[Question #8041] Exposure and Symptoms

49 months ago

Hello.
I met a Brazilian Transexual CSW in The U.K. where we had protected oral. She topped me with a condom on. What concerns me is that she changed the condom part way through topping me. My only assumption is the reason she changed the original condom was because it broke.

Since then I attended a GUM clinic the 48 hours later but refused PEP. As they claimed the risk was to low. I have tested for all STDS InCluding HIV. And awaiting the results. I have since start to show symptoms of a very dry mouth and fatigue. This came on 3 days post exposure and the tiredness has since progressed to becoming very tired. I do t know if this is an ARS symptom or anxiety related. I’ve had no fever.

My questions are:

Could the tiredness and dry mouth symptoms be a very early onset of reaction to the virus? I know normally we see a fever of ARS is present?

Is the absence of fever a good indication of it not being ARS?

If I did a 4th gen test 4 days after the onset of symptoms would it show as positive if indeed these symptoms are ARS?

Thanks

Edward W. Hook M.D.

49 months ago

Welcome to our Forum and thanks for your confidence in our service. I'll be glad to comment. Part of the challenge here is knowing whether the condom broke or not. If the condom did not break, then this was an entirely no risk event. Should something like this happen again, at the very least you should ask if the condom broke if you cannot see it for some reason. When condoms break, it's typically quite obvious as they break wide open when they fail.

Your symptoms have occurred rather early to reflect recently acquired HIV. When symptoms occur, the acute retroviral syndrome (ARS) is characterized by high fever (>101), severe sore throat, and widespread muscle and joint aches, typically all present at the same time. The mild symptoms you describe are non-specific and do not suggest the ARS. Further, if you tested while you had symptoms, were your symptoms due to HIV, the test would have been positive. That your test was negative proves that your symptoms were not due to HIV.

Give the situation you describe, I would not be worried about your symptoms being due to HIV. EWH

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49 months ago

Thanks for your reply.

I agree with all your comments regarding condom breakage and I should’ve asked the the question at the time. She did show me the condoms on the side and told me everything was safe, but I didn’t inspect the condoms closely to clarify. And for some reason the fact she changed the condoms has played havoc with my stress levels.

Just want to clarify I’ve yet to receive my test results. Hopefully over the next few days I should get them.

I just want to clarify that if these symptoms I’ve been showing were indeed ARS symptoms then a 4th gen test result 4 days after the symptoms started would be positive?

If the tests turn out to be negative I will continue to test as I know people don’t always show symptoms.

Thanks

Edward W. Hook M.D.

49 months ago

I don't blame you for wondering why she'd change condoms in the middle of the encounter.

Yes, if your symptoms were due to the ARS, your tests would be positive. The symptoms of the ARS are due to the interaction of very high virus levels (which would give a positive p24 antigen test in a 4th generation test) with HIV antibodies (which would also be detected by a 4th generation test)

You are also correct when the tests are negative, I would still recommend a repeat 4th generation test at 6 weeks since some persons can acquire HIV without symptoms. EWH

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49 months ago

Thanks for your reply.

My initial test came back negative. This was around 4-5 days after my initial onset of symptoms. Do you think that was enough time after the onset of symptoms to indicate that those symptoms were not ARS related symptoms? Ie would the test return positive with symptoms starting 4-5 days before?

I have since began to get aches and pains in my hands and arms. (11 days post exposure). If these aches and pains in hands and arms were typical ARS symptoms would you expect to see other symptoms such as fever, sore throat etc?

I will continue to test and will assume this thread closed after your next response?

Edward W. Hook M.D.

49 months ago

Thanks for the follow up information. As I said above, if symptoms were present and due to HIV test would be positive. This is the case at the onset of symptoms. Certainly after 4 to 5 days of symptoms if your symptoms were due to HIV, your test would be positive.

Regarding your new symptoms of somewhat less generalized pain and muscle aches in your hands and arms, this would not at all be typical of recently acquired HIV. Further, has already mentioned as well, when persons have symptoms of recently acquired HIV (the ARS syndrome) they simultaneously have high fever, severe sore throat as well as muscle and joint aches. You could be comfortable based on your test results as well as the nature of your complaints that these are not due to HIV.

I hope the information I provided has been helpful. As you have indicated and as this is my third response, this will be the final response is part of this thread. Take care. Please do your best to not worry. EWH

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