I have an issue with HIV testing and exposure.

My single exposure was on 28th of April this year. (MSM,insertive, no protection, didnt use Pep)

2 weeks after that i developed something similar to flu or mononucleosis. 

The symptoms were:

Fever (not high - maximum of 37,5*C)

Night Sweats

Red eyes

Cervical lymphadenopaty

Complete loss of apetite.

Skin itching

Extreme fatigue and tiredness. (Felt sleepy at 6 pm, and woke up tired for many days)

All of the symptoms except lymphadenopaty resolved within few days, but rashes appeared (maculopapular with hyperpigmentation afterwards) along with purplish faint discolorations on my inner arms, and red dots (less than 1 cm diameter in random areas that didnt itch)

The above mentioned rashes did come and go for several weeks. Lymphadenopaty was present until 7 weeks, and started to fade down, and is minimal at 10 weeks. Around week 6, i had fullness feeling in my upper abdomen (liver/spleen) - resolved within 2 weeks.

The tests i did were (post exposure):

2 weeks - CMIA combi

3 weeks - CMIA combi

4 weeks - CMIA combi

6 weeks - CMIA combi

8 weeks - ELECSYS duo

9 weeks - ELISA duo

10 weeks - ELECSYS duo

The other person mentioned brief flu like symptoms with low fever 3 weeks after we met. He had 2 negative CMIA combi tests at weeks 3 and 7.

Could this be HIV  and should i keep testing,or is it something else?

Serology for EBV,CMV,HCV,Syphillis are negative.

One of the most consistent and frequent themes on this forum, and the basis for much of our advice, is that the current HIV blood tests collectively are among the most accurate diagnostic tests ever developed, for any medical condition. It takes time (2-6 weeks for most tests) for results to become positive, but when done sufficiently long after the last positive exposure, the results overrule all other considerations:  no matter what symptoms are present or the level of HIV risk at the time of exposure, the test result rules. For the antigen-antibody tests you had (AgAb, "duo", 'combi"), that interval is 6 weeks -- and 98-99% of infected people have positive results by 4 weeks. The only exception is when the exposed person is on anti-HIV drugs, i.e. either post-exposure or pre-exposure prophylaxis (PEP, PrEP), which can delay development of positive results. (In that case, the clock starts when drug treatment stops, rather than at the time of exposure.)

Accordingly, your results are to be believed:  all tests at 6 weeks and more (and for practical purposes, the one at 4 weeks) were conclusive. Your symptoms are consistent with acute retroviral syndrome (ARS, i.e. initial HIV infection), but the test results prove they have some other cause. The symptoms of ARS are due not to the virus, but to the immune response to HIV; therefore, it is not possible to have HIV symptoms and test negative with the standard tests, including the ones you had. And even though consistent with HIV, all these symptoms are nonspecific -- meaning they can result from several different medical conditions and do not point reliably to HIV as the cause. In addition, your partner's negative results show you were not possibly exposed to HIV during the events of last April.

I do not recommend any additional HIV testing. If your symptoms continue or you otherwise remain concerned, keep working with your doctor. But you can disregard HIV -- for sure you don't have it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I have decided to respect the conservative window period of 90 days. (my doctor told me that). Should i expect results to change? Is that even possible after so many tests up to 10 weeks with Ab/Ag  given that i had no other exposure except the above mentioned one? I forgot to mention that all those tests were done in 3 different clinics. 

I was actually very surprised to recieve negative results. I was somehow concinced that i have HIV, so the last almost 3 months have been a hell for me.

I really hope my results wont change, but i still somehow "expect" them to. Its hard to believe them with all those symptoms.

Your "expectation" of a change will not come true. You would have to be the first such case world wide. If somehow I were in your situation, I wouldn't be tested at 90 days or any other time. (And anyway, 90 days is no longer recommended by most responsible public health agencies and other experts -- for the reasons implied by my replies and explanations.)

Although, i have three more questions:

2. Not precisely determined -- probably quicker than the nontreponemal tests like RPR, usually 6 weeks. For sure no longer than 3 months.

3. First, I'll point out that when a person suspects his or her own symptoms have an emotional/psychological origin, usually s/he is at least partly right. I'm not a believer in anxiety creating physical symptoms out of the blue, but certainly it can magnify trivial symptoms or even normal body sensations that otherwise would be ignored or not even noticed. That would fit with at least some of your symptoms.

Six month testing is absolutely not needed and you should not consider it, in my view. If you want to follow the most conservative (but still outdated) recommendations from some agencies, 3 months is OK. Not longer. (If I personalize this and I were in your situation, I would have stopped testing several weeks ago.)

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the disucssion has been helpful. Do your best to move on with no further worries:  you're already home free with no additiona testing.