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Author Topic: concerned over blood/sex expsoure and symptoms  (Read 8647 times)

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Offline dichotomy73

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concerned over blood/sex expsoure and symptoms
« on: March 17, 2008, 02:58:57 pm »
Hello to all – I started posting on the STD forum, but have since tested negative for all STD’s, which brings me to this forum.  I have posted bits and pieces on other threads in this forum, but I wanted to post my full story since I still have some concerns.  I apologize for the long post, but I want to be as detailed as possible.  Background:  I’m a 33 year old gay male, with a chronic EBV infection.  HIV negative.

21 days ago, I had too much to drink and “blacked out” – I “came to” and a guy was performing oral sex on me.  I had no clothes on at all; he was fully clothed (even had his shoes on).  Very shortly after becoming lucid, I ejaculated.  I don’t know exactly what happened except for the oral sex, however, my anus was not sore the next day at all so I don’t think there was any penetration.  I do not know his hiv status.  After I ejaculated, I became upset (I have a boyfriend) – the guy left right after.  I passed out again; the next morning, when I urinated, there were two drops on blood from my penis.  One drop was dried in a bit of lint or fuzz that must have stuck to my penis.  The other drop was liquid so must have come from inside my penis – but there were no cuts on my penis at all.  I’m not sure if the blood was mine or his.  I also had a small cut on the inside of my lip that was not there previously.  I am not concerned about the oral sex; I am very concerned about the blood exposure, especially since I do not know what happened.

A few days later, I started having mild symptoms - day 3 - sweating, mild stomach pain, a sore in my mouth (it was only there on day 3 - then it seemed to pop - it seemed like a swollen ball in the back of my mouth - and then it was just - gone) - and also a bit itchy in general.

Day 8, I went to an STD clinic and got the full panel.  Since I could only be there for a few hours (I work on a ship), she tested and treated me for everything.  I got a shot of rocephin and a script for doxy.  I have taken doxy before with no reaction.  Rapid HIV was negative.  They would not give me an early PCR b/c I was not local to the area.  Turns out - Syphilis, Chlamydia, gonorrhea, etc – all negative.  So I only took the doxy for about 7 days.
 Day 7&8, symptoms worsened – sore throat, huge swollen neck glands, fatigue, feelings of electric current or really strong pins and needles in my body, mainly in my feet, lower legs, hands and slightly in my arms.  the PN lasted a week (worst at day 10-12) and got so bad I could barely sleep.   I noticed a minor rash on my chest and upper arms at day 12, which is still have today at day 21.  Day 7 – 15, i also have a slight feeling of "burn" in my upper stomach/lower chest - inside though, not on the skin.  my symptoms seem to get much worse in the late afternoon/night - the mornings aren't so bad. i have had insomnia the last few nights and have had to take a xanax to sleep.  i also have very little appetite.  day 7-12 were the worst days for symptoms.  i’ve had brain fog from day 7 – 21. (worst days were 7-14)

at day 14, some symptoms have changed.  the PN has since subsided - now more of a feeling of "falling asleep" along with numbness that comes and goes.  i developed what appears to be thrush (around day 10 - lasting about a week - seems to be going away now) - thick white film on my tongue surface with huge wart-like bumps on the back of my tongue -  my throat felt so swollen it hurt to swallow a bit, although the nodes in my neck had gone down some.  I think the thrush was worsened (or possibly caused) by the doxy.

day 16  a mild headache started, which hasn't gone away (still here at day 21).  i still have mild stomach pain, ongoing since day 4 - day 17-19, I had diarrhea.  the worst part now is the ongoing fatigue and also the pain in my feet - the bottoms of my feet hurt so badly - very sore, but I’ve had very little physical activity in weeks.  The glands all throughout my body are very swollen and sore (groin, underarms, even feels like back of knees - ?), my neck nodes are still swollen but not as bad as they were.  I feel a burning sensation in my swollen groin nodes (started around day 17 and still persistent at day 21).  My neck nodes are not as swollen as before, however, it is somewhat hard to swollen b/c it feels like the inside of my throat is swollen.  I’ve lost maybe 5 pounds.

