[Question #7079] HIV Transmission / Hashimoto's

7 months ago
 Hoping you can give me some advice re risk of HIV transmission under the circumstances below.  I am a 62 year old male, heterosexual, circumcised.

I have had a number of enlarged lymph nodes in the neck for around 4 months. The doctor originally thought they were as a result of a bacterial ear infection and he treated me with  2 courses of Levoflaxin  (40 mg, 6 days) as he thought they were going down after the first course.  But they didn't. I had a blood test today together with an ultrasound and it is looking like I have Hashimoto's thyroid disease.  

I have read that Hashimoto's often presents with swollen lymph nodes, but I know also that there is probably an underlying infection somewhere and have read about the link between HIV and Swollen lymph nodes.....  so now I am worrying and back tracking my contacts.

I have always had protected vaginal intercourse, but do recall one time, the lady I was with "just popped it in", I quickly realized, pulled out and got a condom. I was inside maybe 10 seconds at most.  This was around 15-18 months ago.   I have not had any of the other standard HIV symptoms, no fever, headache, sore throat, vertigo, night sweats nor did I have a seroconversion.   What are your thoughts on potential transmission?   I have read that even with a seroconversion, the swollen nymph glands normally get better after a few weeks, but mine might have been there for some time so hoping it is not HIV.

I can no longer contact the girl who I met in a bar... I will obviously have a test soon, but in the interim I am going crazy with worry and second guessing. 

What are your thoughts?  Thanks a lot.

Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
Welcome to our forum and thanks for your question. I happened to be on the forum at the time your question arrived so you are receiving my reply considerably more quickly than is typical for the forum. Follow up responses to clarify questions may not be quite so fast.

While testing for HIV is appropriate, you have little to be worried about. HIV in women in the United States is very, very uncommon and even when women have untreated HIV, transmission through unprotected vaginal intercourse occurs on average less than once in every 1200 Unprotected acts of vaginal intercourse.  Thus, on a purely statistical basis, chances are 99.99% that your swollen lymph nodes are not due to HIV.  

My guess is that your concerns arise from having searched about causes of swollen lymph nodes on the Internet. Unfortunately the nature of the Internet on this topic is misleading and while one of the first things to appear on Internet searches on swollen lymph nodes is HIV, the fact is that only a tiny proportion ofswollen lymph nodes are due to HIV.  Swollen lymph nodes are a manifestation of the body’s efforts to fight off infections and other chronic inflammatory processes. The number of things that cause swollen lymph nodes is extraordinarily long.   For swollen lymph nodes in the neck, dental infections and other oral problems are a common cause and your doctor’s original assumption, although incorrect, was reasonable.  Further evaluation of the sort you describe is warranted. Given the low risk nature of the exposure that you report I am confident that the swollen left notes that have been noted are not due to HIV. If they were an HIV test would certainly be positive and for the peace of mind it offers I would suggest you get tested. I am confident that if you do, that test will be negative.

I hope this information is helpful to you. Please don’t worry. If there are further questions or if any part of this reply is unclear please use your up to two follow ups for clarification. Take care. EWH
---
7 months ago
Thanks so much Dr. Hook, it certainly was a fast reply!

Yes, too much reading on line.

I don't have a mouth infection to my knowledge but did have an tooth implant about 18 months ago...  As you say, if the chances of an infected woman passing on HIV through unprotected vaginal intercourse occurs on average less than once in every 1200 Unprotected acts of vaginal intercourse, then I would be incredibly unlucky to be that one in 1200!

I do believe that swollen lymph nodes and Hashimoto's is closely linked.

It must be something else, just hope nothing nasty.

Thanks again.


7 months ago
Took an at home test...  negative,  so that is good.  Thanks for your input and peace of mind
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
Thanks for sharing your results.  Not surprised at the outcome.  I'm glad you took the initiative to get the test to get some peace of mind.  EWH
---