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Hiv & Non-Hiv Related Meningitis

Nov 12, 2011

Dr. Young, I apologize that this isn't the appropriate forum for this question. However, I've noticed on this site and elsewhere that you have insight on the subject, so I'm hoping you might still provide a response. I'm also in China, and haven't been able to talk with a doctor due to fear of the political situation with HIV.

Basically, can there be any clinical signs that can differentiate Hiv & Non-Hiv Related Meningitis? And how long after showing meningitis symptoms should one wait to take a test? 2-3weeks?

I ask because I had high risk situation 6 months ago. I tested negative at 13 weeks and 2 days short of 24 weeks (oral swab). I was about to move on with my life when I came down with viral meningitis at week 26. At first it seemed like a stomach problem (mild periodic cramping or bloating), which turned into feverishness and chills with mild headache, slight pain w/ moving one of my eyes, and mild aches for 4-5 days. Then, I developed the stiffest neck, sometimes I could not even move it more than an inch. By day 7, all symptoms have gone away except the neck stiffness and pain. On day 9, the neck stiffness begins to subside.

With these symptoms alone, would you suspect an HIV infection? When could I take another home test to know for sure?

Response from Dr. Young

Hello and thanks for posting.

While HIV can cause a meningitis, if it occurs, it typically does in the setting of acute infection. Further, HIV symptoms typically are also associated with fever, rash or swollen lymph nodes. Since you had negative antibody tests at 24 weeks after your possible exposure, we can safely conclude that you are HIV negative.

The stiff neck that you experienced, it very likely what we'd call a non-specific viral meningitis, and the limited nature of the symptoms is reassuring, rather than alarming.

So overall, I don't suspect HIV infection. Unless you've had other HIV exposures in this period, I don't think that you need to retest, other than our usually recommended annual tests for people who are sexually active.

I hope that helps, BY

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