[Question #9331] Negative but have symptoms
 |
33 months ago
|
Hello, thanks for offering this service. I had an exposure (insertive vaginal) last month. Since then I have had three HIV 4th gen combo lab test on day 14, day 28, and day 46. I have also had the full range or STD tests on day 14 and day 28. All tests have come back negative. Since about day 10, I have had symptoms that come and go. These include intermittent fever, fatigue, headaches, diarrhea, nausea, sore throat and recently swollen lymph nodes near armpit (at week 7). My doctor seems confident I haven't contracted HIV.
My questions are:
1. Should I trust the test results even though I have symptoms? Should I get tested again?
2. Can swollen lymph nodes be painless and near the chest rather than directly under armpit?
3. I have been taking Codral on a regular basis to help with my symptoms. Will this impact the HIV test?
4. Has anyone tested negative at 6 weeks / Day 46 only to return a positive test at a later date?
5. When does acute HIV ARS occur? Can it be after 7 weeks?
6. There are some websites that says a confirmation test at 3 months / 90 days is needed to conclusively rule out HIV. Are these recommendations dated?
7. I'm having quite severe anxiety at the prospect of contracting HIV. Not even the negative 6 week test helped my anxiety. Are there ways / methods to cope with the anxiety?
My questions are:
1. Should I trust the test results even though I have symptoms? Should I get tested again?
2. Can swollen lymph nodes be painless and near the chest rather than directly under armpit?
3. I have been taking Codral on a regular basis to help with my symptoms. Will this impact the HIV test?
4. Has anyone tested negative at 6 weeks / Day 46 only to return a positive test at a later date?
5. When does acute HIV ARS occur? Can it be after 7 weeks?
6. There are some websites that says a confirmation test at 3 months / 90 days is needed to conclusively rule out HIV. Are these recommendations dated?
7. I'm having quite severe anxiety at the prospect of contracting HIV. Not even the negative 6 week test helped my anxiety. Are there ways / methods to cope with the anxiety?
 |
Edward W. Hook M.D.
33 months ago
|
Welcome to our Forum and thanks for your questions. I'll be glad to comment. I agree with your doctor. You do not have HIV. Current tests for HIV are amongst the most sensitive tests in all of medicine and provide completely conclusive results at any time more than 6 weeks following an exposure. Further, when symptoms are present, tests are always positive. Finally, your symptoms have many other, potential non-STI causes and the symptoms of HIV do not come and go as you describe. With that, let me address your specific questions:
2. Can swollen lymph nodes be painless and near the chest rather than directly under armpit?
3. I have been taking Codral on a regular basis to help with my symptoms. Will this impact the HIV test?
4. Has anyone tested negative at 6 weeks / Day 46 only to return a positive test at a later date?
5. When does acute HIV ARS occur? Can it be after 7 weeks?
6. There are some websites that says a confirmation test at 3 months / 90 days is needed to conclusively rule out HIV. Are these recommendations dated?
7. I'm having quite severe anxiety at the prospect of contracting HIV. Not even the negative 6 week test helped my anxiety. Are there ways / methods to cope with the anxiety?
1. Should I trust the test results even though I have symptoms? Should I get tested again?
Yes, your results are conclusive and there is no need for further testing.
2. Can swollen lymph nodes be painless and near the chest rather than directly under armpit?
Most people have lymph nodes which can be felt in one area of the body or another. The arm pits in inguinal area at the top of the legs are the most common place where this occurs. Further, lymph node swelling may be the normal, residual of some prior, non-specific source of inflammation.
3. I have been taking Codral on a regular basis to help with my symptoms. Will this impact the HIV test?
No, Codral would have no impact on the results of an HIV test, nor on the timeline of development of a positive test.
4. Has anyone tested negative at 6 weeks / Day 46 only to return a positive test at a later date?
I have never seen or heard of such a case. Not ever.
5. When does acute HIV ARS occur? Can it be after 7 weeks?
Seven weeks is too late for the symptoms of acute HIV to occur. The symptoms of the ARS typically occur between 1 and 3 weeks and never beyond 4 weeks.
6. There are some websites that says a confirmation test at 3 months / 90 days is needed to conclusively rule out HIV. Are these recommendations dated?
Those websites are out of date and incorrect.
