[Question #8466] HIGH RISK EXPOSURE WITH ARS SYMPTOMS

44 months ago

I M 53 YEARS OLD AND ON 23 NOV 2021 HAD A HIV EXPOSURE WITH ONE INDONESIAN GIRL, WHO DOESN’T KNOW HIV STATUS . IN GULF ON VISIT VISA SINCE 8 MONTHS, HAD 2 BF BEFORE. DURING THE ACT , THE CONDOM SLEEP WHILE SHE WAS ON TOP AND AFTER 2 TO 3 MIN WHEN FINISH I PULLED AND NOTICE THERE WAS NO CONDOM. I AM WORKING IN GULF SO I CANNOT TAKE PEP, AS IT IS PROHIBITED AND WILL BE DEPORTED. I JUST PRAYED SHE WILL BE NEGATIVE AND I SHOULD NOT GET SYMPTOMS. BUT 14 DAYS THE FOLLOWING SYMPTOMS APPEARED.

STARTED FEELING WEEK IN LEGS IN MORNING AND AT NIGHT LITTLE MILD FEVER WITH NIGHT SWEAT.

FEELING CHILLS WITH MILD BODY AND JOINT PAIN SINCE 10 DAYS ON AND OFF

I CANNOT SIT IN AIR CONDITION AS FEELING CHILLS AND BODY HOT, BUT NO FEVER, THE MAXIMUM TEMPERATURE 36.9 ONLY. IN NORMAL ROOM TEMPERATURE NO MUSCLE & BODY ACHES OR FEVER.

THE MUSCLE ACHES AND JOINT PAIN ARE ON AND OFF, SOMETIMES FEEL BETTER, SOMETIMES FEEL ACHY LIKE ARTHRALGIA WITH FORCE.

I DID NOT GOT SORE THROAT OR RASH OR GENERAL SWOLLEN LHYMP NODES ON NECK OR GROIN OR ARMPIT.

I CANNOT GO FOR TESTING IN GULF AND MY MEDICAL IS AFTER ONE YEAR IN MAY 2023, SO MY QUESTION ARE

1. I HAVE READ MANY SEROCONVERSION STORIES AND MOSTLY GET HIGH FEVER WITH JOINT & MUSCLE PAINS, SEVERE SORE THROAT, RASH WITH GENERALIZED SWOLLEN LYMPH NODES. SO IF I DIDN’T GOT RASH OR SORE THROAT . SO ONLY CAN ONE NIGHT FOR 1 HOUR GOT MILD FEVER WITH NIGHT SWEAT, MILD BODY ACHE AND CHILLS ON AND OFF FOR 10 DAYS CAN STILL BE SERO CONVERSION. I DINT TAKE ANY MEDICINE TILL NOW AND NOT STOP WORKING.

2. YOU CAN FEEL CHILLS OR MILD MUSCLE AND JOINT PAIN WITHOUT FEVER IN AIR CONDITION. BUT THE BODY GETTING HOT AND NO FEVER.

3. I CANNOT TEST IN GULF, BECAUSE IF ANYONE POSITIVE WILL BE DEPORTED IMMEDIATELY. MY MEDICAL IS IN MAY 2023, SO IF IN CASE ANY ONE POSITIVE, HE CAN SURVIVE UNTIL MAY 2023 WITHOUT ART MEDICINES BECAUSE YOU CANNOT BRING THE ART MEDICINES TO DUBAI.

4. I LIVE WITH MY WIFE AND DAUGHTER AND HAVE ONE CAT. HOW CAN ANYONE PROTECT THE WIFE AND DAUGHTER UNTIL MAY 2023 BEFORE INFECTING.

5. IF THE CAT IS IN FAMILY AND IF IT SCRATCH OR BITE SOMEONE HIV POSITIVE AND BITE ANOTHER MEMBER IS THERE ANY RISK OF TRANSMISSION.

6. IF ANY HIV POSITIVE HAVE VERY BAD DENTAL HYGIENE LIKE BLEEDING GUMS & RECEDING GUMS, CAVITIES ETC, HE CAN SHARE THE SAME GLASS OF WATER OR SAME SPOON WITH OTHER FAMILY MEMBERS OR THEY CAN EAT THE FOOD WITH SAME SPOON.

H. Hunter Handsfield, MD

44 months ago

Welcome to the forum. Thanks for your confidence in our services.

This is the first I have ever heard that PEP is prohibitied in any Gulf states. Even if that's true, it seems it would be easy to acquire anti-HIV drugs for that purpose. On the other hand, my understanding is that newly acquired HIV is exceedingly rare from sex workers in places like UAE and other Gulf states, so PEP probably wouldn't often be recommended there. However, we are definitely not experts in the frequency or epidemiology of HIV in such settings. But I do understand there are excellent, highly confidential STD/HIV clinics there where you can get valid advice.

