Exposure to HIV - Symptoms & Testing

[george123]

Dear Andy / Ann,

I am a male. I had an unprotected vaginal exposure in last week of Sept'2011. In mid Oct'11, I had symptoms of fungal infection on penis, sore throat, swollen lymph gland on neck, muscle pains, white tounge, loss of 2 kg weight. Again after 10 days, I had repetition of same ARS symptoms for a week. I did not have fever or rashes yet. The pain in lymph node at back of my neck was on and off these days. I did a blood count which showed lymphocytes at 16%. CD4% came as 27.3% (norms 32% to 50%). CD4 count is 850. Also HIV CMIA (Ab / Ag) test at 52 days came negative. I know its window period. 

Me and my wife have done unprotected sex 3-4 times in Oct'11 but I did not ejaculate inside her. She had a Vaginal abscess in Nov’11. She also had fatigue, headache & muscle pain for few days. She had pain in her right hand above elbow seems to be Epitrochlear Lymph node pain but only once.

In a high risk exposure with ARS symptoms, if an HIV CMIA Antigen and Antibody Combo Test is taken at 7 weeks, what is the reliability of the test?
1. Is it true that sometimes in an infected person, both antigen and antibodies can be below reactive levels at 7 weeks and thus can give a false negative?
2. Is it true that at least either one of Ab or Ag has to be positive at 7 weeks in an infected person?
3. Have you seen anyone testing negative at 7 weeks and then positive at 13 weeks?
4. Is there any co-relation between mine and my wife’s symptoms concerning HIV? What are the chances of getting it?
I will definitely test at 90 days but please let me know your opinion on above 4 queries. Best Regards, Gold bless you.

[Andy Velez]

The bottom line is that with a negative result at 7 weeks, you are likely to continue testing negative. The average time to seroconversion is 22 days. All but the smallest number of those who are going to seroconvert will do so within 4-6 weeks after an exposure to the HIV virus.

Also, although you did have a risk, it is significantly harder to transmit HIV from female to male than the other way around. And you had a single possible exposure.

All of those factors point to my expecting that you will very likely test negative at 3 months.

There is nothing HIV specific about any of your symptoms or those your wife has been experiencing. She should be seeing her doctor about them and you should do the same if they continue.

I expect you to come out of this ok. Just make sure that in the future should you have intercourse outside of your marriage that you always use a condom. No exceptions.

Good luck with your next test result.

[george123]

Thanks Andy for your reply. Can you also guide me on my 3 specific queries in my original thread concerning the 7 weeks test I had? We both have shown to our individual doctors. The doctors just gave antibiotics for 3 days and did not order any STD tests. I am still have lymph node pains throughout the body. I am scared about our family and under huge stress. There is lot of stigma in the country we live in and no one even want to diagnose HIV.

[Andy Velez]

Lymph node problems happen for many reasons and are absolutely not an HIV-specific happening. You need to keep your hands off of them as they are very sensitive to the touch and by squeezing or otherwise bothering them you can create a real problem.

I've already told you that a negative result at 6 weeks is highly unlikely to turn positive at 3 months. And no, I don't see any reason based in HIV science to think there is any correlation between you and your wife's symptoms in terms of HIV.

Your mind is running wild and you are way too caught up details and imagining that everything that is happening or not happening to each of you is yet another indication of HIV.

You need to make a real effort to focus on other matters in your life while waiting to re-test. Don't bother saying you are too worried to do that because that response is not going to fly here. Just do it. You will find the waiting time to re-test can go much more easily and at the end I expect you to come out of this ok. 

[george123]

Hi Experts,

Thanks for your reply. Just to clarify, the lymph node pain in my neck and armpit is coming and going by itself. I never touch them or press them to feel so. Today I have given 2nd HIV test at 81 days. Result is awaited on 18th Dec. The problem is that the lab receptionist does not know whether it covers both HIV 1 and 2. I hope a HIV CMIA Antibody test covers both HIV 1 and 2.

Are these symptoms common with Syphilis or HSV? When can we test for these 2 STDs? I heard a blood test can be done only after 3 months for syphilis. I heard that after healing initially they can still be present in body even if there are no visible symptoms on genitals after 2 months.

I definitely involve myself by remaining busy at my job and spend time with my family but the fear and anxiety is not just going away due to lymph node pains. I never experienced such pains in 33 years of my life.

God bless you. Thanks & Regards.

[george123]

Dear Ann,

Can you also share your thoughts on my case as you appear to be online if you are not occupied in something else. Thanks in advance.

[Ann]

George,

Most STIs can be tested for at a week to ten days (or later) after an incident. Syphilis shares a three month window with hiv for a conclusive negative result.

Nothing you are reporting sounds like primary hiv infection. It does sound like you may have picked up some other, more easily transmitted STI. We cannot tell you which one, you'll have to be diagnosed by a doctor.

I fully expect you to continue to test hiv negative.

Ann

[george123]

Thanks Ann. I will post my result on 18th Dec. I am Expat living in North Africa. We really have language issues here as the locals don't speak English well and I really have doubts whether the labs cover both HIV 1 & 2. I hope it covers both. I am praying to god for my results and keeping my fingers crossed.

I really want to return to a monogamous relationship with my wife and never want to go out of marriage again. Hope god will give a chance to live life with my family again. She will really break with me if I am positive. I am scared on how will I communicate to her about my situation. I really can not imagine my life without her and If I infected her, I can not forgive myself.

