[Question #7715] ARS 28 days post exposure, but fine in 2 days. Antibiotics masking ARS?

1 months ago
Hi Doctors, 

Hope you and your loved ones have been keeping well over the tough last year. 

My exposure was to a lovely Russian escort in the states at the end of Nov 2019. I was inebriated hence can't remember clearly re use of protection, but my gut feeling says that it was a protected oral / vaginal session.  Few days later i had a burning peeing sensation which cleared the next day. Tested for Chlamydia / Gonn 11 days post exposure and all negative (tested again in future and still negative). 

28 days post exposure on 23th Dec 2019, around 10am whilst on Xmas holidays in Thailand, I came down with a sore throat initially around and within few hours had the chills and body ache. A slightly feverish feeling, but def not over 100C (did not have a thermometer on me but can tell from past experiences it was not high fever ). No observable rashes. Started 7 days of Amoxilin to ensure my holidays wudnt be flu ridden. The next day I felt quite good apart from a runny nose. 2 days later morning of 25th Dec 2019, I was pretty much feeling fine.  

I recently entered into a longer term relationship and have had unprotected sex and feel a bit stupid / guilty for not testing for HIV prior hand. I plan to test but am v anxious. 

1. Is 28 days too late for ARS symptoms to show. 
2. I read ARS lasts for 1 - 2 weeks, but I was fine in 2 days. Could starting antibiotics have reduced it to ~2 days and masked the symptoms? 

The lady unfortunately may have moved back overseas due to Covid and I hav not been  to contact her. 

Appreciate your advice. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Welcome to the forum. Thanks for your confidence in our services and your well wishes.

The answer you seek is embedded in the title you chose for your question -- which obviously wasn't an accident. It indicates your awareness that both the timing of your symptoms and their fast resolution are highly atypical for ARS. I'm happy to confirm both points. It is rare if ever that ARS symptoms start later than ~20 days after infection (90% of the time 8-10 days), so 4 weeks is strong evidence against it. And when ARS causes symptoms, they last 1-3 weeks, sometimes longer. Antibiotics have no effect on any viral infection, including ARS.

And your symptoms are typical for a garden variety respiratory virus. Over the years, I would now be mentioning colds and influenza. But societal and personal prevention against COVID-19 have had even more effect on colds and flu. Influenza rates worldwide are the lowest ever recorded in the past century -- and probably the common cold as well. Accordingly, there's a good chance you had a mild case of COVID, assuming you had not been infected previously. Maybe acquired during travel to Thailand (?) depending on timing of your flight, airport transit, etc. Or from any other personal contact, depending on how careful you've been with masking, social distancing, etc.

That's probably not what you were expecting to hear. But the bottom line is that regardless of the cause of that brief illness, you're well now and probably won't have any consequences of any kind. Given your concerns about HIV, you probably should be tested with an AgAb (4th generation) blood test. Even after professional reassurance like this, most people concerned enough to ask about it are likely to worry until a negative test settles the issue. You can expect a negative result, of course. As for COVID, testing is optional. But if I have aroused your curiosity about it, you could have a coronavirus antibody test -- but not if you have had your vaccination, which also will give a positive antibody test result. (If and when you become eligble for immunization, the providers may be able to arrnage antibody testing if you request it.)

I hope this information is helpful. Let me know if anything isn't clear. Best wishes and stay safe -- both sexually and against COVID!

HHH, MD
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1 months ago
Thank you Dr. Handsfield. 

Yes, Ive often wondered if I was one of the original Covid 19 victims outside China ie patient zero in US. But i did get tested and came back negative. 

Nonetheless I shall confidently take an HIV test just for reassurance purposes. 

Thank you again for your time and patience. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Thanks for the follow-up information. I assumed your exposure was more recent -- only now realizing 2019. Either I misread the date (probable) or assumed it was a typo and you meant 2020. Obviously that nearly eliminates COVID, but I'm glad to hear you were aware of the risk at the time and were tested.

Thanks for the thanks. I'm glad to have helped.
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