I'll also point out that you were at low risk even if your partner happens to have HIV. The average transmission risk by unprotected vaginal sex with an infected female partner is around 1 in 2,500. That's equivalent to having condomless vaginal sex with infected women once daily for 7 years before infections would be highly likely. Yes it can happen with only one exposure, but almost never does. And as I said, it is very unlikely your partner has HIV anyway. To your specific questions:

1. The clinical manifestations of new HIV infection are called acute retroviral syndrome. Around half of newly infected persons have no ARS symptoms at all. When ARS occurs, the symptoms can be trivial to severe. Some cases are as definitive as you describe, but many are not. Symptoms almost never are a good indicator either for or against ARS.

2. This sounds like anxiety magnifying trivial symptoms or normal body sensations. Without the anxiety, you likely wouldn't notice anything.

3. We hear this all the time, that people "cannot test in Gulf". It's nonsense. Testing is readily available and, I understand, pretty frequently done at the STD/HIV clinics I mentioned. If negative, no problem. And if positive, you have to leave anyway in order to have proper medical care and life-extending treatment, which ideally is started within days of learning of a new positive test result. We now know that delaying treatment, even by a couple of weeks, lowers the chance of long term survival. Since you have to leave the country to be treated anyway, what's the difference? Sure it would be inconvenient -- but not worth risking your life.

4. Get tested and resume sex with your wife when known negative. Or use condoms consistently. Or don't have sex with her.

5. Nobody in the world ever caught HIV by animal bite or scratch (not counting some bites by chimpanzees, perhaps).

6. Similarly, HIV is never transmitted by shared drinking glasses, eating utensils, etc. Inflamed or bleeding gums makes no difference. It has never been known to happen.

So my closing advice is to find a way to be tested, which many expats do in your situation. Almost certainly the result will be negative and you can stop worrying. Beyond that, I really can't help much.

Let me know if anything isn't clear.

HHH, MD

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43 months ago

Dear Doctor,

Thank you for your reply.

The pep in uae are only for locals and not for expat, So I cannot take the pep. Regarding the test I can do the test but if anyone positive he will be deported immediately.

I would like you to know that, I am living with my wife and kids in uae and suddenly I cannot go to india leaving my job, my car, bank loans, kids studying in school and my wife also working in school. I didn’t thing of the repercussion that time of doing sex with that lady. Now everything is haunting me. If I go means they are under my sponsorship, so they have to automatically leave uae. I don’t know my bad luck one time exposure with the girl put me in so much trouble. My questions are

1. Regarding symptoms, Still now more than 34 days I am getting chills/shiver in my legs and back of shoulder on and off for 30 min in day or night. My feets sometimes are hot when there is inflammatory response and becomes normal after few hours. One day I am perfect other day again feeling like minor flu type in body or malaise, but without fever. Some day I get night sweat and some day I m normal no night sweats, but never fever in 34 days, except the first day. Does ARs symptoms are continue or on and off. Why I get night sweats without fever. How long the ars fever last. Does the fever goes on and off. What is the reason of my chills daily on and off.

2. I read many seroconversion stories mostly getting high fever, sore throat, rash, swollen lhymp nodes. Does the chills and mild flu type symptoms on and off can be ars or something else. What the severity of fever and duration. What about the malaise or body ache severity and duration.

3. Most of the time I am low temperature 36 only. The maximum temperature goes 36.4 only. Morning time mostly my temperature is low, below 35.9 Does hiv ars causes low temperature.

4. I had read that, if art treatment started during seroconversion is better as the virus doesn’t permanently damage the immune system. If someone gets positive and start medicine within acute phase like within 6 months is it ok. Whats your opinion. As I m planning to go India for test in End of January of first week of February.

5. What about the seroconversion illness, mostly doctors saying ars symptoms last 1 to 2 weeks, but my minor flu like symptoms is going on since 34 days. How the patient are treated for the ars symptoms without art medicines. Should I visit the GP Doctor for my very minor flu type malaise.

6. Sometimes I have nerve vibration in the morning affecting all joint and head making me feel weak like fatigue, what is that. I have mitral valve prolapse before I use to get like that, but since I start taking my hypertension medicine it stopped.

7. If anyone has kidney cyst stage 2, does hiv virus can make problem for the cyst if the treatment start late in acute phase like 3 to 6 months.

8. How long someone gets from Hiv acute infection to Aids without treatment in general population above 50 years of age and co morbiliby of hypertension.

By the grace of God and prayer of my wife and blessings of children, hopefully this symptoms might not be hiv ars. in sha allah ameen.

H. Hunter Handsfield, MD

43 months ago

1-3,5. ARS isn't the cause of these symptoms. ARS symptoms cannot come and go as you describe, and usually do not last so long.

4. Wrong. There is now very strong consensus among experts that the earlier anti-HIV drugs are started, the better the immune system is protected and survival improved.

6. Not an ARS symptom.

7. ARS or HIV do not interact in any way with renal cysts.

8. The prognosis of HIV/AIDS probably is no different in people over age 50 or with high blood pressure.

I still recommend you find a way to be tested as the best way to resolve your fears of HIV. A negative test result will be much more effective than anything I can say. I will have no other comments until/unless you report a test result, within a week -- at which time this thread will be closed. Thanks for your understanding.

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