[Question #9916] HIV Tests and Symptoms

27 months ago

Hello Drs,

On 09 Jan 2023, Had a sexual with a CSW, had unprotected oral sex, for about 2 minutes, after that we had protected vaginal sex, after the sex, the condom looked like ok.

I looked at the internet, and saw the insertive oral sex is or very low risk ou zero risk,

I relaxed about de exposure until I return to my GF, about 5 weeks after the exposure.

At 7 weeks I feel a little node in my armpit also noticed geographic and white tongue, both my armpits started to pain, felt a lot fadigued,

I had night sweats at weeks 9 and 10, I was not sleeping well, waking up during the night thinking about HIV, seraching in the google to make me feel better, also I had that time some muscle aches, arms and legs, but not all the time.

At the 11 and 12 weeks I felt a little scratching throat, and at 13 week I feel my thigh very painful, I noticed a node, in the back of my thigh and felt my groin unconfortable.

Now I am at 15 week after the exposure, My thigh muscle still pain, and my armpits some days pain others not.

My negative tests:

- 35, 46, 74 and 81 days Self blood test surecheck

- 53 and 91 days Self blood test Panbio Abbott

- 55 (0.08), 59 (0.08) and 84 days (0.07) CMIA AgAb test from Lab

- 65 days ECLIA AgAb test from another lab (0.21)

- 100 days rapid 3rd gen test from testing center of my city - Abon (abbott)

Had others STD tests on day 65 all negative.

1- My tests are conclusive?

2- Do you think my symptoms are related to ARS HIV?

3- Do you think I need more tests?

H. Hunter Handsfield, MD

27 months ago

Welcome to the forum. Thank you for your confidence in our services.

One of the most common kinds of questions on the forum concerns symptoms that make people worried about HIV in the presence of negative HIV test results. Our reply is always similar and is what I now have for you. First, the symptoms of a new HIV infection (called acute retroviral syndrome or ARS) are "nonspecific" -- that's medical terminology for something that doesn't point to any particular condition. The symptoms of ARS occur in hundreds of other medical conditions, most of them minor and almost all of them more common than ARS itself, even in people potentially exposed to HIV. That is, none of your symptoms really suggests HIV, despite what you think you have learned, perhaps by online searching.

Second, it is not possible to have ANY symptoms of HIV in the presence of negative blood tests. It isn't HIV itself that causes symptoms, but the immune system's response to the virus. If symptoms are due to HIV, then within a few days of the first symptom, the HIV antibody ALWAYS is present and detected in the standard blood tests.

In addition, it is true that "insertive oral sex is very low risk or zero risk" for HIV. In fact, "zero" is probably right. To date there has never been even a single reliably reported case of HIV transmitted oral to penis.

Those comments pretty well cover your specific questions, but to be explicit:

1- Yes your test results are conclusive. (You have been seriously over tested. Indeed, even with your symptoms, had you been my patient I would have advised no testing was even needed.)

2- No. Your symptoms are not possibly due to ARS or HIV.

3- For sure no further HIV testing is needed.

If your symptoms continue or you remain concerned, see a doctor to sort it out. But you can stop worrying about HIV.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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27 months ago

Thanks Dr

On week 5 and 14 after exp I had protected sex with my GF, but in both (week 5 and 14) I fingered her, and I had a little cut in my finger close to the nail, not bleeding, 5 days after the second time, she had fever, sore throat, throat plaques and body aches, she and take benzetacil injection, now 3 days after the injection she is very well (worried me about ARS)

1. Even if the condom wasn't intact, my results are conclusive?

2. what worries me most, My both armpits are painful, for almost 2 months, sometimes I feel nodes, but most I cant feel, and sometimes one thigh is painful, it could be anxiety?

3. If I Had, any STD, the events I described would be zero risk for my GF?

H. Hunter Handsfield, MD

27 months ago

1. Lab test results of course are not affected by the kind of risk or how high the risk was at the time of exposure. In any case, HIV is not transmitted by fingering, ever -- regardless of cuts and wounds on the finger.s

2. Your test results prove that HIV isn't causing your symptoms. I'm sorry your armpits hurt, but that's not even an HIV symptom anyway.

3. I won't speculate about something that has no basis in reality. You cannot have HIV, so you cannot possibly infect your partner.

Yes, many or most of your symptoms could be the physical manifestations of anxiety; or of anxiety magnifying minor symptoms or normal body sensations that otherwise would not bother you and maybe not even be noticed.

You do not have HIV. Please do not ask anything more about things that make you feel you might have it anyway. My replies will not change! See a doctor about your symptoms if they continue or you remain concerned. Also re-read my comments above.

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27 months ago

Thanks for being so helpful Dr Handsfield, recently Im reading yours and Dr Hook's answers, to feeling better.

I have done different tests to peace my mind, 2 different labs (4th gen test), a rapid 3rd gen IGG and IGM, because the symptoms worried me.

Several years ago already had anxiety for another low risk exposure. But I had few questions only for a little bit more peace of mind:

1- Only a rapid AB blood IGM iGG test would be conclusive after 90 days?

2- Is it possible, only my last symptoms after week 11 or 12, being HIV ARS?

3- I have read a reply from you, the lymph nodes from ARS usually are painless, correct?

4- Should I test for mono?

5- Do you recommend another kind of test to be 100% in peace? maybe RNA?

27 months ago

Im from Brazil, 33 years old, the last question,
The tests are standard for over theworld correct? Here in Brazil the window period usually is 60 days.

H. Hunter Handsfield, MD

27 months ago

The various HIV diagnostic tests are pretty much the same world wide, especially in medically sophisticated countries like Brazil. The window periods for the various tests are identical everywhere, regardless of the standards espoused by various public health agencies and other authorities. The data on 45 days (or 6 weeks) for the AgAb tests are very solid and universally accepted by HIV/AIDS experts-- including, I am sure, HIV/AIDS experts in your country.

Questions 1, 2, 3 and 5 are addressed in my comments above, or the replies should be obvious. 1) Yes for sure conclusive by 90 days, actually 6-8 weeks for most tests. 2) Therefore your test results prove your symptoms are not caused by ARS. 3) True, but this doesn't matter since your test results are conclusive. 5) You have been seriously over tested already and I would advise no further HIV testing of any kind.

4) Infectious mononucleosis symptoms are almost identical to those of ARS, but your symptoms are not typical of either one. However, if you remain concerned, you could discuss evaluation for mono with your doctor. Something to discuss with your personal physician.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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