[Question #8342] Hiv Symptoms and worry
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45 months ago
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Hello, I was in an encounter with a csw in which she performed oral sex on me (fellatio), which lasted probably about 5 minutes. That was that, we didn’t do nothing else more, and two weeks after this incident I felt sudden extreme fatigue like my whole body just felt weird and also I started to get repeated headaches which lasted about a week. The fatigue gradually went away but then I started to feel really nauseas and vomited a couple of times I want to say 3 weeks after this exposure. I got really worried and decided to test at 30 days post exposure with a 4th generation hiv test and tested non reactive. That was that it made me feel good, but then a sudden sore throat which only worsened more and more started to occur. I decided to test again at 39 days with Elisa ab/ag test this time with my healthcare provider which also ordered other tests like CBC, wbc, & other sti’s like gonorrohea, syphyllis, Chlamydia and all sti’s tested non reactive and normal, except for my white blood count which was low at 3.0 automated count. Also, maybe doesn’t matter much, but my vitamin b12 came up pretty high. Currently at 8 weeks post exposure I have horrible sore throat pain which my doctor suggests is from strep throat and just recently prescribed antibiotics to treat it. On back of my throat I can spot some white spots, not on the tonsils or anywhere else just on the back. Also I’ve been feeling sore muscles for days now.
My questions are
1. Will further testing be needed doctor to ensure I’m 100% don’t have hiv or any other sti ?
2. Can my low wbc count be an indication of an hiv infection or something bad going on ?
3. If I tested when I was getting my early symptoms like fatigue, headache, nausea, vomiting, will the 4th generation tests have picked it up at 30/39 days ?
4. Can hiv potentially cause a strep throat infection?
5. Probably doesn’t matter, but will my high vitamin b12 in blood affect how accurate the hiv tests are ?
6. Lastly, how accurate would you say would be my
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H. Hunter Handsfield, MD
45 months ago
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Welcome to the forum. Thank you for your confidence in our services.
The quick reply is that you definitely do not have HIV. First and most important, the AgAb blood tests never are wrong if enough time has passed since the last possible exposure. That time can be up to 6 weeks, but 98-99% of newly infected people are positive by 4 weeks, so your 39 day result is highly reliable. In addition, the negative test result proves that HIV is not the cause of your symptoms: it's the body's immune response to the virus, which is reflected in the antibody portion of the AgAb test, that causes symptoms -- not the virus itself. So for sure your symptoms are due to something else. I'll also point out that you had an exposure that was entirely risk free: there has never been a proved, scientifically documented case of HIV transmitted oral to penis. Oral sex is also low to zero risk for other STIs: no risk for chlamydia, low risk for gonorrhea, and little risk for others.
With those preliminary (and I hope, reassuring!) comments, on to your specific questions.
1. Perhaps you will want a negative HIV AgAb test that is 100% proof you don't have HIV. If so, have another test after 6 weeks (42 days). But from a medical standpoint, it really isn't necessary. There is no chance you have HIV. Your tests for other STIs also are completely reliable.
2. Low WBC is typical for many viral infections, which also is a likely explanation for your sore throat. Or as your doctor has advised, maybe strep throat -- which often follows an initial viral upper respiratory infection. And in addition to the info in my opening comments, your onset of symptoms was too late for HIV or any STI from the oral sex event two weeks previously. In addition, you should discuss COVID-19 with your doctor: your symptoms are not entirely typical, but they certainly are consistent with COVID, especially if you have not yet been vaccinated against it. But for sure none of this has anything to do with the sexual contact you have described -- just a coincidence in timing.
3. Yes -- see opening comments.
4. HIV could predispose to strep throat, but you blood test proves you don't have HIV, so it's not an issue.
5. I don't see any connection between your B12 level and your other symptoms and test results. But you could discuss this with your physician.
6. Not sure what you intended to ask here -- probably you hit the word/character limit for new questions. Feel free to continue that question in a follow-up comment.
I hope these responses are helpful. Let me know if anything isn't clear.
HHH, MD
So all is well from an
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45 months ago
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First of all thank you for answering my question doctor.
I would also like to add that I’ve noticed how on my urine I’ve been urinating very yellow and with a foul strong smell, but it doesn’t hurt at all when I pee, or anywhere in my penis. I don’t know if this would alter your previously mentioned comments or not but I would just like to emphasize it. And yea my question for #6 was actually cut off, but you sort of already answered it by stating that 98-99% of infections are found by 4 weeks, the question was just how reliable my 39 ag/ab test would be ?
And about possible covid symptoms, I actually tested three different times as I was having the symptoms to discard it being covid 19 and I tested negative all three times as well I am fully vaccinated.
I guess my ultimate last set of questions would be
1) Do you recommend I move on from this situation with no more testing for any type of std’s/ sti’s ?
2) Is that time frame of 3 months still a thing? Or is 6 weeks fully conclusive when it comes to 4th generation test?
3) Would your comments change on oral sex, let’s say if we knew for a fact that the csw performing the oral sex had hiv with a high viral load ?
4) I forgot to even mention HPV, but would HPV be something to worry about or no having in mind that it can also be asymptomatic ?
5) To clear up something, if ones hiv positive and tests and p24 Antigen is not detectable in the body does that mean that antibodies should be detectable, and vice versa saying that if antibodies are not detectable than p24 antigens should be detectable?Having in mind the 4th generation test at the correct time frame of the tests window period of course.
And once again doctor I would like to thank you, for helping me and all the other people in this forum with worries and concerns about our mishaps we need more people like you in this world.
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H. Hunter Handsfield, MD
45 months ago
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Urine color and odor are determined entirely by diet and fluid intake and almost never indicate an STI or any other health problem. Glad to hear you tested negative for COVID.
1) Move on with no more testing? Yes!
2) As already discussed, 6 weeks is conclusive with the AgAb (4th generation) HIV tests and that is our consistent advice. However some agencies take a very conservative stance and recommend a final test at 3 months.
3) Oral to penile HIV transmission has never been scientifically documented, regardless of viral load.
4) HPV is rarely transmitted by oral sex. And everyone gets HPV anyway -- if you have had 3 or more lifetime vaginal sex partners, you can assume you have had HPV and could still be carrying it. Genital HPV is a normal, expected, and generally unavoidable consequence of human sexuality. Getting vaccinated is the main way to avoid potentially serious outcomes.
5) It is the HIV antibody that clears HIV antigen from the blood. Soon after Ag appears, Ab also becomes detectable. For a brief period (a few days) both Ag and Ab may be present. After Ab removes all Ag from the blood, only Ab remains, and it persists for life. Therefore, once the AgAb test is positive, it remains positive for life.
Thanks for the thanks. That concludes this thread; I'm glad the information has been helpful to you. Best wishes and stay safe, as you apparently have been.
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