[Question #9808] To Dr HHH. ARS symptoms

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28 months ago
Dear Dr HHH.
this is a follow-up question to my previous enquiry. I apologise beforehand for asking you this directly, but, in this case, I think you would provide a clearer response regarding ARS.

Approx 115 days ago, I fingered a CSW (in Colombia) with a hang nail. since then, I have got tested 8 times with HIV Ag/Ab tests. All of these have come back negative (the last test was done 5 days ago which is the same day or the day before symptoms started developing). Approx, 5 days ago, I started feeling some weird symptoms. Body temperature of 37.2 C maximum for 3 days. Some swollen lymph nodes under my right armpit for 3 days. 2 mouth ulcers that have not gone away. 

According to your previous responses in this forum, 110 days would be too far away for ARS symptoms development. This makes me this that maybe I might have got exposed to HIV 65 days ago when I got tested with a rapid 4TH gen test at a community-based sexual health clinic. That day the nurse used a lanced that clicked when it pricked my finger. However, I do not remember seeing where the nurse got the lancet from. based on these events, I would like to ask you:

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28 months ago
1. Do you think these symptoms are due to HIV infection?
2. Is it possible to start developing ARS symptoms 65-110 days post-exposure?
3. in one of your responses in this forum you mention that the development of ARS symptoms after 5-6 post-exposure was impossible, however, some websites suggest that it could take 2 to 6 weeks, is this true?
4If I got tested today, even though the symptoms have not gone completely away, do you this I would get an accurate result? is there any chance of getting a false negative result because the symptoms have not gone completely away?
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Edward W. Hook M.D.
28 months ago
Welcome back tot he Forum although I'm sorry that you felt the need.  I note that you have addressed your question to Dr. Handsfield, perhaps in the hopes of getting a 2nd opinion however, clients are not permitted to choose who responds to their questions.  Dr. Handsfield and I have worked together for nearly 40 years and while our verbal styles are different, the factual content of our responses is ALWAYS the same.  Your repetitive, follow-up questions have been assigned to me.

My assessment of your risk for infection will not change with repeating the question.  Your tests prove that you were not infected when you masturbated (fingered) a Columbian CSW.  Further, you can be confident that you were not infected when your blood was drawn 65 days ago for testing- laboratory procedures and tools are carefully regulated to avoid any chance of infection as blood is drawn.  The lancets used for drawing blood for finger sticks can only be used a single time.  In addition, the symptoms you describe have occurred too late to be due to the ARS- the ARS never occurs more than 30 days after an exposure (More on the ARS below).  In response to your specific questions:

1. Do you think these symptoms are due to HIV infection?
No. These symptoms are not the symptoms of the ARS.  The symptoms of the ARS include high fever (>38 degrees), severe sore throat, muscle or joint aches and in some, swollen lymph nodes a rash or diarrhea.  Isolated swollen nodes under the armpit are non-specific.  Mouth ulcers are not suggestive of the ARS.

2. Is it possible to start developing ARS symptoms 65-110 days post-exposure?
No.  The ARS always occurs within 30 days of exposure- most often between 10 and 20 days.  

3. in one of your responses in this forum you mention that the development of ARS symptoms after 5-6 post-exposure was impossible, however, some websites suggest that it could take 2 to 6 weeks, is this true?
Those web sites are incorrect.

4If I got tested today, even though the symptoms have not gone completely away, do you this I would get an accurate result? is there any chance of getting a false negative result because the symptoms have not gone completely away?
Yes.  When persons have symptoms due to HIV, their tests are always positive.  There is no chance of a false negative in your situation.

I hope these responses will be helpful.  Please don't worry.  You can be confident you have not acquired HIV.  EWH
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