I’ve had two boyfriends who are positive, and I’ve remained negative, so I’m fairly educated on HIV transmission, etc., and I’m a pretty rational guy – I know the oral sex was low-risk (but not no-risk), but the presence of blood and the absence of memory scare me, especially in light of my symptoms, which could suggest primary HIV infection.  I’ve had the HIV-scare a couple times before during testing, given my risk factors in previous relationships, and I’ve never had these symptoms due to that anxiety.  I do have a chronic EBV infection, which is consistent with some of my symptoms – however, I have never had the PN, nor the thrush, nor the swollen/burning lymph nodes in my groin/underarm with former EBV flare-ups, so I’m concerned.  I am working on a ship and will be here another week, at which point I will get a PCR and antibody test.  if this is primary hiv, my thought is that I had an ebv flare up or even just a flu bug for the first few days I had symptoms, and with a lowered immune system, I could have contracted hiv and started showing symptoms of primary hiv or ARS around day 7.  Now day 21, I still have some symptoms (foot pain, lymph, fatigue) but overall I feel like I’m getting better.  i know some of my symtpoms are some of the more unusual primary HIV symptoms - (e.g. the neuropathy and the thrush) - i'm thinking that if this is primary hiv infection, it could be happening in my case, b/c of the weakened immune system due to the chronic EBV. 

Anyway – just wanted to share my story – I fear the worst, but am still hopeful.  I know testing is the only answer (which I will do when back on land), but I’m looking for some advice or guidance from people who know more about this than i. I feel that, given the blood exposure, if this guy is positive, then I am likely positive.  Given my symptom set, can you guys think of other infections or conditions that could be causing this?  unfortunately, everything seems to point to HIV (even though I know symptoms do not diagnose HIV).  thank you for listening and for letting me vent a bit. 

Offline Matty the Damned

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Re: concerned over blood/sex expsoure and symptoms
« Reply #1 on: March 17, 2008, 03:13:00 pm »
Dichotomy,

Ah, the perils of too much drink! It has a nasty habit of erasing our memories.

Look, I think you've got nothing to be worried about here in terms of HIV, but given that you can't remember what happened an HIV test 13 weeks from the date of this sexual encounter is probably wise.

You should be aware that syphilis also has a 3 month window period so I'd recommend having the full STD screen performed again when go to be retested at 13 weeks.

Now, don't panic I'm only advising you to retest as a technicality. I expect you to test negative at 13 weeks.

MtD

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #2 on: March 17, 2008, 03:47:31 pm »
yes, too much drinking leads to many a bad decision.  unfortunately, hindsight....

thank you for the reassurance.  i will take your advice and test (repeatedly, i'm sure) up thru the 13th week - just to be sure.

however, if not HIV, what else do you think could be going on?  some of the symptoms are general - but the PN (and the thrush if not due to the doxy) in particular seem to me to suggest an infection new to me (non-EBV).

regarding syphilis, wouldn't the shot of rocephin have cleared that up (even if i had a false negative due to the window)?

Offline Matty the Damned

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Re: concerned over blood/sex expsoure and symptoms
« Reply #3 on: March 17, 2008, 04:03:58 pm »
Well, the problem with talking symptoms and HIV is that the symptoms sometimes associated with it are non-specific. Any viral infection could produce similar symptoms. So could lots of other things.

So why don't we stop worrying about symptoms and focus on what happened? You got bladdered, you had some sort of sexual encounter the nature of which you can't recall.

Therefore, get tested at the appropriate juncture.

Doxycycline and Ceftriaxone (rocephin) are used to treat chlamydia and gonorrhoea respectively. They have no effect on syphilis. It sounds like the doctor you saw treated you presumptively for these conditions because you're a sailor. You probably didn't have either but given the nature of your work (ie you're only on shore every now and then) it was a sound medical decision.

Syphilis is treated with injections of penicillin and you need more than one. But let's not get ahead of ourselves, I doubt very much that you have the Pox and testing for that in three months is just a precaution.

The candida and the "peripheral neuropathy" you refer to are most assuredly not caused by HIV, even in the extremely unlikely event that you are HIV positive. PN is commonly a side effect of certain HIV medicines which appears after some extended period of use, and thrush can be caused by any number of things. Including, as you note, anti-biotic use.

MtD


Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #4 on: March 17, 2008, 05:05:41 pm »
hi - me again.  :)  thebody.com and the cdc list PN as a symptom (albeit rare) of primary hiv invection.  pins and needles i have felt with anxiety - what i experienced for about a week was something altogether different - it was much more severe.  i know, i know, stay off the internet and quit self-diagnosing, but this is my only outlet for the next week (and has been for the last 3 weeks) - so it's difficult.

it's also confusing b/c the clinician also told me that the rocephin would take care of syphilis (if i had it).  there is so much mis-information out there, it's tough to know who/what to listen to. 

i'm hoping you are right.  :)

Offline Matty the Damned

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Re: concerned over blood/sex expsoure and symptoms
« Reply #5 on: March 17, 2008, 05:09:53 pm »
it's also confusing b/c the clinician also told me that the rocephin would take care of syphilis (if i had it).

