[Question #7139] Covid or HIV infection

60 months ago

Here is my concern:

For about two weeks I had flu like symptoms. My symptoms included: Fatigue, sore throat, nasal congestion, sinus pressure, ear pressure, chest pressure, chest congestion, tightness in chest and back, mild dry cough, severe joint pain, headache, back ache, sharp shooting pain in the body, rash on eyelid, mild shortness of breath, neck pain, dizziness, diarrhea, loss of appetite. Important to note that these symptoms came in waves, tending to ebb and flow. They did not feel like a normal flu/cold that is consistent where it progressively gets worse and then progressively gets better. It was a roller coaster. At the same time had a herpes outbreak (I have been hsv 2 positive for 10 years) These symptoms eventually improved after 14 days, I felt much better for about a week, and now the joint pain and headaches are flaring up again. Again they tend to come and go.

Symptoms I did NOT have: fever, swollen lymph nodes, chills, night sweats, vomiting, severe shortness of breath, severe coughing.

Now for my question: when I first got the symptoms, I was pretty sure it was Covid. I have also been exposed to a confirmed positive case about a week prior to these symptoms. The problem is I got tested for Covid and it was negative (I did a self nasal swab at a drive-through CVS.) So, after day 14 and then at 20 days after symptom onset I got a covid antibody test. Both of those antibody test came out negative. From the testing, there has been no indication of Covid infection. So, I start to think what else could this sickness have been. From what I’ve researched, it sounds like I definitely had some sort of viral infection if it was not Covid. The only other thing I could think of is possibly HIV.

As for my sexual status, I’m 37 heterosexual female. My last HIV test was 2 years ago. I have had unprotected sex with 2 men in those 2 years in which I do not know their status. I normally would not be worried about this but the Illness I had was definitely something, and if not COVID, could it be HIV? From a Covid support group my symptoms sound very textbook Covid, I’m just doubting it because of all of my negative tests.

I know there’s not a lot of research on Covid now, but any insight to this would be appreciated.

Edward W. Hook M.D.

60 months ago

Welcome to the forum and thanks for your confidence in our service. I’ll do my best to help. I’ll comment on two separate issues, could this illness have been COVID 19 and is it likely to have been due to HIV.

COVID first. Your symptoms, including the undulant course are absolutely compatible with COVID and testing was the right thing to do. Current tests are, unfortunately not 100% sensitive and the antibody tests are highly variable in their accuracy. There is still a modest chance that this was COVID, particularly given your exposure.

HIV. As a heterosexual woman with two new sex partners since your last HIV test, your risk for HIV is quite low. Most heterosexual men do not have HIV and even when they do, transmission occurs rarely- on average less than once for more than every 2000 unprotected sexual encounters. I doubt that your symptoms relate to HIV. The symptoms you describe are not suggestive of recently the ARS seen in recently acquired HIV in which high fever and severe sore throat are typically present. Nor are they typical of more established HIV infection.

What to do. I agree with your support group that the illness you describe is quite compatible with COVID and can say with confidence that they are not suggestive of HIV. If you remain concerned, I can’t think of any reason that getting an HIV test (along with testing for other far more common STIs like chlamydia if you have not been tested in the past two years) would not absolutely rule out the possibility of infection although I remain confident that none of your symptoms suggest HIV or, for that matter, any other STI.

I hope that these comments are helpful. If there are further questions or if anything I’ve said is unclear please feel free to seek clarification with your following questions. EWH

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60 months ago

Thank your for your medical insight. I do understand that I am at low risk for HIV, and that one can not simply “diagnose” HIV by symptoms alone; only a test can. But when I did look at a list of ARS symptoms they match up very very closely with COVID-19 which prompted some reflection on how safe sexually I really have been. Also, since I don’t know much about ARS, nowhere did I read how the course of the sickness went, only symptoms which then prompted some worry.

But yes, my symptoms ran an undulant course and were opposite of unabating. And besides the body and joint pain, all of my symptoms were on the mild side. The sore throat tended to radiate from my chest and was lower down in my throat rather than a normal sore throat with a cold or flu. And no fever. And a month later I’m still getting bad days here and there. I just wish the covid testing was as accurate as other viral tests so I could have more certainty.

Thank you again and I will schedule a bloodwork test, HIV included.

Edward W. Hook M.D.

60 months ago

Glad I could help. One problem with the “lists” of symptoms found on the internet is that in efforts to be complete, they tend to be overly general. Your illness really does not sound like the ARS. Hope you’re feeling better soon. EWH ---