Recently Tested Pos, Displaying Symptoms Again

[muchfun]

Hi,

I tested positive nearly 5 weeks ago now, early on in seroconversion (prob around 2.5 weeks after infection). I had pretty much every documented symptom under the sun, rash, sore throat, sweats, fever, dry hands and feet and so on. The rash dis sapeared after 14 days, as did the sore throat etc. The fever episodes were getting milder and less frequent, but all in all i still hadn't fully bounced back as of last weekend (coming up to four we eeks seroconversion illness). My CD4 count was very low at 210 (40%)when tested in the first week of the illness. 2 weeks later it was tested again and had risen to 460 (10%). I foolishly went out last Saturday night, drank a bit excessively and had a late night. The following day i was back to feeling as rough as i had done, fever back, and that has lasted the entire duration of this week. Symptoms this time were also as though i was fighting a slight cold, as mucousy in the nasal passage, and a very slight chesty cough. As the week has progressed (but largely today) the early symptoms have returned, the rash, ulcerated tonsils, dry hands and feet etc...

I was infected by my hiv+ partner (who did not know at the time). We immediately stopped unprotected sex as per advice. 2 days ago he did ejaculate on my anus, of which i later found a sore near the entry. I am concerned this has caused a super infection and the cause of my most recent symptoms. Is it likely that even though we have the same strain, his could have mutated within the last 5 weeks? With my weakened  immune system, would seroconversion illness be evident within a day or two if so? Or is it more likely that pushing my body a bit to hard last weekend has caused my immune system to weaken again, possibly with fighting a secondary viral infection, and therefore showing the early signs of infection again?

I hope this makes sense 

Many thanks,

[mecch]

hey I'm not expert.  just sharing my experience:

My ID said super infection is quite rare, but, when it does happen, it can be early in primary-infection. However, the act that concerns you was two days ago, this seems to be worry, on your part. And maybe excess stress on your system. And maybe you picked up a bug.

Secondly, seroconversion is not standard experience. Can be unnoticed. Can go on for several weeks.

You are in primary infection until your CD4 and viral loads stabilise at some set point.

I think you should be asking your doctor these questions, if you have access to him/her.

If you were identified in seroconversion, as I was, it seems to me you should be having closer contact with your doctors until your health stabilises....   If you have ulcers (a "sore") you might be asking your doctor to explain them.

Sounds like you had a rough seroconversion.   Maybe calm down on the drinking and late nights until you are fit again.

[muchfun]

Thanks mecch,

Yes, it has been a pretty rough seroconversion illness . It is a question i will pose to my doctor. I guess that will have to wait until tomorrow. I was just hoping for some reassurance to stop me from stressing.

My hope is that my stupidity last weekend has set me back, and a second viral illness has knocked my immune system so it's low again. I am not sure whether you can display those early symptoms for a second time in the same period of sereconversion illness if your immune system gets knocked, or whether it would more worryingly be a second HIV infection. Also, as it is the same partner that infected me in the first place, would the 5-6 weeks of protected sex give his strain a chance to mutate enough in order for it to infect me with a second strain?

From the occasional studies i have come across there is a suggestion that regular unprotected sex with you HIV partner does not lead to superinfection. I guess the problem there is what is regular... and realistically, how long does it take for a strain to mutate sufficiently into a new strain with no medication.

Stress stress stress...

I shall be taking it exceptionally easy from now on!

[Ann]

Much,

The super in superinfection does not mean "super-duper", it is a prefix, as in superimposed. It means one infection on top of another. If you were infected by your partner, he cannot cause you to have a superinfection. That would take someone else with a different strain of the virus. So, unless you've been out barebacking with other people, you are not experiencing superinfection.

In fact, if you two are monogamous and don't have other pre-existing STIs, there's no reason you need to use condoms now. The horse is already well and truly out of the barn. I bareback with my partner (from whom I got my infection) all the time and it's never been a problem.

As for your symptoms, it sounds like you're run down and your original infection is still playing havoc with your body. Get in touch with your hiv doc first thing monday and explain what's going on.

Ann

[chguy78]

Ann, I'm not wanting to hijack this thread but I wanted some clarification on one of your statements:

In fact, if you two are monogamous and don't have other pre-existing STIs, there's no reason you need to use condoms now. The horse is already well and truly out of the barn. I bareback with my partner (from whom I got my infection) all the time and it's never been a problem.

I'm not worried about ALL possibilities: just ones that have a higher probability of occurring.  I was infected by my partner and we are monogamous: the chance is low for either of us to be infected with a resistant strain from the other?  We are on different medication (one is on Truvada+Kaletra, other Truvada/Reyataz/Norvir) and that's what worried me.  Incidentally, we've been tested for every other STI under the sun and all have come back negative.

Thanks!

[Ann]

ch, as long as you two are undetectable, I wouldn't worry about it. My partner is on meds, but I'm not and never have been. If he became resistant to one of his drugs, I would only worry about it myself if I still was not on meds. If that were the case, I might consider condoms, but probably wouldn't bother. If I was on meds and was undetectable myself (when he developed a resistance), I wouldn't worry about it.  You'll have to make your own judgement call on this. When in doubt, talk to your hiv specialist. (and yes, I have discussed this issue with our own specialist - we have the same doc - and he supports our decision)

There have only been a couple - a handful at most - of documented cases of reinfection/superinfection. In all cases, the person was dealing with a new initial infection. This is why I wouldn't worry myself if my partner became resistant. I've been poz for years and my body is well used to dealing with the virus.

Much, I realise this is the case with you, but the people who ended up with superinfection had more than one partner. It's highly improbable that your partner's virus could have mutated that quickly, unless he was on meds and developed sudden resistance. It doesn't sound like that's the case with you two, as he was only recently diagnosed himself. It takes time to develop resistance.

Ann

[chguy78]

Thanks, Ann, and sorry, muchfun, for hijacking your thread.  My ID specialist recommended using a condom but she said she does so mostly due to the possibility of passing other STIs due to the possibility of "open" relationships. Whether the other partner knows it's open is another story :-)

[muchfun]

Thanks all, you have set my mind at ease. Hopefully i shall sleep a little sounder tonight, and speak to my dr tomorrow. I suspect i have caught a secondary illness whilst my immune system was so low, and that has knocked me back to a very low cd4 count again.

Oh well, stay positive

[Ann]

Thanks, Ann, and sorry, muchfun, for hijacking your thread.  My ID specialist recommended using a condom but she said she does so mostly due to the possibility of passing other STIs due to the possibility of "open" relationships. Whether the other partner knows it's open is another story :-)

Yes, sometimes relationships can be open on one side only, with the other side being in the dark.

At this moment, my bf is in Thailand with a mate of his. He has my permission to indulge in a bit of trade if he so desires - but only with condoms. In fact, I bought him a dozen to take with him and made sure they were in his bag. He knows that if he brings home anything that could have been prevented with condoms, I'll rip him a new one. Having an open relationship doesn't necessarily mean you can't still have sex your own way when it's just between the two of you - you just have to make sure everyone knows and respects the ground rules. And you have to have the trust that the ground rules will be respected and followed. We do have that trust.

Ann

[Ann]

Thanks all, you have set my mind at ease. Hopefully i shall sleep a little sounder tonight, and speak to my dr tomorrow. I suspect i have caught a secondary illness whilst my immune system was so low, and that has knocked me back to a very low cd4 count again.

Oh well, stay positive

Much, good luck with the doctor tomorrow and keep us posted.

Ann