Hey whaddya know? I just checked some sources and there is evidence that ceftriaxone is effective against syphilis. Ya learn something everyday. :)

More properly however, one shot of ceftriaxone still wouldn't deal effectively with syphilis. But that's neither here nor there, I really don't think you need to fret about that.

MtD

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #6 on: March 17, 2008, 07:10:54 pm »
ok - will definitely get the full panel again in 2 more months.  regarding the PN (i'm certain this wasn't just anxiety-related) and the burning & swollen lymph nodes - what else do you think could be going on?  with primary hiv infection, do the symptoms tend to progress or go in phases as mine have/are , or is more of an all-or-nothing, in and out with a bang-type thing?

Offline Matty the Damned

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Re: concerned over blood/sex expsoure and symptoms
« Reply #7 on: March 17, 2008, 07:35:58 pm »
Dichotomy,

Symptoms of primary HIV infection arrive all at once and leave all at once. They don't come and go in an on and off fashion. It's important to remember that many people get no symptoms at all.

We don't do the symptom thing here, rather we focus on risk behaviours and test results. I really don't think you will test positive for HIV at the end of the window period. As for what's causing your symptoms we really can't speculate about that.

You'll need to work with your doctor to determine what is making you ill.

Be well,

MtD

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #8 on: March 18, 2008, 08:49:07 am »
ok - thank you for the encouragement and advice.  i will test in 8 days when i'm off the ship - this will be 30 days post-exposure.   i will try not to stress.  will keep you posted.  thanks again.

Offline Ann

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Re: concerned over blood/sex expsoure and symptoms
« Reply #9 on: March 18, 2008, 09:31:43 am »
Dicho,

The earliest you should test is six weeks, as the vast majority of people who have actually been infected will seroconvert and test postiive by then.

A six week negative should be confirmed at three months. A four week test is a waste of time, money and resources.

Given what you've told us, I expect you to test negative.

Ann
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Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #10 on: March 18, 2008, 10:44:12 am »
hi ann, i am considering a PCR and a standard antibody at 4 weeks.  and then following up with antibody at 6, 8, 12, etc.  is the PCR not reliable?

i certainly hope i test negative!  it's just the blood factor that scares me.  my symptoms seem to be lessening - so at least i am starting to feel better. 

thanks for your advice.  :)

Offline Ann

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Re: concerned over blood/sex expsoure and symptoms
« Reply #11 on: March 18, 2008, 01:54:50 pm »
dicho,

PCR testing is not approved for diagnostic purposes as it has a high rate of false positive results. You do not need PCR testing.

As I said, the earliest you should test is six weeks - and confirm what I fully expect will be a negative result at the three month point.  You seriously do NOT need to go nutz over testing for this - most likely - no risk event.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #12 on: March 19, 2008, 05:29:50 pm »
hi ann,

i have been doing much better about internet-hunting and searching symptoms (honest!)  i've been quite busy with work and feeling better overall.  still some symptoms - fatigue, mild, persistent headache, the soles of my feeta re still quite sore, but the main thing is still the burning, swollen, sore lymph nodes, especially in my groin and underarms (and in the inner upper arm) and the floating numbness.  i found out that i will be going home in a few days - i know you stressed that i do not need PCR testing, but to be honest, i think i'm going to go to a primary care physician and get a full panel - testing for everything - EBV, HIV, etc.  i am certain that there is some infection in my body - i'm hoping this is just a strong flare up of EBV (since i know i have , but regardless, only bloodwork will show what's going on with my body.  the main thing that scares me is the strong PN that i had (and the thrush) - i have never felt anything like it - and i don't know what else could cause it.  the burning lymph nodes, i know can indicate an infection, but i'm still hopeful overall that this is all due to epstein-barr. 

i just received an email from a friend - he tested positive today - although i know his diagnosis is not my diagnosis, it makes the waiting game that much harder - not that he and i ever had relations, but it still hits close to home.  trying to remain optimistic...

by the way, your profile picture looks a lot like a joni mitchell album cover.  :)

Offline Andy Velez

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Re: concerned over blood/sex expsoure and symptoms
« Reply #13 on: March 19, 2008, 05:52:54 pm »
It's good that you're checking out things with your doctor. That way you can find out whatever the real cause is. Which is not going to be HIV.

