[Question #9261] follow-up for hiv risk

34 months ago

hello doctors, after the follow-up with doctor handfield I decided to continue with my life without worries, but the worries have returned due to some symptoms that I had, after the previous follow-up I had cold sores, and yesterday I had a swelling just in the back of the neck, I don't know if it's a ganglion but it did swell and it hurt, I haven't had blows, it swelled for no apparent reason, and now I woke up with a hoarse voice, my throat doesn't hurt or I have the flu but it seems that it wants to give me. I have 4 and a half months since my exposure, they would recommend me to do another test, since that swelling that I have scares me that it is a symptom of hiv. Would you change your initial assessment from the previous thread? Should I keep trying to test control? I'm sorry for my English

Edward W. Hook M.D.

34 months ago

Welcome back to our forum. On this occasion i, rather than Dr. Handsfield, happened to pick up your latest questions. Thus you will be getting my opinion on top of his earlier response to your questions. In preparing to answer this question I reviewed your earlier interaction with Dr. Handsfield and agree completely. As he said, the testing that you had had at the time you interacted with him conclusively and unequivocably rule out any possibility that you had acquired HIV from the exposure you described. That remains the case.

You should look for another cause for the swelling at the back of the neck and your recent hoarseness. It is certainly not due to HIV. There is no need for additional testing for HIV. Additional testing would be a waste of time and effort. Be certain that you don’t have HIV and move forward without concern.

I hope this assessment is helpful to you. EWH

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34 months ago

Thank you doctor, even so I am still worried, perhaps because I have read cases of people who claim to have tested positive after 4, 5 and 6 months. That makes me think more about this. I would like to know what you think about these cases, is it possible? I have some extra questions:

1. I know there are no specific symptoms, but what are the most common symptoms of HIV seroconversion?

2. The ganglia due to hiv, do they hurt or not, do many say that they do hurt? 3. Regarding the probability of contagion of 1 per 1000 or 2000, in my opinion I doubt that HIV is so difficult to contract, perhaps it would be 1 in 10 exposures being optimistic, what are these figures based on, what do you think about this?

4. Is it possible that the virus progresses slowly and remains undetectable for a long time?

5. I know it's repetitive, even so Are you completely 100% sure that my tests are conclusive and I don't need more tests no matter what symptoms I have or if I have more symptoms? You really wouldn't change my diagnosis? . Finally, to comment that the inflammation is giving way, I took analgesics and anti-inflammatories, it lasted approximately 1 day, it hurt, if it were due to HIV, would the inflammation have also given way or would I have had it for longer ? Thanks a lot. I know that I have one more follow-up, I will take care of it later if I take another test or if I have something more important to add.

Edward W. Hook M.D.

34 months ago

I'm sorry you did not find my answer satisfactory. I suspect the "cases" you are referring to above are things that you have read on the internet. If so, I urge you to stop. Statements made on the internet are often incorrect, either because they are out of date, misinterpreted, taken out of context of just plain wrong. Further, since the internet is unmonitored. there is no way to tell what is true and what is not. I repeat, you do not have HIV- you have proved that. As for your follow-up questions:

1. I know there are no specific symptoms, but what are the most common symptoms of HIV seroconversion?

The symptoms of HIV seroconversion occur between 1 and 4 weeks after exposure. so-called "late seroconversion" is an internet-based myth. The symptoms of HIV seroconversion, which typically occur in combination are high fever, severe sore throat (not just hoarseness), and severe muscle and/or joint aches. Lymph node swelling may or may not be present. The symptoms you describe do not even begin to suggest HIV seroconversion and your timing is absolutely wrong.

2. The ganglia due to hiv, do they hurt or not, do many say that they do hurt?

By "ganglia I presume you mean lymph node swelling. If so, they are most typically painless once established. Further, lymph node swelling is non-specific and has many causes, only a tiny proportion of which are HIV.

3. Regarding the probability of contagion of 1 per 1000 or 2000, in my opinion I doubt that HIV is so difficult to contract, perhaps it would be 1 in 10 exposures being optimistic, what are these figures based on, what do you think about this?

The 1 in 1000-2000 estimate for unprotected genital intercourse is based on careful scientific studies carried out on thousand of persons and have been verified literally hundreds if not thousand of times. If you choose to believe otherwise, you are sadly mistaken.

4. Is it possible that the virus progresses slowly and remains undetectable for a long time?

No, as Dr. Handsfield told you, all persons who acquire HIV have positive 4th generation, combination HIV antigen/antibody tests within 6 weeks of exposure.

