[Question #8961] HIV-2 60 days - second attempt
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37 months ago
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Hi, weeks 2-4 post-exposure I had joint pain, felt feverish (didn’t test temp), night sweats, and muscle pain, potential thrush. Neg PCR test at 18 days. Then negative 4th gen at 32 days. Felt fine until day 50 when joint pain and muscle ache, potential thrush, and feverish feeling (this time tested, never seemed to be too hot, sometimes a bit cold) returned but now with intense Nausea and a rash on feet (red dots on ankles and on top of feet). 53 days neg home blood test, 60 days neg 4th gen test.
My main worry now is HIV-2 as only antibodies have been tested. Is a 4th gen test at 60 days conclusive for HIV-2? At the very least, can it rule out that symptoms starting 10 days before the test are from HIV? The symptoms have largely subsided the day after the test as well if that means something with regards to antibody production. I just find it hard to believe that I don't have HIV as all the symptoms come and go at the same time- including that rash. This happened with the first set of symptoms at 2-4 weeks too and they definitely can't be from HIV (right?) given my testing so that's reassuring, but it's harder to believe when physical manifestations go at the same time too (rash). So my questions - do I conclusively not have HIV-2? If not, are my symptoms at 50 days conclusively not caused by HIV-2? And could either of these questions be impacted by the fact that I'm not sleeping much or eating well at the moment - i.e. that could delay antibody production?
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Edward W. Hook M.D.
37 months ago
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You've posted your question twice. I answered an earlier version of this question. I suggest you contact the site administrator and ask them to not charge you for this repeat question. If there are questions my reply on the other link, please don't hesitate to use your up to two follow-ups for clarification. EWH---
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37 months ago
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Hi I just thought I’d use this question quickly if that’s ok.
Update - I got a 68 day negative test as well.
Unfortunately today (80 days post-exposure) I was found to have small red blood cells, perhaps due to an iron deficiency (they stress I’m NOT aneamic) Is it possible that this could be caused by HIV so early as on after infection as I’m really freaked out?
I think it could be due to excessive blood testing for hiv itself.
Thanks
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37 months ago
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2229839/
This study in particular worries me - Fifty-seven participants with acute HIV infection were identified at a median of 14.5 days post-infection (range 10–81) and were enrolled in the CAPRISA Acute Infection cohort at a median of 41 days post-infection (range 15–104). Mean haemoglobin prior to HIV-1 infection was 12.7 g/dL, with a mean decline of 0.46 g/dL following infection. The prevalence of anaemia increased from 25.0% prior to HIV-1 infection to 52.6% at 3 months post-infection, 61.1% at 6 months post-infection, and 51.4% at 12 months post-infection.
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Edward W. Hook M.D.
37 months ago
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I fear you continue over thinking things. Small red blood cells are a classical sign of iron deficiency and can occur even before anemia occurs. The study that has caught your attention is not relevant to you. Please note that all of the persons described with acute infection were South African women in whom anemia is far, far more common, both among women with and without HIV, than in the United States. Further, as indicated in this study, the anemia was not a sign of HIV infection but the authors were concerned about a convergence of morbidity.
I really urge you to trust your test results. You have not acquired HIV-1 or HIV-2. Really!. EWH
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37 months ago
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To be honest I’m finding this all very confusing, so to clarify, I’m not saying I have anemia if this comment is meant to reassure me on that - ‘Small red blood cells are a classical sign of iron deficiency and can occur even before anemia occurs’, but simply that I’m having issues with red blood cells that hiv can cause, that being said -
HIV does cause anemia in 10% of latent and people, and 92% of people with aids due to
- Normal progression of HIV disease. The virus can infect parts of the bone marrow responsible for manufacturing red blood cells. (Could this apply to me?)
- Deficiency of a hormone called Erythropoeitin which is required to stimulate red blood cell production. (Could this apply to me?)
- Opportunistic infections such as mycobacterial disease (MAC), or fungal diseases. - I assume this doesn’t apply to me
- Cancers of the bone marrow such as Non-hodgkins lymphoma.- I assume this also doesn’t apply to me
- Nutritional deficiencies of malabsorption. This is the major source of anemia Vitamin B12 deficiency. - could this apply to me?
- Bleeding. - could this?
Low iron levels are also found with hiv
The study says -
Previous reports have suggested that there is an increased risk of anaemia with more advanced HIV infection[5], however, here we demonstrate that anaemia occurs with increasing frequency during the early stages of HIV-1 infection. Whether this acute infection associated anaemia will resolve during the typically latent period prior to clinical AIDS remains to be seen.
