people...." you are referring to something you read on the internet because I know of no credible scientist who would say that many people with the ARS are missed by 4th generation tests. During the ARS, levels of HIV virus (and thus p24 antigen) in the blood are higher than they are at any other time during the infection and as a result 4th generation tests are nearly always positive within a day or two of the onset of AARS symptoms related to recent acquisition of infection. If you symptoms on June 5th or beyond were due to recently acquired HIV, your tests on the 6th, 7th, and certainly by the 9th would have been positive.
In theory, if you were taking PEP and then failed, while the PEP might have delayed the onset of both circulating virus and your symptoms BUT, if your symptoms were due to HIV, the tests would have been positive. EWH
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74 months ago
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So based on what I’m reading you say:
1) your evaluation of my exposures was “no risk”
2) with HIV, when someone is symptomatic it would likely trigger a 4th generation or rna test at that point
Am I correct?
Thank you so much for what you do. I realize you have no idea who’s on the other side of the screen but you’ve helped me a ton! Thank you! Thank you!!
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Edward W. Hook M.D.
74 months ago
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Yes, your repetition of what I've already said is essentially correct.
This is my third response to your questions. Thus, as per forum guidelines, this thread will now be closed without further responses. Take care. Hope you will now be able to move forward and cease your excessive testing. EWH
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