[Question #6614] HIV Scare

14 months ago
At the end of December 2019, I began to notice a weird spot on my face. It gradually got bigger and almost looked like a cigarette burn. In early January, I went to the doctor and was diagnosed with ringworm of the beard. I was prescribed antifungal creams and terbinafine. The spits cleared up after about a week and a half or so.

However, as the ringworm was healing, I developed flu like symptoms. A moderate fever, sore throat, indigestion, diarrhea, fatigue. I would say this began around January 4th or 5th.

Then, I stated to develop neuropathy. My hands and feet were burning. Walking is a struggle. My legs feel heavy.

I got a blood drawn 4th gen HIV test performed on 01-16-2020. The results were negative. No antigen or antibodies were identified.

In December, I gave unprotected oral sex to 2 men. I am a gay male. One incident occurred on 12-14-2019 and the other incident occurred at the end of the month. The ringworm was in the beginning stages at the time of the 2nd exposure .

I took another 4th gen test last week. I will get those results this upcoming week.

Given that I had all of these symptoms at the time of my test, shouldn’t I have tested positive? Or is it possible to show symptoms without identifiable levels of antigen and antibodies?

I should also note that neither individual finished in my mouth. If I’m infected, it would have to be from pre-cum.

Thank you experts,
Anxious & Struggling
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Welcome to the Forum and thanks for your confidence in our service.  I'll be glad to comment.  I anticipate that your recent test will be negative, proving that your symptoms are not due to HIV.  I say this for a number of reasons including:

1. You do not know that either of your partners had untreated HIV (remember, persons with HIV on effective therapy are not infectious to others).

2. Even if they did, while there are cases in which HIV has been transmitted through performing oral sex on an infected partner, it is very, very rare.  The CDC estimates it occurs less than once in every 10,000 exposures (i.e. 99.99% of the time the infection is  NOT transmitted).

3.  Your symptoms are not particularly suggestive of HIV and are most likely coincidental. The classical symptoms of recently acquired HIV are HIGH fever, and severe sore throat, often accompanied by muscle aches.  Your ringworm and milder symptoms do not raise a concern for HIV.

As far as your test results are concerns, in the unlikely circumstance that your symptoms were due to HIV, your 4th generation test would be positive.  Further, although I am not completely sure of your exposure timeline, I can tell you with confidence that over 99% of 4th HIV tests will be positive 4 weeks after exposure and all will be positive at 6 weeks. 

I hope that this information is helpful to you.  Please don't worry.  EWH

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14 months ago
Thank you.

I was concerned about ringworm because I read that fungal infections are more common in patients with HIV.

Is neuropathy a symptom of early HIV? I keep getting differing opinions from Google.

The neuropathy has rapidly progressed. It’s freaking me out the most.
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

While fungal infections ARE more common among persons with HIV, mot persons with ringworm do not have HIV.  Your infection is almost certainly coincidental and not related.

No neuropathy is certainly NOT a symptom of recently acquired HIV.  There are a huge number of causes of neuropathy and most persons with neuropathy do not have HIV.    I does occur in persons who have been infected for many year but even then, as often as not among persons with HIV, there is another cause for the neuropathy.  If you have a neuropathy, unless it is progressing rapidly, it is not an emergency and you should seek evaluation by a neurologist.  Given your statement that it is progressing rapidly, I would suggest you see a neurologist sooner than later.  EWH

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14 months ago
Thank you. I truly hope you’re right. I can’t shake the feeling that this next test is going to end up being positive.

My final questions: Are the symptoms during seroconversion caused by the origin of antibodies? So if my mild fever, sore throat, diarrhea and night sweats were caused by HIV that would have been picked up  in the last test, right? Because that last test  on 1-16 occurred at the height of my symptoms.

Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Trust me, your test will be negative.

The symptoms of seroconversion are due to inflammation resulting from the interaction of both antibodies and the HIV virus (antigen).  It is this reason that when symptoms occur during the ARS, tests are positive.  Your test on 15 January would have been positive if your symptoms were due to HIV seroconversion.

As you have noted, this will be my final response as part of the thread.  The thread will be closed shortly without further replies.  Please don't worry, take care.  EWH

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