[Question #9618] scared of ars symptoms, possible hiv?

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30 months ago

Hi all, per my last post I was taking your guy’s advice, and laying off the internet/ trying to fight my OCD thoughts… I was ok until I recently developed severe flu symptoms which I attributed to possibly being ARS. My symptoms began ~ 5 weeks after my exposure, I had a moderate fever (101/102), extreme chills, then a VERY sore throat and extremely swollen tonsils. I also have been experiencing diarrhea and vomited once. I was constantly spitting up this yellow phlegm prior to vomiting. I don’t have any sores/rashes, but the gum around a SINGLE one of my teeth is inflamed, no ulcerations. I went to the er the other day & they tested me for strep, flu, covid, all of which were negative. (This only worsened my anxiety). I didn’t want to have to post on here again; I don’t want to come off as bothersome or anxious/annoying, but these symptoms have been some of the worst I have experienced in years. It’s now day 6, no fever still sore very throat. My exposure was unprotected fellatio (me-female- giving a -male- oral, 3x same guy, he did not ejaculate in my mouth the first time, the other 2x I immediately spit out the remainder & ran to the bathroom to gargle with Listerine and check my mouth for cuts. Idk his HIV status, but he is very high risk, slept with 50+ people easily and doesn’t always use condom. My biggest concern is that he has an untreated, recent HIV infection due to his sexual history. I’ll likely end up test at 8wks… given these symptoms + exposure level how likely is it that you think I have HIV? Numbers/statistics are helpful to me. Any advice would be helpful. Many thanks. 

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Edward W. Hook M.D.
30 months ago
Welcome back to our forum. As you know, Dr. Handsfield and I share the forum and have worked together for over 40 years in this capacity. The facts of our recommendations are always in agreement although our verbal styles very somewhat. In preparing to answer your new concerns I reviewed your earlier interactions with Dr. Handsfield, and, not surprisingly, agree completely with all that he said. You risk for acquiring Is vanishing Milo and his estimate of less than one in 1 million is on track.

I’ll do my best to reassure you. FYI, when at risk persons presenting to emergency rooms with flu like symptoms such as yours were tested for HIV, far less than one percent of those individuals proved to have the ARS.  The same symptoms that you experience are indeed caused not only by HIV, but far more commonly by influenza, Covid- 19, and a long, long list of other community acquired viral infections. Further, that your symptoms occurred about five weeks following your exposure is outside the window when the ARS would be expected to occur.  I am confident that the symptoms you’re experiencing are not the ARS.

I also understand that despite my confidence that this is not the ARS your concerns may well persist. The best way to address them would be to seek testing for HIV at this time. FYI, HIV test results are 100% conclusive when tested using a fourth generation, combination HIV antigen/antibody test at any time more than six (not 8) weeks following an exposure. Well over 99% of recently acquired infections are detectable at four weeks and if your symptoms were due to HIV an HIV test At this time would be positive. Also, as an FYI, we have never seen or heard of a person with a negative test at four weeks or beyond who are done then develop a positive test.

I hope you find the information I have provided reassuring. I understand that when a person feels poorly such as you do doubts may arise. Please don’t worry. EWH.
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30 months ago

Hi Dr. Hook, thank you very much for your kind words and promptly response, it truly means a lot. The only other thing I wanted to mention was I noticed what looked like a small canker sore on the roof of my mouth and by my wisdom tooth (didn’t need to have mine removed), as well as what looks like a tiny whitehead pimple on the roof of my uvula right by my tonsil that is the most swollen/infected (right side). I have a history of canker sores since childhood, and normally wouldn’t think twice, but given the totality of all my other symptoms, I wanted to confirm whether you thought that this would increase the likelihood of my risk in your opinion? Or would you still say 1 in a mil? I am glad to hear I can take the test earlier than I thought, I plan on taking the rapid finger prick test  to avoid the agony of waiting on results, assuming it’s a 4th gen test, would you say it would be as accurate as receiving a blood draw sample? Or more prone to false neg/pos results?

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Edward W. Hook M.D.
30 months ago
Your tendency for canker sores, as well as an inflamed wisdom tooth in no way changes your risk which, as Dr Handsfield has said, is less than 1 in a million.

The white spot on your uvula is consistent with a plain, every day, non- HIV viral sore throat.

Finger stick HIV tests perform just as well as tests in blood from the vein.  EWH 
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30 months ago
Hi Dr. Hook, sorry for the late response, I ended up having to be hospitalized due to the severity of my symptoms, I could not drink or eat anything without being in excruciating pain & as a result was basically starving and dehydrated for 5 days. I am assuming this is my final follow-up question, so I just wanted to recap everything. Given my symptoms being sore throat, fever, diarrhea, and mouth ulcers (canker sores and inflamed gums) this does NOT change your risk level assessment at all, correct? Being at the hospital really did a number on me because they tested me for a whole bunch of things (mono, tonsillar abscess, strep, covid, flu) ALL of which came back negative. They even sent in a infectious disease specialist who said my symptomology was "inconclusive." I think the various Drs. collectively being unable to figure what's wrong with me is what's really freaking me out the most, also because they said they thought it was most likely viral which scared me. I also have not experienced symptoms this severe in years. I just don't know what type of terrible virus could cause something this debilitating . Anyway, thank you for everything that you guy's do on here and for bearing with me on this anxiety-ridden post. Your kind words genuinely mean very much to me <3 . 
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Edward W. Hook M.D.
30 months ago
I'm sorry to here that you needed hospitalization.  I t sounds like your evaluation was quite thorough.  To be honest however, I am not surprised that it was inconclusive- there are just so many community-acquired viruses which can cause the sort of symptoms you report.  None of  this however alters my confidence that this is NOT HIV.  I hope you are feeling better.

As you point out, this will complete this thread which will be closed without further comment.  I wish you the best.  EWH
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