Yes, I am completely confident that the results you have reported prove that you do not have HIV, Further testing is a waste of time and resources. When tests are used to evaluate symptoms, it is the tests that provide the final answer.

Finally, to comment that the inflammation is giving way, I took analgesics and anti-inflammatories, it lasted approximately 1 day, it hurt, if it were due to HIV, would the inflammation have also given way or would I have had it for longer ?

Typically the symptoms of HIV last a week or so.

EWH

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33 months ago

Good morning Dr Hook. I've come to close the thread. I'll try to be brief:

From the last time until now I have not had major complications, a couple of times my submandibular lymph nodes hurt, but they receded in 2 and 3 days, and I have had neck pain. Nothing serious just temporary.

I want to completely forget about this, maybe a lot of stress and anxiety is affecting me. I did one last test for my peace of mind at 21 weeks, giving it negative.

I know that you have been here for 6 weeks and they told me that no more tests were necessary, but when there is a lot of anxiety and discomfort in the body, the result is very reassuring, even so many doctors not only in my region, even in the US and Europe they handle 3 and 6 months regardless of the generation of the test. I know you will tell me that it is obsolete, but if there are cases I do not think it is obsolete, because it depends a lot on each person. Is it assumed that since it is not very contagious the chances are very low or to encourage people to get tested? And for those who do have a real risk with an infected person, will your advice remain the same? What do you think about this?

I also have some additional questions to the above:

1. If someone is with an infected person without knowing it for at least 6 months, and there is transmission of the virus at least 3 times, would the second and third count as reinfections? And this can affect the production of antibodies and the window period? Or how would it affect?

2. When the infection is asymptomatic, is the seroconversion time the same? Or if it is asymptomatic, does it affect acute detection, for example, would p24 be detectable?

3. What percentage of people pass the infection asymptomatic?

4. Is it possible that the virus does not replicate from the beginning and remains dormant without replicating?

5. Lastly, what problems can cause the lymph nodes to swell without being infected by a virus or bacteria?

Thank you very much in advance for your advice, I will finish this and move on. Have a happy day Dr Hook!

Edward W. Hook M.D.

33 months ago

I'm sorry that you continue to worry. I am also sorry that you have been misled by incorrect statements that you have found on the internet stating that it may take longer than 6 weeks for HIV tests to become positive. I'll go straight to your follow-up questions:

This question is difficult to follow. It seems that you are asking whether more than one exposure to an infected partner might interfere with test results. It will not. Remember, that the statistical chance of acquiring HIV from unprotected genital sex is less than one infection in more than 1000 exposures. With more exposure, the risk for infection increases but remains low. Multiple exposures do not prolong the sindow period

2. When the infection is asymptomatic, is the seroconversion time the same? Or if it is asymptomatic, does it affect acute detection, for example, would p24 be detectable?

Yes, no matter whether the infection is asymptomatic or symptomatic, the average window period is the same and, if tests are going to become positive, they always become positive within 6 weeks.

3. What percentage of people pass the infection asymptomatic?

Most people who transmit HIV are asymptomatic. more than half of persons who acquire HIV are asymptomatic

4. Is it possible that the virus does not replicate from the beginning and remains dormant without replicating?

No, this is not possible. If the virus is able to infect, it must be able to replicate.

5. Lastly, what problems can cause the lymph nodes to swell without being infected by a virus or bacteria?

Lymph nodes can swell due to an enormous including viral infections, bacterial infections, inflammatory diseases such as rheumatoid arthritis and lupus, cancer, drug allergy, and more.

This is my 3rd reply. As a result, this thread will now be closed. There should be no need for further questions. Repetitive, anxiety driven questions may be closed without an answer and without refund of the posting fee.

EWH

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33 months ago

Thank you Dr Hook, I am very sorry for my bad English, perhaps I did not express myself very well in my comments, in my first question I meant that if there is transmission of the virus more than once with the same person, this would affect the body's response to the virus ? .

Finally I just wanted to tell you that I am not worried anymore, without a doubt your answers reassured me a lot and I was able to get answers from experts like you and Dr Handsfiel, without a doubt they were of great help. Again, thank you very much!!!

Edward W. Hook M.D.

33 months ago

Thank you for the clarification. Transmission of the virus does not seem to occur. As I said above, while multiple exposures to an infected partner increase the risk for infection, it would not effect the body's response to infection. The tests would work just the same.

I'm pleased my comments have been helpful. The thread will now be closed. Take care. EWH

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