7. I'm having quite severe anxiety at the prospect of contracting HIV. Not even the negative 6 week test helped my anxiety. Are there ways / methods to cope with the anxiety?
Believe the test results. Have faith in the science. This has been studied very well. Consider other possible causes of your symptoms including the possibility of anxiety relate to an encounter you may now regret.
I hope this information is helpful. EWH
--- |
33 months ago
|
Thanks for your detailed response Doctor. I'm stressing even more now as I had quite severe night sweats last night (50 days post exposure) and now have swollen lymph nodes in both armpits.
Would HIV still be possible? Or is it more likely symptoms of something else entirely? Should I still get tested for HIV again?
Would HIV still be possible? Or is it more likely symptoms of something else entirely? Should I still get tested for HIV again?
|
33 months ago
|
Just adding on top of the previous post. There's an additional swollen lymph node on my neck and hives on my knees. I'm wondering if these could be acute HIV symptoms.
|
Edward W. Hook M.D.
33 months ago
|
Straight to your follow up questions: you have completely ruled out any possibility that you acquired HIV from the exposure you described. There is no medical or scientific reason for additional testing.
As I also mentioned, lymph node swelling is a nonspecific response to any number of causes. It requires an experienced clinician to differentiate normal lymph nodes which can be felt from abnormal lymph nodes which may be indicative of a problem. I suggest you see your own health care provider for evaluation of your possible lymph node swelling and, if it is present and abnormal, work with him/her to evaluate the cause. It is not HIV.
EWH
--- |
33 months ago
|
Hi Doctor, sorry for the repetitive nature of my question. I'm starting to think that I am getting symptoms of HIV. Since the negative 6 week 4th gen test, I've been getting swollen armpit lymph nodes, and quite frequent and sever night sweats. I have recently (at week 8 since exposure) developed a mild sore throat and an ulcer on my tongue (and my tongue feels sensitive / painful when I touch it). I've since mentioned these symptoms to my doctor and he's now insistent that a 3 month confirmation test is required to complete rule out HIV (he seemed confident previously that a 6 week test is sufficient, but had since changed his view).
1. Can these be symptoms of early HIV?
2. Do mouth ulcers typically form around 2 months post exposure?
3. Are night sweats typical in early stage HIV or do they only develop in advanced stages? When do they typically start? Can it be after 7 or 8 weeks post exposure?
4. I have an appointment with my GP next week, should I request another HIV test?
5. Is my doctor correct in that only a 3 month test will conclusively rule out HIV? It seems odd as he was confident I'm not infected after the 6 week test but now he seems not too sure and says a 3 month test is required.
6. I'm also worried if I go for another test, it could be a false positive as the more you test, the higher the chance of a false positive. What are the typical causes of false positives in 4th gen lab tests?
I understand this is my last question, so I wanted to thank you for your responses.
|
Edward W. Hook M.D.
33 months ago
|
You are correct, some of these questions are repetitive and repeating your questions will not change the answers.
1. Can these be symptoms of early HIV?
No, S I SAID ABOVE- "Seven weeks is too late for the symptoms of acute HIV to occur. The symptoms of the ARS typically occur between 1 and 3 weeks and never beyond 4 weeks"
2. Do mouth ulcers typically form around 2 months post exposure?
No
3. Are night sweats typical in early stage HIV or do they only develop in advanced stages? When do they typically start? Can it be after 7 or 8 weeks post exposure?
Night sweats may occur as the result of an oppotunistic infection occurring years after infection. They are also a non-specific symptoms with many other potential causes.
4. I have an appointment with my GP next week, should I request another HIV test?
As I also said previously, ".. your results are conclusive and there is no need for further testing."
5. Is my doctor correct in that only a 3 month test will conclusively rule out HIV? It seems odd as he was confident I'm not infected after the 6 week test but now he seems not too sure and says a 3 month test is required.
He is incorrect in his 3 month recommendation but correct that you are not infected. See my response to your repetitive question no, 4 above.
6. I'm also worried if I go for another test, it could be a false positive as the more you test, the higher the chance of a false positive. What are the typical causes of false positives in 4th gen lab tests?
False positive tests are rare. There is no specific association with false positives. The testing procedure, which typically does a second tesst to confirm positive tet results virtually eliminates false positives.
This completes this thread. Please seek professional help for your anxieties. EWH
---