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Concerned about symptoms and possible exposure after drinking too much
Nov 7, 2011

Dear Dr. Fawcett,

I recently was very drunk and may have made a bad decision in terms of drugs. I have never used IV drugs before, however the next morning after imbibing a very unhealthy amount, I woke up with a bump on my arm that was round, red and protruding. I didn't think much of it at the time, however after 3 days, it formed a scar. It was not in a location where a vein is, and I didn't feel like I had taken any unknown substance the next day, yet the feeling that I could have made a bad decision persists and will not go away no matter how rational I try to be. Now whether or not I actually poked myself or allowed someone else to poke me with a needle is not my question, although it is the source of most of my anxiety as I cannot remember exactly what I did that night.

I received a 4th generation test 4 weeks after the risk event which was negative. After 5 weeks, I developed a headache, sore throat and slightly enlarged lymph nodes. A couple of days later I took my temperature which was normal, and since then, it has ranged from 97.5 to 99.4 in the last 2 weeks since initial symptoms. Right now it is under 98.6.

After 6 weeks (last night), I woke up 4 times during the night with an itchy raised hive, meaning they came all at different times and not at once, 3 located on my shoulder and one 6 inches away on my upper arm, I thought they could be from bug bites, but I see no puncture wound that would suggest that. They look consistent with pictures of what I have found on the internet for an HIV Rash. I also have had a fungal infection for about 6 months now that was present before the risk of infection. I have not seen any remarkable increase of fungal production, as one might expect with the onset of ARS. Is that assumption right? Would one expect the fungal growth to increase during ARS? I may or may not have oral thrush and cannot trust myself to accurately diagnose it.

I will be testing again in 3 days at the 6 and half week mark. My question is are my symptoms consistent with acute HIV Infection?

Thank you in advance for your response.

Response from Dr. Fawcett

Thanks for writing. The symptoms you describe are consistent with HIV, although usually with the acute phase which occurs 2 to 4 weeks after infection. They have been known to develop later, so you should continue to be followed. Fungal infections related to HIV typically occur after the immune system is weakened, which I wouldn't expect to be the case after 6 weeks. A fourth generation test will detect antigens and therefore identify infection at an earlier phase. Continue to discuss these symptoms with your physician and I would recommend testing through the six month window since you don't know exactly what happened.

Now, about your drinking. If you are having blackouts you have already progressed beyond the point of social drinking. Hopefully you were lucky this time, but I would certainly get some support to assist you with this problem. You can find more information about support group meetings in your area through Alcoholics Anonymous and Smart Recovery.

-David



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