Regards, George

[Ann]

George,

I'm pretty sure the test you mentioned tests for both hiv1 and hiv2 - most of that type do test for both. Ask the doctor next time - it will be printed on the box the test kit came in. The receptionist is not likely to have access to this information.

Epidemiological studies have shown that hiv2 is more difficult to transmit anyway - that is why it is much less prevalent than hiv1. You are not likely to be infected with hiv1 either, as hiv (either type) is much more difficult to transmit from a woman to a man during unprotected vaginal intercourse. I would not expect you to be infected from a one-off.

With that seven week negative, you are highly unlikely to go on to test positive. So chill.

Ann

[george123]

Hi Ann,

Last week, having strange symptoms in addition to lymph pains. Some teeth pain, abnormal bowel sounds at night, face itching at night, a new black mole at lower back, etc.

Can you pls tell me what are the symptoms from 3 months to 1 year in positive people. I will need some time to tell my wife and my employer if I test positive. Need to know whether I will have normal health for next 9 months or I mean can I delay treatment as I have to travel back to my home country.

[george123]

Also one more query. Do we have any data, when did (at which time period) the majority of positive people in the world tested positive actually? I mean if majority tested positive after 3 months, we cant really rely on 7 week results.

[Ann]

George,

There's no point in describing anything to do with early hiv infection. Most people experience absolutely nothing at that stage.

Your seven week negative is NOT going to change. If all those symptoms you started having in October had anything to do with hiv, your seven week test would have been positive. It wasn't.

You need to chill out and stop thinking you're going to test positive. You are NOT.

If you feel unwell, see a doctor. It has nothing to do with hiv.

In response to the question you asked while I was typing...

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days. A six week negative is highly unlikely to change, but must be confirmed at the three month point.

The window period remains at three month to catch the RARE person who takes a little more than six weeks to test positive. I fully expect the window period to be changed to six weeks sometime in the next few years.

Ann

[Andy Velez]

George,

There's no point in describing anything to do with early hiv infection. Most people experience absolutely nothing at that stage.

Your seven week negative is NOT going to change. If all those symptoms you started having in October had anything to do with hiv, your seven week test would have been positive. It wasn't.

You need to chill out and stop thinking you're going to test positive. You are NOT.

If you feel unwell, see a doctor. It has nothing to do with hiv.

In response to the question you asked while I was typing...

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days. A six week negative is highly unlikely to change, but must be confirmed at the three month point.

The window period remains at three month to catch the RARE person who takes a little more than six weeks to test positive. I fully expect the window period to be changed to six weeks sometime in the next few years.

Ann

You keep grabbing on to physical events which you continue to misinterpret as ANOTHER SIGN OF HIV, when they aren't. Ann has given you the real deal. You don't seem to be listening or willing to believe what she has told you after evaluating the situation.

[george123]

Thanks Ann and Andy both of you. God bless you.

[Andy Velez]

You're welcome. We don't see HIV as your problem. Discuss those various symptoms with your doctor to determine the real cause if they are persisting.

[george123]

Dear Ann / Andy,

Today I had my 81 days HIV antibody only test and it was negative. The lab told me this was a CMIA Antibody test which covers HIV1. However, I feel that the lab guy might not be knowing the details because they send the blood samples to their head office as they don't test HIV / Immunology cases at branch office as it needs professional handling.

The CBC is also normal at 81 days. The RBC is normal. In WBC, lymphocytes are 33% with absolute count of 2271 (both well within normal range).  One month back only the lymphocyte was 16% only. The neutrophils and segmented results are also within normal range.

Relaxed a bit after more than 2 months of stress and worries. Glad that I have not infected my innocent wife and will carry on only a monogamous relationship with her. More happier to note that I will not loose my wife and my kid.

Just want to thank both of you for helping me and also helping hundreds of thousands of people like me on this forum by tirelessly putting your time and energy in answering their questions and repeated queries. I know this is not an easy task and needs lot of dedication and compassion.

Further by this thread, for many of curious users who face similar symptoms like ARS after a potential unprotected exposure the way I faced them virtually all, I want to tell them that still there is a possibility of being not infected with the virus. The tests only can confirm. Still why we face ARS like symtpoms after unprotected sexual exposure only and not through out anytime past in our life remains a mystery for me.

Just want to re-iterate your advice to all users, "sex is for few minutes, the virus is forever, do not indulge into unprotected sex at all, always use a condom". After few days I even forgot how enjoyable was my sexual exposure and what did I get from it after these 2 months of pains.

Hope there is no need for me test after 90 days or do I need to test for HIV 2 at a different lab after 90 days. Do I need test like PCR Viral load to exclude any rare strain of HIV as I live in North Africa and Africa is known to have rare strains?

[Andy Velez]

In relation to HIV all of those various blood test results are irrelevant. It's the HIV test that matters and you are consistently coming up negative.

As I see it your sense of guilt over having strayed is making this situation much more complicated than it actually is. You have actually reliably tested negative for HIV. Re-testing at 90 days is just a matter of form to confirm the negative results you already have just for your peace of mind.

Ann suggested you discuss the issue of any other possible STDs with your doctor. We can't diagnose anything in this setting and our focus is strictly on HIV here.

I don't expect anything other than another negative test result for you at 90 days, which confirms that you don't have an HIV problem. Period.