One of the most common types of questions we get is just like yours:  an exposure that is concerning for HIV, symptoms that seem to suggest acute retroviral syndrome (ARS, i.e. initial HIV infection), and negative HIV test results. The large majority are based on the same very common misunderstanding, which you display. It is not possible to have ARS symptoms and not test positive with the standard HIV tests, like the AgAb (4th generation) blood tests. It isn't HIV itself that causes symptoms, but the immune response to the virus. The immune response is indicated by anti-HIV antibody. The antibody tests are always positive within a couple days of onset of symptoms, no exceptions. Stated another way, a negative antibody test proves that any symptoms present are not caused by HIV, no matter how typical for ARS they seem to be.

In addition, the symptoms of ARS are what is called "nonspecific":  that is, they occur in many different medical conditions, most of them mild (common viral infections, for example). If you read through lists of ARS symptoms, you're also seeing the symptoms of at least 100 other conditions, almost all of them far more common than HIV. Therefore, individual symptoms almost never are helpful in judging presence or absence of HIV infection. The pattern and timing of symptoms can indeed be helpful in pointing toward HIV and ARS:  the typical ARS case has at least three of these four symptoms:  body wide skin rash (not itchy, more on the trunk than the extremities), enlarged lymph nodes in several areas like neck, armpits, and groin; sore throat; and fever. Diarrhea, mouth ulcers, and other symptoms can occur, but usually do not. In someone with this pattern starting 1-2 weeks after a high risk exposure (but never earlier than a week and rarely beyond 2 weeks), ARS indeed is possible. But even this pattern is mostly not due to HIV. And almost any other symptoms or pattern of symptoms is due to other things.

Further, here are some common symptoms that DO NOT occur with ARS:  nasal congestion, stuffy or runny nose, cough, pain in the neck, groin or arms, without obviously enlarged lymph nodes, muscle aching in absence of fever, joint pain, and many more.

But again, the main point is that a negative HIV antibody test -- or a negative antigen-antibody (AgAb, "4th generation") blood test, or negative HIV PCR ("viral load") test -- proves that HIV is not the cause.

Be clear: it can take up to 6 weeks after exposure for a negative AgAb test to become positive. Negative results at say 3 weeks do not exclude a new HIV infection; it only means that HIV isn't the cause of the symptoms. Someone can have new HIV, without symptoms, with a negative blood test result. However, this is a very rare circumstance, and in any case don't apply to testing done at 6 and 10 weeks.

Those comments pretty well cover your specific questions, but to be explicit:  your test results prove you do not have HIV and that something else explains your symptoms. And as just suggested, your symptoms are not at all suggestive of ARS anyway. Finally, it certainly is possible to cause pain by repeatedly massaging various body areas looking for lymph nodes. Finally, I'm not a believer in anxiety causing physical symptoms when nothing is wrong. However, anxiety can dramatically increase the awareness of minor symptoms or even normal sensations that otherwise would not be bothersome or even noticed. And when someone suspects his or her own symptoms have an emotional or psychological origin, usually s/he is right!

So all is well in regard to HIV:  you don't have it and no more testing is needed. If your symptoms continue or you otherwise remain concerned, see a doctor. But no worries about HIV.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

I thank you very much for your reply!

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That concludes this thread. I hope the discussion has been helpful.