[Question #6753] HIV

65 months ago

Hi Dr thank you for taking the time to answer my questions; I’m very anxious .

About 18 days ago I smoked out of a water pipe/Bong . About 3 days later I notice red swelling in the back of my throat which some discomfort it got worse over the next 2 days with some swelling in my left lymph node in my neck so I went to the dr he gave me anti biotics thinking it’s strep but after finishing the anti biotics my throat still wasn’t better and I had developed thrush so he gave me auro fluconazole 200 mg and said if it didn’t get better in a few days it was likely a viral infection

My questions are 1. If the person who gave me the bong to smoke wanted to infect me with hiv and put a small amount of blood ( like a couple of drops from a finger prick ) in the water chamber , could I then inhale the water vapor that is also carrying HIV virus and get infected ? Is this possible ?

2. The first onset of soar throat was at 3-4 days post exposure with small swollen lymph node then the oral candidiasis set in at around 6-7 days after . Is this too soon for ARS ? When does ARS most commonly occur?

3 . Is Oral thrush a symptom of ARS?

4. Last night day 16 and 17 slight temperature feeling hot and flushed but generally havnt experienced an obvious fever . Does this sound like ARS?

5. do you recommend testing ?

Edward W. Hook M.D.

65 months ago

Welcome to the Forum. Sharing a water pipe/bong is a no risk event in terms of risk for HIV, even if the person you shared the device with had HIV and even if that person had placed blood or saliva on the surface of the water pipe/bong placed in your mouth or in the water in the pipe. There is no reason for concern and certainly to scientific or medical reason for testing. Answers to your specific questions are below:

1. If the person who gave me the bong to smoke wanted to infect me with hiv and put a small amount of blood ( like a couple of drops from a finger prick ) in the water chamber , could I then inhale the water vapor that is also carrying HIV virus and get infected ? Is this possible ?

See above, Blood contained in the water would not be infectious.

This is too soon to be the ARS which typically occurs between 10 and 21 days following exposure.

3 . Is Oral thrush a symptom of ARS?

No. In addition, information found on the internet on this topic is misleading. Most people with oral thrush do NOT have HIV. One of the most common causes of oral thrush is use of antibiotics .

4. Last night day 16 and 17 slight temperature feeling hot and flushed but generally havnt experienced an obvious fever . Does this sound like ARS?

No, this does not suggest the ARS in any way.

5. do you recommend testing ?

No, I see no medical or scientific reason for testing related to the no-risk event you describe.

I hope this information is helpful. Nothing you have reported above suggests any reason for concern or testing for HIV. EWH

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65 months ago

Thank you for your fast reply doctor . I would like to clarify a few thing with my follow up questions.

1. why would the blood in the water not be infectious? surely if I inhaled water mixed with blood in the form of water vapour from the pipe that would present a risk? especially given the direct access it would have to my blood stream..

2.You say the onset of my sore throat and swollen lymph nodes in neck arrived to early to be ARS since it was only 3 days. does that mean to say any symptoms occurring outside of the 10-21 days are highly unlikely to be ARS? last few days I'm having a slight fever in the evenings but not through the whole day could this be ARS starting? . Is ARS fever typically constant or remitting ? is the fever always very high? is 37.5 oral temp a fever?

3. just to finalize my symptoms are: Swollen lymph nodes in neck day 3/4 with painful sore throat that is not responding to antibiotics then starting day 16 slight fever in the evenings that seems to go down during the early morning/afternoon. could this be the ARS starting day 16? how long is the duration of ARS? are symptoms generally quite severe?

Edward W. Hook M.D.

65 months ago

1. Viruses and bacteria typically do not survive in water or other liquids - there need to be very specific concentrations of salts and other chemicals present for them to survive. Too dilute or too concentrated and they die.. Further, no one has ever been proven to acquire HIV from ingesting or inhaling contaminated material. NOT EVER!!!

2. Correct. In fact, studies have shown that even the vast majority of flu-like illnesses occurring in at risk persons in the 10-21 day range are NOT HIV-related but are due to common, every day community acquired, non-STI viruses., When the ARS occurs, the fevers tend to be high, well over 38 degrees.

3. Understood, This does not suggest the ARS, even if your exposure did put you at risk, which it did not. People with the ARS are quite ill.

EWH

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65 months ago

Thank you doctor . I realise this is my final follow up question . Please clarify

1.you have NEVER heard of anyone or any case showing ARS sooner than 5 days?

2.What is the duration of symptoms ? is my sore throat of 3 weeks too long in duration to be ARS?

3.you and your colleagues are 100% sure it is IMPOSSIBLE to get hiv from using a water pipe regardless of if there was blood in the water or on the mouth piece?

4.even if I had ALL the typical ARS symptoms you still wouldn't recommend testing?

5.If ARS symptoms were present following a high risk exposure would a lack of the fever symptoms be highly likely to exclude his infection?

65 months ago

Also if I may add one more question to my final follow up .

I had recently received a negative 4th gen combo test 7 weeks post a sexual exposure , this combo test I did was about 2-3 days after the onset of my sore throat and swollen lymph nodes in neck ( about 6-7 days post smoking this potentially infected water pipe) . my question is if this sore throat and swollen lymph nodes in neck were infact due to some sort of early onset ARS would the 4th gen test pick up p24 antigen seeing as symptoms of ARS occur due to presence of antigens ?

65 months ago

I'm worried as my doctor is having trouble diagnosing my sore throat and the lack of response to anti bionics and anti fungles points to a viral infection . however I don't have any nasal congestion or other cold virus symptoms . So as I see it the options are getting narrower , my doctor is testing for EBV which has very similar symptoms to ARS I have read which is very scary to me

Edward W. Hook M.D.

65 months ago

Your follow-ups are a bit repetitive. I understand that you are nervous but my assessment will not change. I am confident that this is not HIV. The additional information you provide makes me still more confident that this is the case. In reply to your follow-ups:

1. Correct, never

2. Symptoms typically last about a week. Three weeks is far too long.

3. repetitive, no change in my answer

4. When I said there no medical or scientific reason to test I meant it.

5. It would be extraordinarily unusual for the ARS to occur without fever. I have never seen or heard of such a case.

Yes, your 7 week test is more than 99% conclusive for all HIV and would have been positive if your symptoms had been due to HIV.

Your prolonged viral illness is just not all that unusual. Many, many people get EBV (it is the major cause on mononucleosis) and it is just not that scary.

As you point out, this completes this thread. There will be no further replies and the thread will be closed shortly. I hope my comments have been helpful. The event you describe was a no risk event for HIV and your testing proves you do not have HIV. Please don’t worry. EWH

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