Dear experts,

On September 15, I (28, male) performed oral sex on an unknown male of unknown status who said he was 19. I cannot say for sure whether there was any semen involved. Anyway, I was wondering if really heavy night sweats which started on September 23 could be related to this incident. I read online that drenching night sweats are a symptom of early HIV infection which has me worried. I can find no explanation for the night sweats which appear to be occurring without any fever or other symptoms. I have been very anxious and unable to concentrate since after the incident and was wondering if you know of a case where really heavy night sweats followed an HIV exposure risk coincidentally. Also, when I drank alcohol over the weekend, perhaps to get my mind off this whole case, I didn't experience the night sweats. But last night they were back. So I thought that perhaps it's a psychological issue linked to my worries. But I don't know if that is possible.

Thank you very much in advance for your response.

Best,
Larry

Welcome to the forum. Thanks for your confidence in our services.---

Thank you very much for your reply, doctor! A few more things: I did have a sore throat and large lymphe nodes five days after the incident but dismissed it as other problem because I thought it would be too early for a sign of HIV infection. Would the symptoms you list generally occur simultaneously? Also, I don't think I have had a fever since the incident. But sometimes people have a temperature without noticing? Would such heavy night sweats genereally go together with particularly high fever during the day? I never had to stay in bed and could always go to work. I'm not a hypochondriac and wouldn't usually worry about such things. But the fact that it began a while after the oral sex has been freaking me out. Thanks again!

Your early symptoms indeed occurred too soon for typical acute retroviral syndrome (ARS, i.e. new HIV infection), and enlarged lymph nodes and other symptoms would continue for at least a week or two. All the symptoms of ARS typically start within a few days of each other. Individually your symptoms can occur with ARS, but the pattern and timing you describe are not typical. That said, it would be reasonable for you to see a doctor knowledgeable about HIV -- not because I believe ARS is likely, but because you could have a valid HIV RNA blood test, expecting the result to be negative and highly reassuring. Also take your temperature a few times during the day, including before bedtime and if you later have a night sweat, and record the results. You cannot reliably self-diagnose fever or dismiss it on the basis of symptoms alone.---
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Thank you so much for your advice! I have been thinking about getting tested obviously, but if I'm not mistaken I would have to wait another three weeks to expect a reliable result? If I were to take a rapid test now (it has been three weeks), how reliable would the result be? In the meantime, I was wondering if you would say it is irresponsible or even reckless after an exposure like mine to have unprotected vaginal intercourse with my girlfriend? It is truly reassuring that you are so confident about the low risk I had. Just to be sure, because I'm not certain there was any ejaculate involved, would the risk be even lower without ejaculate? Also, I understand from your reply that the sore throat would have stuck around for longer than a day or two if it was indeed something to worry about. That would furhter calm my nerves, because I haven't had any problems with my throat since approx. day 7 after the possible risk. Thanks again, doctor!

Indeed the standard HIV antibody tests, or antigen-antibody combination tests, are not conclusive until a few weeks after infection. However, HIV RNA ("viral load") testing detects many HIV infections 10 days after exposure and nearly all by 2-3 weeks. Their main use is to follow the amount of virus in the blood of known infected persons, and they are more expensive than Ab or Ag-Ab tests, but they are increasingly used to check for early HIV infection in some situations. The decision for such testing should be made in person with an HIV knowledgeable physician or clinic. For all the reasons we have discussed, you can expect a negative result.---
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