Cheers,
Andy Velez

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #14 on: March 19, 2008, 08:23:09 pm »
ok - so i'm off the wagon - i've been doing a bit more digging (on this site) - and i've come across several posts where users have stated that they had PN during primary infection.  however, i've also read posts on this site where it is stated that it only occurs after years of med's or in later stages of disease progression.  as stated in previous posts, this is the single most distressing symptom i've had (but i have had most, if not all associated with ARS), as i've never had it before.  the other more general symptoms i have experienced at one time or another (though not all together like in this case) with other infections.  which is accurate - is PN associated with primary infection? 

since there was possible blood exposure, how can my risk be dismissed so easily?  i want nothing more than to be proven wrong - but it's just so difficult in the face of the symptoms and the timing - sorry - i'm having a moment. 

Offline Andy Velez

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Re: concerned over blood/sex expsoure and symptoms
« Reply #15 on: March 19, 2008, 08:41:47 pm »
And if you keep on digging you will absolutely find more to torture yourself about.

You've already received informed evaluations of your situation here. It's not our job to indulge you about everything you drag in from elsewhere on the net.

We expect you to test negative. Your time until you can test would be much better spent staying busy and productive. The time can pass that way more quickly than you may imagine is possible. If you choose however to indulge in looking for more to feed you anxiety that choice is yours. All to no good purpose of course.

Utlimately I expect you to test negative.

Andy Velez

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #16 on: March 19, 2008, 08:47:00 pm »
of course, you're right.  sound advice - which i will try to follow.  i do appreciate the comments provided - i will try to take them to heart.  thank you for your time and support.  i will let you know how it goes.

Offline Andy Velez

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Re: concerned over blood/sex expsoure and symptoms
« Reply #17 on: March 20, 2008, 08:24:50 am »
Ok. Now get busy with other things. You'll see, it works. And if you get anxious, do the good deep and slow breathing which I recommend. That also helps.
Andy Velez

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #18 on: March 31, 2008, 01:00:29 pm »
hello - me again.

ok - so updates...i got home 3.22.  i went to get an HIV antibody test on 3.25 - this was exactly 4 weeks post-exposure.  negative.  since this was still in the window, and since i was still not feeling well, i went to a PCP the same day and got alot of blood work done, including hepatitis, lyme disease, etc, plus an HIV-1 RNA QN PCR test.  (ann - i know you mentioned that i didn't need PCR testing, but since i was at the doctor already, i asked him to test for everything).  everything came back negative (HIV was <400 copies and <2.6 log copies).  doctor didn't test me for EBV titers, even though i asked him to - it was an urgent care center - they were swamped - i think he just forgot to be honest.  anyway, my question:

1.  is a negative antibody and PCR (<400) test at 4 weeks conclusive for HIV, or should i retest at 6 & 13 weeks, to be sure?

personally, given the negative HIV viral load, i think this was a strong EBV flare up, or perhaps another case of mono - the doctor i saw for the results said he thought it was likely mono (even though i have had this before - he said it is possible to get it more than once).   

anyway, please let me know regarding additional testing or if i am in a position to "move on"

also - thank you so much for getting me thru crisis mode - matty, andy, and ann - you were incredibly helpful in getting me thru a rough few weeks - for that i am extremely grateful.  you guys perform an amazing service to so many people who are scared and looking for answers.  and, regardless of the outcome, your presence, guidance, and information makes the process a bit more bearable - thank you so much.

Offline Andy Velez

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Re: concerned over blood/sex expsoure and symptoms
« Reply #19 on: March 31, 2008, 02:22:48 pm »
You already know the consensus here was that you'd test HIV negative. So no surprise there with your result although it's always a happy thing to get a negative test result. I don't see any need for further HIV testing.

Move on with your life.

Cheers,
Andy Velez

Offline dichotomy73

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Re: concerned over blood/sex expsoure and symptoms
« Reply #20 on: March 31, 2008, 02:25:32 pm »
noted - i will put this behind me.  thank you again for the work that you do.

Offline Andy Velez

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Re: concerned over blood/sex expsoure and symptoms
« Reply #21 on: March 31, 2008, 04:01:58 pm »
You're welcome.
Andy Velez

 


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