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Negative at 12 weeks
Dec 14, 1998

Over a two week period, I had gave unprotected oral sex to the same guy on two separate occasions (no ejaculation, but I now have reason to think he had recently been exposed to HIV). Nine weeks after the last encounter (and almost 11 from the first), I came down with flu-like symptoms that, 5 weeks later, still haven't cleared completely: Sore throat, significant night sweats, glands so swollen it was tough to button some dress shirts, painful red sores on my gums and top of my tounge, a sore back, intermittent low-grade fever (around 99.5 or less), some diarrhea, and an occasional mild headache (maybe due to lack of sleep). I also lost my appetite, dropped about 5 pounds, but have gained most of it back (only weighed 143 to start). No fatigue (except for a couple of days the first week and from sleepless nights), rash, joint pain, congestion, vomitting, or nausea. From what I've read, it sounds like acute retroviral syndrome. I've had no risk factors other than the two mentioned. I've been extremely depressed and worried since experiencing these symptoms and am sure that it is HIV.

I went to my family doctor the first week, and he diagnosed a viral infection, but I didn't tell him about my risk factor. I took an HIV antibody test three days short of the 12 week mark of the last encounter, and it came back negative. I had been experiencing some of these symptoms for 2-1/2 weeks at that point. The two counselors (not doctors) I talked to before and after the test said they didn't think my symptoms sounded like HIV. I know I ought to go see a doctor, but if it is HIV, I don't want to find out until after the holidays, and plus, I'm really scared.

A couple of questions: Any idea how likely it would be to start experiencing ARC symptoms 9 weeks after an encounter, and that last 5 weeks? Second, how much value (if any) should I put in the antibody test at 12 weeks (considering the symptoms)? I read in some of your responses that the new generation of ELISA tests are very accurate and can detect antibodies earlier than before. I wouldn't be worried except for the symptoms. I'm going back for another test at the 20 week mark (in 5 weeks).

By the way, thanks for all the hard work keeping up with the questions on this site. You do a great service to those who post questions here. It is appreciated by many people!

Response from Dr. Holodniy

Although many of your symptoms could be attributed to ARS, it would be unlikely, although not impossible, that symptoms would start 9 weeks after an encounter. After HIV infection, ARS symptoms can last for a few days or several weeks in some people. I would say that a negative test at 12 weeks is very good news. MH



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