The anaemia of these participants trended towards microcytosis and hypochromia and this trend persisted throughout the first 12 months following HIV-1 infection. The trend towards microcytosis combined with the progressive decline in serum iron levels and the elevated red cell distribution width (RDW) point towards iron-deficiency as the most likely etiology of the anemia in this cohort
So in sum - to me this all says that hiv often causes small red blood cells (on the road to anemia, I’m not saying I have anemia but HIV effects iron levels, leading to smaller red blood cells, amongst other things) even early in infection, so it isn’t too early for it to be an effect. Iron deficiency is often the cause as well, which is what they’re testing me for next.
With that all being said
- I really don’t see how the study above doesn’t apply to me. They say anemia/RBC issues increase during the acute stage. Regardless of the prevalence in South African women, the study compared them to women without hiv with the same background- and the hiv cohort had more red blood cell issues than those without - which suggests acute and early hiv has can have an effect on red blood cells - is this right, if not, why not? Do you think pre-3 months any effect on red blood cells wouldn’t happen/wouldn’t occur just 4 weeks after the onset of ARS, despite the study?
- Is it plausible that my small red blood cells is due to the blood loss from my excessive testing recently? I’ve had 4 lab quantity blood tests in the last 3 months, 2 since day 60?
- could you comment specifically on my new test. 68 days 4th gen. Would my symptoms starting 17 days before have led to a positive antibody result/is it conclusive in general for hiv-2? (I’ve seen mixed things from you and dr HHH about when, from the onset of symptoms practically all antibody ONLY tests would be positive, could you clarify if possible -and does this vary between hiv-1 and 2?) I’ve also seen you and dr HHH say different things for hiv-2 window periods in general and there seems to be some uncertainty - often 8-12 weeks (rather than simply 8 weeks) is mentioned for the window period. That has me worried. Also, I know the antigen part isn’t for hiv-2 but does it help at all in detecting hiv-2 - I’ve heard sometimes the hiv-2 antigen can be detected due to similarity to p24. Could it lead to indeterminate results making it SLIGHTLY better than just a 3rd gen test with regard to hiv-2?
Sorry for the large reply but I’m really concerned at the moment and all this iron deficiency/red blood cell stuff is really confusing.
4- (Oh and one more thing - I saw a post where someone found a study where hiv-2 was found to not be killed by saliva and dr HHH acknowledged it but said it probably doesn’t matter much for the risk of giving Oral - do you agree/could you elaborate on why salivary inhibition of the virus may not be that important for the risk of giving oral? Does this change any of your assessments?
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Edward W. Hook M.D.
37 months ago
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Sigh. You are not going to give this up, are you. You are searching for anything that might support your mistaken belief that you have some form of HIV. I’ll provide brief final responses which will complete this thread. I will also remind you that anxiety- driven, repetand argumentative questions will be deleted without comment. Your questions are in that realm.
Anemia, including microcytic anemia occurs regularly in persons with ADVANCED HIV who have been infected for years. The reasons are too many to mention and irrelevant to your circumstance. If the virus had damaged your bone marrow to cause anemia you test would certainly be positive. Anemia due to B-12 and other malabsorption syndromes is macrocyclic, not microcytic which is you concern.
It would be unusual for a person with normal nutrition to have microcytic anemia,
In answer to your questions:
1. This study is nearly a decade old and has not been regularly confirmed. There are numerous other HIV con founders which may explain the reported findings.
2. See my comment above. It would be most unusual for diagnostic blood testing to explain your small red blood cells
3. In persons who have had symptoms for more than a few days, if the symptoms are due to HIV the blood test would be positive. Symptoms in the situation you describe a curb because of the interaction between the HIV virus and antibodies to infection
4. Whether or not HIV is killed directly by saliva, exposure to saliva has never been shown to lead to HIV infection. Once again, you are grasping at threads. As you know, there has never, not ever been a documented case of HIV proven to have been acquired from receipt of oral sex. There are a handful of documented cases of HIV acquired the result of performing oral sex on an untreated, infected partner. The CDC conservatively estimates the likelihood of acquiring HIV for performing oral sex on an untreated, infected partner as being substantially less than one episode in 10,000. Your risk is likely lower than that, particularly after your multiple negative tests.
You really need to move on. It’s completes this thread. EWH
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37 months ago
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Thanks for the response and I’m not trying to be argumentative, I’m sorry it came across that way, was just trying to get your expert opinion of on something that looks concerning to the eye of a layman.
To add -
I still find the whole red blood cell confusing but I guess the bottom line is it’s too early to be caused by hiv and if it was my test would’ve been positive a few weeks ago?
Regardless my 9.7 week test is conclusive for HIV-2?
Otherwise I’ve got another 4th gen test on Wednesday and if that negative I’ll start to let go.
Thanks so much for putting up with me, you, Terri, and Dr HHH are doing God’s work and I can’t thank you enough.