Nov 19, 2007
I am normally very health conscious, exercise regularly, eat well, and almost never feel ill, get colds, etc. About a month ago I began feeling extremely tired all the time and had a weird skin sensitivity all over my chest, abdomen, and upper back. There was no visible rash. It felt very much like I had a bad sunburn, but only in those areas (sensitive to touch, kind of a burning sensation. I had no fever when checked, but felt like I might have had a mild fever at times. I had some headaches, and strange pain in my eyes. My eyes kind of ached if you pressed on my eyelids lightly or if I moved my eyes up or down very far. After about 5 days of this I went to my doctor and an HIV quick test was performed which came out negative. Many other test were performed which all came out normal, except my WBC's were "slightly" below normal. I was then sent to an eye doctor who said there was "some" swelling of my optic nerve, but it was not very significant. Because my father has MS they decided to admit me to the hospital to expedite various tests. I was given a CT scan and brain MRI to rule out signs of MS-both came out okay. They also did a spinal tap to r/o meningitis and that also came out okay. All other blood tests and standard screenings came out negative, but my symptoms continued. I was released from the hospital and everyone seemed to be baffled at the cause. I was to return to be monitored and have more tests done. My fatigue began to subside 12-14 days after it began. The eye pain also went away, but the skin thing seemed to persist, but eventually lessened. Eleven days after the antibody test I was given a Western Blot which was done twice (split sample) and this came out positive and confirmed with an ELISA. I am waiting now for the results of a viral load.
1. Is this definitive or should another round of tests be performed? Is it strange that the anti body test changed from neg to positive in that time frame or is that expected?
2. When was I likely exposed?
3. Are any common causes of false positives suggestive in all of the aforementioned?
4. I had unprotected anal and oral insertive and receptive sex 7-10 days prior to my symptoms first starting with a regular partner and no one else. We both tested negative within the last 90 days and only have unprotected sex with each other. We do, however, have unprotected oral sex with other people. The partner tested negative to an antibody test yesterday. This person is very worried because we had unprotected anal sex (I came in him orally and anally) after my negative AB came back and before the Western Blot. This was immediately after my symptoms began to subside and I was feeling better. Obviously, the choice to have unprotected sex was not wise (so save your remark about that please). When should this person get retested and with what kind of test? I'm guessing your response will be "test again in three months," but is there any way to have more information before that is appropriate and reliable given the situation as described?
5. If I contracted the virus from him, wouldn't his antibody test be positive as of yesterday?
Response from Dr. Frascino
Your situation is a bit confusing and obviously still evolving. I agree your decisions to have unprotected sex were not wise and no, I will not "save my remark about that" because this is an HIV information forum dedicated to HIV awareness and prevention. I'm hopeful that other guys considering unsafe sex read my comments and your story and subsequently decide to use a condom instead of going bareback to avoid winding up in a predicament exactly like yours.
To answer your questions:
1. I always recommend a positive HIV test be confirmed. Regarding the change in antibody status, no, this is not unexpected if you were experiencing acute retroviral syndrome and seroconversion.
2. You would be able to answer this question far more accurately than I can.
3. You can read about false-positive HIV tests and the potential causes in the archives. I have nothing to add to those comments.
4. Your partner should retest three months after the last potential exposure.
5. If your partner was still in his window period, he could be highly infectious (high viral load), but still test HIV-antibody negative.
I'm hoping your positive test was a false positive and that your partner's test remains HIV negative. However, in light of your risk behavior and test results to date, obviously close follow-up and additional evaluation for you both is absolutely warranted.
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